In my role as a Child Passenger Safety Specialist, I work with lots of families who are preparing to take their baby home from the hospital. Most people understand that a newborn must ride in a rear-facing car seat (and never in front of an active airbag). But when is it safe to turn your child forward-facing? The American Academy of Pediatrics (AAP) recommends that infants and toddlers ride in a rear-facing car safety seat as long as possible, until they reach the highest weight or height allowed by their car seat.

Why rear-facing?

Here’s some information from AAP about why rear-facing is so important:

“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.”

What kind of rear-facing seats are there, and how should I use them?

Many families begin with a rear-facing only (“infant”) seat. When your child reaches the highest weight or height allowed by this seat (or it becomes too difficult for you to carry or lift into/out of your vehicle), your child should move to a convertible or “multimodal” (3-in-1, 4-in-1, or all-in-one) car seat.

Install a convertible or multimodal seat rear-facing and keep it that way until your child has reached the maximum weight or height, according to the manufacturer’s instructions. The majority of these kind of seats allow rear-racing to at least 40 pounds, or even higher.

For a rear-facing car seat, there must be at least 1 inch of room between the top of the child’s head and the top of the car seat. The manufacturer may also supply a specific number (in inches and centimeters), or indicate a harness slot above which the child must ride forward-facing.

Note that for some car seats, you may need to switch from using the lower anchors to the seat belt for a safe installation for a larger child. Refer to the car seat labels and instruction manual and the owner’s manual for your vehicle, for more information.

Make sure if you are getting a seat labeled “3-in-1,” it is a seat that can be rear-facing, forward-facing with a harness, and a booster seat. Some seats that are labeled as “3-in-1” refer to a forward-facing harnessed seat that can become a booster with or without a back.

Wait – what about legroom?

As the AAP says:

“Children can bend their legs easily and will be comfortable in a rear-facing seat. Injuries to the legs are very rare for children facing the rear.”

A crash that could cause leg injuries would also be highly likely to cause more severe head, neck, and spinal injuries.

I still have questions

  • Refer to the AAP webpage on Car Seats: Information for Families to review this revised recommendation and other car seat information.
  • Read the car seat instruction manual and the labels on the car seat.
  • You can also make an appointment at a car seat fitting station, where a car seat technician can help you make sure your seat is installed correctly and fits your child.
  • See the Vermont Health Department’s Be Seat Smart website for a list of fitting stations, car seat events, and resources.

Maureen Johnson, CSP, CPST-I, is a Child Passenger Safety Specialist at the University of Vermont Medical Center.

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