Here’s a list of concrete reasons why we recommend rear-facing past age 1 and 20 lbs. That old recommendation that many pediatricians still hold onto stresses the bare minimums of when to turn a child forward-facing. Who wants the minimum for their child? It’s best practice to rear-face to the limits of the child’s convertible carseat: check the label for the rear-facing weight limit and make sure there’s at least 1″ of carseat above the top of his head (this height limit “rule of thumb” does not supersede the instruction manual’s height limit).
The American Academy of Pediatrics (AAP) has recommended since 2002 that after age 1 and 20 lbs., children should ride in a rear-facing convertible seat until reaching the weight limit of that carseat. They’ve just amended that policy (3/2011) to recommend rear-facing to age 2 or until they reach the “highest weight or height allowed” by that convertible carseat. (http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/25435)
The back of the car seat supports the head, neck, and spine of a child in a frontal crash. “When a child is in a rear-facing seat, the head, neck and spine are all kept fully aligned and the child is allowed to “ride down” the crash while the back of the child restraint absorbs the bulk of the crash force.” (http://cpsafety.com/articles/StayRearFacing.aspx)
The semi-reclined position allows the child to sleep comfortably and there’s always a place to put the child’s legs without dangling uncomfortably in front.
Forward-facing children under the age of 2 are 75% more likely to be injured. (Car Safety Seats for Children: Rear Facing for Best Protection)
Toddlers up to the age of 2 are more than 5 times safer riding rear-facing. (http://aapnews.aappublications.org/cgi/content/full/30/4/12-a )
Here’s the full article showing why children up to the age of 2 are more than 5 times safer riding rear-facing. (Rear-Facing Car Safety Seats Getting the Message Right)
SafetyBeltSafe USA’s opinion on how long children should ride rear-facing. (How Long Should Children Ride Facing the Back of the Car?)
After reviewing studies from the U.S. and Sweden, a study published in the highly regarded British Medical Journal advises keeping children rear-facing until age 4. (www.bmj.com/cgi/content/full/338/jun11_2/b1994?view=long&pmid=19520728 )
Forward-facing children are more likely to sustain leg injuries in crashes than rear-facing children. (Jermakian, J.S., et al. “Lower Extremity Injuries in Children Seated in Forward Facing Child Restraint Systems.” Traffic Injury Prevention 8 (2007): 171-179.)
Child passenger safety is very much based on statistics. It’s more likely that a frontal or side impact will occur than a rear impact. Rear-facing carseats provide the best protection against those types of impacts. (http://www.crashtest.com/imgserver/angle468.gif )
A tightly installed rear-facing carseat allows the vehicle and carseat to absorb crash forces and increases “ride down,” the amount of time it takes a body to come to a stop in a crash. The longer the ride down time, the less chance of injury. (http://www.car-safety.org/rearface.html)
Rear-facing carseats provide excellent protection in side impacts as well. Because there’s usually a vehicle moving forward, as through an intersection, that element of forward motion can easily throw a child’s head clear of the carseat if he’s forward-facing. If rear-facing, his head will stay protected inside the carseat. (http://www.carseatsite.com/rf.htm)
Infants and young toddlers have spines made of soft bone and cartilage that doesn’t begin to harden until around age 3. As a result, the spinal column can stretch up to 2 inches; however, the spinal cord will rupture after being stretched after only ¼ inch. This damage cannot be repaired. (http://www.carseat.org/Technical/tech_update.htm#rearfacFF)
Approximately 75% of kids in Sweden rear-face until at least age 4. From 1999-2006, only 4 rear-facing children under age 4 were killed in crashes and their deaths were due to circumstances unrelated to the direction the carseat was facing (fire, drowning, excessive intrusion). During that same timeframe, 6 kids under age 4 facing forward in booster seats were killed; 3 of these crashes were potentially survivable crashes had the children been in rear-facing carseats. (http://www.bmj.com/cgi/content/full/338/jun11_2/b1994)
Anecdotal evidence suggests that infants around ages 10 mos.-18 mos. enter a fussy stage that makes it difficult to put them into any carseat, rear- or forward-facing. Many parents prematurely switch the rear-facing carseat forward-facing thinking that the child is objecting to riding rear-facing, when the child is objecting to being restrained at all. Visit the Car Seat Safety forums at www.car-seat.org and you’ll hear from other experienced parents regarding this phase.
The above video shows how the dummy stays contained in the seat during a rear-facing crash test. The tape on the dummy’s head is for measurement and doesn’t affect its head during the test.
This video is the companion video to the one above and shows a side view of the crash test. Note how little the head moves.
The above video shows a properly installed forward-facing seat. Note the seat belt stretch and how far forward the dummy bends.
The above video from Norway shows the differences between rear- and forward-facing carseats in an animated crash.
If you need more convincing, take it from Dr. Marilyn Bull, a noted pediatrician from one of the country’s best pediatric hospitals, Riley Children’s Hospital in Indiana. This video was produced for, and used in, the current Child Passenger Safety Technician course.
Vehicle crashes are the number 1 killer of children. Protect your children to the best of your ability. Follow best practice.