Why Rear-Facing Is Better: Your RF Link Guide

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Evidence-based justification for extended rear-facing

It’s all the rage among parents nowadays: extended rear-facing. If you’re turning your child to face forward before age 2, then you’re old-schooling it and increasing your child’s risk of injury in a crash. Many pediatricians still hold onto the now ancient recommendation of turning kids forward-facing at age 1 and 20 lbs., even though their own professional organization, the American Academy of Pediatrics, hasn’t recommended that since before 2002. You were probably in grade school then.

Why is it so critical for kids to stay rear-facing?

When you use the carseat right, it protects them and you from potentially being forever changed if you get into a crash.

Simple Physics Lesson

A carseat will always move toward the point of impact (Newton’s 1st Law). In a frontal collision—statistically the most common type of crash—the entire back of a rear-facing carseat will protect the head, neck, and spine of a child as it rotates down toward the front of the vehicle. Even in a side impact, which is a more serious type of crash due to its proximity to passengers, there is usually an element of frontal movement, such as a vehicle moving forward through an intersection, as it’s hit from the side. So a rear-facing carseat will rotate down and forward, then toward the side where the impact occurs.

Click each graphic to see the motion:

rf-physics-animation ff-physics-animation

Compare this to a forward-facing child in a harnessed carseat. In a frontal crash, the carseat still rotates down and forward toward the front of the vehicle, and the child will be flung forward into the harness and forward of the carseat shell. In a side impact, again the carseat rotates down and forward toward the front of the vehicle; the child comes forward into the harness and out of the carseat shell and there is rotation toward the vehicle door where the impact occurs. Because the harness is holding only the shoulders and hips, the head, arms, and legs are flung violently forward. If the harness is loose, which is one of the most common mistakes a caregiver makes, there’s a high likelihood of the child hitting the vehicle seat in front or the side pillar. According to this study, rear-facing children 12-23 months are 5.53 times safer in a side impact than forward-facing children and there’s no indication that safety magically disappears at 24 months.

Anatomy 101

The folklore is that a child’s neck muscles aren’t developed enough to keep a baby’s neck safe in a car crash, which is why they have to face the rear of the vehicle. I suppose that’s true in a way: it does take babies time to develop their musculature so they can hold their heads up to keep their airways open. But the muscles don’t protect the fragile spinal cord, which is the bundle of nerve fibers that forms the central nervous system and is connected to the brainstem. No amount of baby push-ups will strengthen your child’s muscles to the point of protecting his spinal cord.

The bones of the spinal column are what actually protect the spinal cord and in infants and young children; they aren’t completely fused together for years. One of the most important cervical bones, the Atlas (C1), is what attaches the head to the spinal column. Drawings show where it ossifies, or fuses, at varying times: the anterior arch fuses around age 7, while the posterior neural arches fuse around age 3. Before it fuses, the Atlas and Axis (C2), the 2nd vertebra that the Atlas nestles into, are made of bone and cartilage, which is very pliable. These two vertebrae are held in place by ligaments, which are very elastic (lax) to allow the child to grow.

atlas-side-view axis-side-view simplified-upper-cervical-spine

Studies of infant cadavers have shown that vertebral columns can stretch up to 2” but that the spinal cord is damaged after only ¼”. Given that a baby’s head accounts for ¼ of its total body size versus 1/7 an adult’s size, plus the immaturity of its vertebrae and laxity of the ligaments holding those vertebrae together, rear-facing seems the obvious choice.

The child’s large head shifts the fulcrum of movement, where the head swings forward, higher, elongating the spinal column and potentially causing catastrophic damage to the spinal cord. Before age 8, this fulcrum is in the upper cervical spine, at C2-C3. After age 8, the fulcrum shifts down to C5-C6, where it stays into adulthood. When you hear the term “internal decapitation,” it encompasses this movement of the upper cervical spine since the head swinging forward must happen in order for the ligaments to stretch and pull the head from the Atlas.

Another devastating injury that doesn’t show up on x-ray is called Spinal Cord Injury without Radiographic Abnormality (SCIWORA). This is when the spinal cord stretches because of the elasticity of the ligaments and cartilage in the spinal column. An x-ray will show normal bone alignment and no fractures, but the spinal cord may be irreversibly damaged. Remember that this bundle of fibers can only stretch up to ¼” before having catastrophic damage.

