What You Need to Know About the New AAP Child Seat Guidelines

The American Academy of Pediatrics has dropped the age milestone that children should remain rear-facing until age 2, and replaced it with the new recommendation that children should remain in a rear-facing car safety seat as long as possible, until they reach the highest weight or height allowed by their seat.

The past decade has seen an incredible dramatic evolution in improvements to child passenger safety. Never-the-less, motor vehicle crashes continue to be the leading cause of death for children ages 4 and older.

baby in rear facing car seatAccording to Dr. Benjamin Hoffman, MD, FAAP, lead author of the policy statement and chair of the AAP Council on injury, Violence and Poison Prevention, “Car seats are awesome at protecting children in a crash, and they are the reason deaths and injuries to children in motor vehicles have decreased”. However, according to the AAP, what many parents don’t realize is that each transition – from rear-facing to forward-facing, from forward-facing to booster seat, and from booster seat to seat belt alone – reduces the protection to the child.

Using the right car safety seat or booster seat, says Dr Hoffman, lowers the risk of death or serious injury by more than 70 percent.

When a child rides rear-facing, the head, neck, and spine are all supported by the hard shell of the car safety seat, allowing the car seat to absorb most of the crash forces, and protecting the most vulnerable parts of the body. When children ride forward-facing, their bodies are restrained by the harness straps, but their heads – which for toddlers are disproportionately large and heavy – are thrown forward, possibly resulting in spine and head injuries.

According to Dr. Hoffman: “if you have a choice, keeping your child rear-facing as long as possible is the best way to keep them safe.”

Here is what the American Academy of Pediatrics is recommending:

  1. Infants and toddlers should ride in a rear-facing car safety seat as long as possible, until they reach the highest weight or height allowed by their seat. Most convertible seats have limits that will allow children to ride rear-facing for 2 years or more.
  2. Once they are facing forward, children should use a forward-facing car safety seat with a harness for as long as possible, until they reach the height and weight limits for their seats through at least 4 years of age. Many seats can accommodate children up to 65 pounds or more.
  3. When children exceed these limits, they should use a belt-positioning booster seat until the vehicle’s lap and shoulder seat belt fits properly. This is often when they have reached at least 4 feet 9 inches in height and are 8 to 12 years old.
  4. When children are old enough and large enough to use the vehicle seat belt alone, they should always use lap and shoulder seat belts for optimal protection.
  5. All children younger than 13 years should be restrained in the rear seats of vehicles for optimal protection.

One of the most important things a parent or caregiver should do is to read the manufacturer’s manual and labels for that particular car seat to find the correct weight and height limits. When a child is approaching one of those limits, it is time to think about transitioning to the next stage.



About the Author

Stefanie Zucker is President and co-founder of Pediatric Medical and Managing Director and co-founder of Axios Partners, a strategy consulting firm. After a number of years spent researching the safety issues associated with transporting children on ambulances she became a child health safety advocate and formed Pediatric Safety with a goal of creating a world-wide movement of parents and caregivers inspired to protect the health and safety of kids. Stefanie is a member of the PedSafe Team


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