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You’ve heard Rear-Facing (RF) is safest. Maybe you’ve heard that RF car seats provide the best head protection. That’s probably true, in general. Maybe someone told you RF is “5x safer”. That statistic is based on only one study that used limited data and covers very specific circumstances, so it may or may not apply to your situation. What’s important is that rear-facing is very safe when the child is within the limits allowed by the carseat. In fact, simply using any age-appropriate carseat according to both instructions and state laws will be very effective at reducing the risk of severe injuries and fatalities.

Very safe in an upright convertible carseat!

So, what’s the deal? It turns out, that while rare, moderate and serious head injuries can happen in rear-facing carseats. There are typically 3 possible causes.

  1.  The top of a baby’s head might move out of the protection of the carseat shell and strike a front vehicle seat, pillar or console. This may be more of a concern with rear-facing only infant carriers, especially when fully reclined with a baby near the height limit.
  2.  The carseat shell strikes part of the vehicle interior, possibly resulting in the back or side of baby’s head hitting the inside of the carseat with enough force to cause a contusion or other injury.
  3.  In unusually energetic frontal crashes, the carseat could rebound with enough energy that the front of baby’s head may strike part of the vehicle interior.

Don’t Panic! High speed and very energetic crashes are not common, but can result in serious injuries, especially when misuse or non-use of restraints are involved. The good news is that if you are using a carseat and have installed and adjusted it as best as you can, you probably have very little to worry about.

So what can you do to reduce the chance of injury? The same simple things we’ve always told you and that you’ve probably done:

  • Install and use your carseat in the back seat, according to manufacturer instructions AND state law
  • Drive unimpaired and undistracted

How can you further reduce the chance of head injury in rear-facing carseats?

  1. In particular, make sure your carseat installation and harness are tight.
  2. If your child is approaching the stated rear-facing height limit, or when the top of the head is 1″ from the top of the carseat shell, then a taller seat may be necessary.
  3. For older babies and toddlers who have good head and neck control, install your carseat as upright as allowed by the instructions.
  4. If your carseat offers a load leg or anti-rebound feature, use it.
  5. Choose a Recommended Carseat that has a layer of energy-absorbing foam both behind and on the side of baby’s head.  Deep side wings and load legs (on certain infant seat bases) can also be advantageous.
  6. When shopping for a newer vehicle, select one with good safety ratings made in 2011 or later, when side-impact airbags and stability control are usually standard features.

“Bracing”, or having the rear-facing carseat touching the front vehicle seat, is a very complex topic.  Some vehicles don’t allow this at all, due to passenger airbag sensors.  In other vehicles, there are various conflicting factors to consider.  If allowed by both the vehicle and carseat owners manuals, bracing could potentially reduce the risk of the carseat energetically striking the vehicle seat back and related head injury (point B above).  On the other hand, it could increase the risk of direct head contact for an older, taller baby ramping out of the infant seat and striking a part of the vehicle interior (point A above). This is especially a concern with rear-facing only infant carseats that have shorter shells, tend to sit lower in the vehicle and tend to be installed with more recline than a rear-facing convertible carseat.

Above all, try not to lose sleep over this!  Loose installations, loose harnesses, too much recline and exceeding the rear-facing height limits are always a potential concern, so just make sure you read the instructions and consult a child passenger safety technician if you have any questions about your installation and usage of child restraints.