The evidence is clear. Rear-facing carseats protect the most fragile part of a developing child’s body: the head and spinal column. The American Academy of Pediatrics recommends rear-facing to a minimum of age 2 and instructs their pediatricians to counsel parents about rear-facing to age 2 and longer as the carseat allows. The National Highway Traffic Safety Administration (NHTSA) recommends rear-facing  as long as possible.

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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 amended that policy in March 2011 to recommend rear-facing to age 2 or until they reach the “highest weight or height allowed” by that convertible carseat.

 

Note how the legs fly away from the back of the vehicle seat during the test. In the forward-facing seat, the properly secured dummy bends nearly in half during the crash test. Photo courtesy Kathy Weber, ret., UMTRI, and SafetyBeltSafe USA.

Note how the legs fly away from the back of the vehicle seat during the rear-facing test on the left. In the forward-facing seat, the properly secured dummy bends nearly in half during the crash test.  Photo courtesy Kathy Weber, ret., UMTRI, and SafetyBeltSafe USA.

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

Here’s an 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)

Leg injuries account for 28% of significant injuries faced by forward-facing children in crashes  (Jermakian, J.S., et al. “Lower Extremity Injuries in Children Seated in Forward Facing Child Restraint Systems.” Traffic Injury Prevention 8 (2007): 171-179.)

This analysis shows how leg injuries are common among forward-facing children (Bennett, T.D., et al. “Crash Analysis of Lower Extremity Injuries in Children Restrained in Forward-facing Car Seats During Front and Rear Impacts.” Journal of TRAUMA® Injury, Infection, and Critical Care 2006;61:592-597

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)

Evenflo is now requiring that children be age 2 before forward-facing in their convertible and combination carseats.
 

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.

The above video from the Buckle Up Brutus at Ohio State University demonstrates the difference between rear-facing and forward-facing in crash tests.

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.

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Britax Recalls B-Agile and BOB Motion Strollers

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Britax, in cooperation with the U.S. Consumer Product Safety Commission (CPSC), Health Canada, and Profeco (Mexico), is conducting a voluntary recall of all Britax B-Agile and BOB Motion stroller models listed below.

When used as a travel system with the Click & Go receivers to attach the carseat to the stroller frame, the receiver mount may be damaged and cause the carseat to disengage unexpectedly and fall. If the carseat falls to the ground, the child may be injured.

Model numbers for single strollers are located on the inside of the stroller frame near the right rear wheel. For double strollers, it’s located on the front middle underside of the frame. Models affected:

B-Agile

S01298600 S01298700 S01635200 S02063600
S02063700 S02063800 S02063900 S02064000
S03803400 S03803500 S03803700 S03803800
S03803900 S04144400 S04144500 S04144600
S04144700 S04144800 S04144900 S04145000
S04183700 S04183800 S04184000 S04281200
S04281300 S04402800 S04437700 S04628500
S04884200 S04884300 S04884400 S04884500
S04975600 S04978900 S05060600 S05260200
S05511600 S05511700 S865800 S865900
S874300 S874400 S874500 S877200
S890100 S896000 S896200 S896600
S907200 S907300 S907400 S907500
S907600 S910200 S910300 S910400
S910500 S912300 S914300 S914500
S914700 S914900 S915200 S915400
S917400 S921800 S921900 S923700
U341763 U341764 U341782 U341783
U341825 U341826 U341828 U341X82
U34X782 U361763 U361818 U361819
U361825 U391875 U451835 U451837
U451841 U461763 U461764 U461782
U461783 U461825 U461826 U461828
U471818 U471819 U491842 U491843
U491844 U491908 U491909 U491910
U511875 U511877 U551835 U551837
U551841 U551861 U551862 U551863
U551864 U551865 U551905 U551906
U691878 U691879 U691881 U691882
U691884 U691904 U691905 U721895
U721896

 

BOB Motion

S888600 S890200 S890300 S890400
S890500 S909700 S910600 S910700
S910800 S910900 S912600 U391820
U391821 U391822 U481820 U481821
U481822 U501820 U501821 U501822
U501907

What should you do:

  • Stop using the carseat on the stroller as a travel system IMMEDIATELY. It is completely SAFE to continue using your stroller in the recline mode for infants though.
  • Go to www.us.britax.com/recall or call 1-844-227-0300 to request a free repair kit that contains a new set of Click & Go receivers and instructions.

