Key takeaways for parents in preparation for Child Passenger Safety Week is 

Sept. 23-29, 2018

• Children should ride properly restrained on every trip, in every type of transportation, beginning from birth.
   
• Rear-facing is the safest way to ride. Parents should keep children rear-facing as long as possible until they fit within the weight and height limits set by the manufacturer of their car safety seat.
• While parents look forward to children moving from one milestone to another, car seats are one area where delayed transitions are best. Each transition – from rear-facing to forward-facing, forward-facing to booster – lowers the child’s protection in the event of a crash.
   
• When a child rides rear-facing, the head, neck, and spine are all supported by the hard shell of the car safety seat and all move together, with little relative movement between body parts. 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.

What is the change in recommendations?

• Previously, the AAP recommended children should remain rear-facing at least to age 2; the new recommendation removes the specific age milestone.
• The prior recommendation to keep children rear-facing to age 2 was based in part on a study that found lower risks of injury among children ages 1 to 2 years who were rear-facing. That data was supported by biometric research, crash simulation data and experience in Europe where children ride rear facing for longer periods. However, in 2017, questions arose about the original study, and it was retracted by the journal Injury Prevention. A re-analysis of the data found that while rear-facing still appeared to be safer than forward-facing for children younger than 2, the injury numbers were too low to reach statistical significance.
• This means we don’t have a large enough set of data to determine with certainty at what age it is safest to turn children to be forward-facing. If you have a choice, keeping your child rear-facing as long as possible is the best way to keep them safe.
• The AAP decided to update its recommendations to reflect how the science has evolved.
• Fortunately, car seat manufacturers have created car seats that allow children to remain rear-facing until they weigh 40 pounds or more, which means most children can remain rear-facing past their second birthday.

Facts about car seats and motor vehicle injuries:

• Motor vehicle injuries are the leading cause of death among children in the United States. (CDC)
   
• In the United States, 633 children ages 12 years and younger died as occupants in motor vehicle crashes during 2015 and more than 132,000 were injured. (CDC)
   
• Of children ages 12 years and younger who died in a crash in 2015, 35 percent were not buckled up. (CDC)

• Child safety seats are often used incorrectly. Approximately 59 percent of car seats and 20 percent of booster seats are installed or used incorrectly. (CDC)

• Car seats reduce the risk of death in car crashes by 71 percent for infants and 54 percent for toddlers ages 1 to 4.  Booster seats reduce the risk for serious injury by 45 percent for children ages 4 to 8 years.  (CDC)

Child Passenger Safety Week culminates with National Seat Check Saturday Sept. 29. Certified child passenger safety technicians will be available at car seat events nationwide to provide safety tips and car seat installation instructions to parents and caregivers.

Car Seats: Product Listing for 2018

My bottom line and practical advice is to let your toddler ride in an appropriate rear facing car seat until he/she doesn't fit any more (knees are almost in your child's face).

Dr. T