Graco 4Ever Extend2Fit All-in-One: Rear-Facing Space Comparison

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One of our most popular blogs is the Rear-Facing Space Comparison where we rate convertible seats based on the amount of room they take up in my vehicle compared with other seats in the group.

I was eager to add the new Graco 4Ever Extend2Fit to the comparison but I knew this was going to be more work than usual based on the many rear-facing installation options you have with this particular seat. This seat has 4 recline positions on the base that can be used to achieve an acceptable rear-facing recline position as per the angle indicator. The angle indicator is a liquid bubble level that has to be in the range of the blue line shown on the window. 4Ever Extend2Fit also has Graco’s unique 4-position legrest extension feature (truthfully there are 3 extension positions, the first position is fully retracted) AND the coveted 50 pound rear-facing weight limit.

 

I summarized my findings in the space comparison ratings but I wanted to supplement that information with the full scope of my conclusions here.

I started with the 4Ever Extend2Fit in base position #1 (most reclined), no legrest extension, head rest flush with shell. This is how the seat would be installed for a newborn or younger baby. I gained 3.5″ of room (based on the worst performing seat in the peer group). This measurement translates into a “B” rating in the comparison.

 

 

Base position #2 (more upright), no legrest extension, head rest flush with shell. This is how the seat might be installed for an older baby who has good head and neck control and can tolerate being seated in a more upright position. In this position I gained 4″ of room. This is a B+ rating in the comparison.

 

 

Base position #3 (very upright), no legrest extension, head rest fully extended. In this position the bubble level was outside of the acceptable range for rear-facing. This was NOT an acceptable installation as per the angle indicator so I’m not counting it. However, for those who are curious, it only gave me an extra half inch of room beyond what I got with the base in position #2. My measurement with the seat in this position was +4.5″ of space.

 

 

At this point, it seemed likely to me that you would only be able to use 2 of the 4 base positions in any particular vehicle to achieve an acceptable recline angle in the range allowed. But as I found out when I started to install using the legrest extension, the recline angle can change when you start to use this feature. More on that in a little while.

I went back to base position #2, extended the legrest 1 notch, head rest is still fully extended. Because I’m using the legrest extension now, I’m starting to lose space. Now I have +3.5″ (which is what I had with the seat fully reclined reclined in position #1 and no legrest extension). Again, this rates a “B” in the comparison.

 

Here we are in the same #2 base position, with the legrest fully extended and the head rest fully extended. As you can see, it’s taking up a LOT of space now. At this point I’m measuring a gain of only 1″ (based on the biggest space hogs in the peer group). In the comparison, this is a C- rating.

However, I was surprised to see the bubble level indicator in the middle of the blue line range now. When I installed using the same #2 base position without using the legrest extension, the bubble was much closer to the end of the allowable range. This made me wonder if I could get an acceptable installation using recline position #3 on the base with the legrest panel fully extended…

 

 

Final installation: Base position #3, legrest fully extended, head rest fully extended.  The liquid bubble is on the most upright end of acceptable range but it is within the range. I picked up a extra half inch of space with the base in position #3. The measurement is now +1.5″ which is a little better but still rates a C- in the comparison.

 

The other thing to keep your eye on when using the legrest extension feature is the amount of overhang allowed. When you start extending the legrest panel you increase the space between carseat and the vehicle seat and that positions the base closer to the edge of the vehicle seat cushion. Thankfully, Graco put a little blue sticker label on the edge of the base to show what the acceptable amount of overhang is. Overhang past that blue line is NOT acceptable. Too much overhang could be an issue in backseats with shallow cushions (e.g., Jeep Wranglers, some compact cars, extended cab pickup trucks, etc.). Luckily, you don’t have to use the legrest extension so you can just ignore that option if overhang becomes an issue.

 

Summary:

The Graco 4Ever Extend2Fit is a versatile 4-in-1 product with a 50 lbs. rear-facing weight limit and a very unique legrest extension feature. You may use base positions 1, 2, 3 or 4 to achieve an appropriate RF recline angle as per the angle indicator but don’t expect that all 4 positions will yield an appropriate recline position in your vehicle. You may use any of the legrest panel positions rear-facing without restriction. The only rules are: make sure your recline angle is in the allowable range and make sure you don’t have too much overhang of the base.

Having so many rear-facing installation options creates more potential for finding a suitable recline angle, giving your child some extra legroom and taking up less space in your vehicle. However, the reality is that once you start using the legrest extension feature, the seat definitely takes up more front-to-back space in the vehicle. I lost 2-3″ of space in my vehicle when I extended the legrest fully and that was using the more upright #2 & #3 recline positions. The seat would have taken up even more room if I had extended the legrest in the most reclined position.

Parents who are taller than average and/or driving vehicles with limited legroom in the backseat may find that they aren’t able to take advantage of the legrest extension feature without seriously compromising the space upfront for the driver or passenger. I found it interesting that in my vehicle the less expensive Graco Extend2Fit convertible actually takes up slightly less space without the legrest extension than the 4Ever Extend2Fit model. With the legrest fully extended, both seats had the same +1.5″ measurement.

Regular Extend2Fit convertible on left; 4Ever Extend2Fit on right

 

 

 

If front-to-back space is a big issue in your vehicle, and you don’t think that you will ever be able to take advantage of the legrest extension, then you might be better off with a different convertible seat since it doesn’t make sense to pay for a feature you won’t ever use. The original Graco 4Ever All-in-One, Graco Milestone All-in-One, Graco MySize 65 convertible & Graco Contender 65 convertible are all options that did better than average in our Rear-Facing Space Comparison but don’t have the Extend2Fit legrest feature.

Evenflo Spectrum 2-in-1 Booster *Giveaway* – USA & CANADA

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Happy Valentine’s Day!

How do we love thee? Let us count the ways…

We know we have the most awesome, most thoughtful, most caring readers and followers and we love you all for that! We also know that our most awesome, most thoughtful, most caring readers and followers love to win cool stuff so we thought this would be the best way to show you how much we love and appreciate you.

For this promotion we’ve partnered with our generous friends at Evenflo to give away not one, but two awesome new Spectrum Booster seats in the “Seascape” fashion – one for the U.S. and one just for Canada!

Spectrum Specs & Features:

  • Weight 40 – 110 lbs.
  • Height 44 – 57”
  • For kids at least 4 years old
  • Dual mode (highback & backless)
  • Adjustable headrest with 8 height settings (it’s taller than most other highback boosters)
  • Lyf+Guard side-impact protection technology in the head rest
  • Rollover tested
  • 6 year lifespan before expiration
  • Dual cupholders/snack trays
  • Machine washable cover that can also be thrown in the dryer
  • Made in USA

See our complete Evenflo Spectrum review here: https://carseatblog.com/41458/all-the-specs-a-review-of-the-evenflo-spectrum-2-in-1-booster/

This promotion is now closed. Congratulations to our winners, Amy H. & Jasmine D. 

How to Enter Evenflo Spectrum Booster Giveaway – USA

  • Leave us a comment below telling us what you love about the new Spectrum booster (comment required to be eligible to win), then click on Rafflecopter to qualify yourself.

a Rafflecopter giveaway
Now for the fine print – winner must have U.S. shipping address to claim the prize. Only one prize will be awarded in the Seascape fashion. Only one entry per household/family, please. If you leave more than one comment, only the first one will count. We reserve the right to deem any entry as ineligible for any reason, though this would normally only be done in the case of a violation of the spirit of the rules above. We also reserve the right to edit/update the rules for any reason. The contest will close on February 14, 2017, and one random winner will be chosen shortly thereafter. If a winner is deemed ineligible based on shipping restrictions or other issues or does not respond to accept the prize within 7 days, a new winner will be selected. Good luck!

How to Enter Evenflo Spectrum Booster Giveaway – CANADA

  • Leave us a comment below telling us what you love about the new Spectrum booster (comment required to be eligible to win), then click on Rafflecopter to qualify yourself.

a Rafflecopter giveaway
Now for the fine print – winner must have Canadian shipping address to claim the prize. Only one prize will be awarded in the Seascape fashion. Only one entry per household/family, please. If you leave more than one comment, only the first one will count. We reserve the right to deem any entry as ineligible for any reason, though this would normally only be done in the case of a violation of the spirit of the rules above. We also reserve the right to edit/update the rules for any reason. The contest will close on February 14, 2017, and one random winner will be chosen shortly thereafter. If a winner is deemed ineligible based on shipping restrictions or other issues or does not respond to accept the prize within 7 days, a new winner will be selected. Good luck!

Please note: If this is your first comment at CarseatBlog, or if you are using a different computer/device or a new email address, your comment may not appear immediately. It will not be lost; it may just take a few hours for it to be manually approved by one of us. Thank you for your understanding and patience as this is the only way we have to reduce comment spam.