News Archive

Language from a bill known as the Helping Overcome Trauma for Children Alone in Rear Seats Act (or HOT CARS Act) has been approved by the United States House of Representatives. The HOT CARS Act requires auto manufacturers to include an alarm reminding drivers to check the back seat of their vehicles, ideally leading to a decrease in the number of deaths caused by inadvertently leaving children in the back seat.

The HOT CARS Act was initially introduced in the Energy and Commerce Committee in June, but language from the bill was passed on September 6 as an amendment to the DECAL Act, which seeks to inform consumers about the capabilities and limitations of self-driving cars.

The amendment concerning children left in hot cars says that within two years of the bill becoming law, the National Highway Traffic Safety Administration must issue a rule requiring automakers to include an alarm that will alert drivers to check the rear seat when they turn off the engine. Auto manufacturers would then have two years to comply with the rule.

Children dying in hot cars is a serious issue, and one that has been getting more attention lately. Some vehicle manufacturers, like General Motors, are already putting safeguards in place (as are some car seat companies, like Evenflo). This regulation would force other auto manufacturers to follow suit.

While this bill is a step in the right direction for protecting children from accidental deaths, there’s still a long way to go. First, the bill will need to pass the U.S. Senate. If it does, it will then need to be signed into law by a president who has signaled a resistance to new regulations.

If the bill does become law, the regulation will need to actually be enacted–a process that is often met with challenges, changes, and delays.

We have questions about how these proposed alarms will work. If an alarm chimes each time the car is turned off (as is suggested in the language of the bill), people are more likely to ignore it or otherwise tune it out, especially once they get used to hearing it. Falling into a routine is exactly the problem these alarms should be trying to solve; they shouldn’t be contributing to it. A system like GM’s, where the alarm sounds only if the back door had been opened and shut prior to the car moving, seems more likely to be effective since it has a better chance of catching people specifically when they have a child onboard.

Even under the best scenarios, this regulation is still years away from becoming reality. 

There are benefits and downfalls to relying on technology or gadgets to help keep caregivers from forgetting children in the car. People can always take precautions on their own, though. We recommend that people put an item they’ll need at their destination (like a phone, a purse, or a shoe) in the back seat so they’ll need to open that back door and see the child inside.

Legislation might eventually help, but it’s a long road.

We’ve recently returned from the Kidz in Motion (KIM) Conference, which is the National Child Passenger Safety Conference, where we had a chance to talk with the very experts who help to shape policy on rear-facing. An open forum was added to the conference schedule at the last minute to address the current status of research on which the American Academy of Pediatrics’ rear-facing to age 2 policy is based. The original study from 2007 claims that rear-facing to age 2 is five times safer; however, Dorel commissioned a review of the study that shows those statistics to be in error. We now have a better idea of what’s going on with the recent Dorel policy statement, where they removed language from their labels and instruction manuals requiring children to remain rear-facing in their convertible seats until age 2.

Dr. Ben Hoffman MD FAAP CPST-I, Chair of the AAP’s Committee on Injury, Violence, and Poison Prevention, led the session and stated that the AAP is not making any changes to their rear-facing policy right now. Jeya Padmanaban, the author of the new research, who found the errors in the original study, has submitted her research to an unknown journal and we are all waiting for it to be peer-reviewed and published. Dr. Hoffman said the AAP is closely monitoring the situation but has no inside information on when, or even if, publication may happen. And he’s the guy who would know.

There was a discussion of research currently being done in the area of child passenger safety and it’s pretty slim. As we all know, money has dried up. Years ago, State Farm had an excellent partnership with the Children’s Hospital of Philadelphia (CHOP) where they pulled data from State Farm’s customers. That program, Partners for Child Passenger Safety, ended a decade ago. CIREN is another network where data from level one trauma centers was analyzed in conjunction with biomechanical engineering teams. The last data set from that program is dated 2015. That’s not to say there aren’t currently any studies being made and progress being made in CPS. It’s just that data to focus on injuries to RF children exclusively isn’t being collected.

The panel did discuss Sweden, since it’s a popular comparison country because of its low crash injury rates for children. All agreed that because of the way their carseats are engineered and installed, we can’t compare the U.S. to Sweden. Their vehicle fleet is newer and different, their roads are different as are the miles driven. They also don’t use forward-facing carseats with a harness so there is no way to compare the effectiveness of RF seats to FF seats in that country. From a pediatrician’s perspective, Dr. Hoffman contributed that their entire healthcare system sets them up for different crash outcomes because they may start out healthier.

The big take-home message of the session was that when used and installed properly, carseats are doing an amazing job of keeping children safe, no matter which direction they face.

What to Do

• Keep your child rear-facing until age 2
  • Stay the course until/unless it’s proven to change
  • There’s no evidence currently that RF until 2 is harmful
  • Some carseats and some state laws require it
• Don’t say “It’s 5 times safer to RF to age 2”
  • That’s the statistic that’s being called into question
• After 24 months, it’s a parental choice when to turn
  • We simply don’t know if it’s safer to RF after age 2. Yes, it seems logical that it should be safer, but there are other variables in the vehicle crash environment.
  • If you choose to RF after age 2, make sure to snug up the harness so you can’t pinch any webbing above the chest clip and put the seat in its most upright angle as the manufacturer allows

At this point in the research, there are more unknowns than knowns and we’re definitely in a holding pattern waiting for that revised journal article to come out. There’s no doubt that Dorel’s statement came at a damaging time when states are passing laws requiring rear-facing to age 2 based on what turned out to be a flawed study. We’re in shock as much as the original authors are, as they didn’t set out to mislead anyone. They are all highly qualified researchers in their fields with professional reputations to uphold.

Just as I say to all my child passenger safety technician candidates in tech class: “Never say never in CPS. It’s an ever-changing field with no absolutes.”

Ever wondered why after decades of popularity, infant carriers still seem heavy?  With all the inserts and a canopy it’s like somehow the upscale models all feel close to 10 pounds. We’ve heard promises of ultra-light, carbon fiber designs for years, but they’ve never appeared.  So what is the absolute lightest weight rear-facing only infant carseat carrier on the market in the USA for 2017?  In September, it will be the nuna PIPA™ lite at only 6 pounds with canopy!  It’s a hair over 5 pounds without canopy, and just under 7 pounds with both the full newborn insert and canopy.

The PIPA lite will be sold at independent Brixy affiliated retailers in the USA for $349.

Here are the basics.  The PIPA lite shaves over 2.5 pounds off the fabulous PIPA.  Lightweight, high performance materials in the shell and foam liners allowed nuna to cut the weight considerably while claiming to have no reduction in crash testing performance!  Notably, they use high strength aluminum and proprietary aeroflex™ EPP energy absorbing foam fused directly to a re-invented semi-flexible thin wall shell.  That means no more breaking of the stiff, white energy absorbing foam layer found in most carseats.  PIPA lite is completely flame retardant free.   Both lite models come with an all-new matching head and body newborn insert.  The patented design with memory foam insert helps PIPA lite to meet the enhanced European 129 safety standard.  They also include an extra set of dye-free GOTS™ certified organic cotton newborn inserts and harness/crotch strap covers inside the box!

PIPA lite carrier specs:

• Weight limit: 4-32 lbs
• Height limit: up to 32″
• Inside depth: ~14″
• Inside hip width: ~9″
• Inside  height: ~18″
• Buckle slot depth: 7″
• Harness slot heights: 6″, 7.5″, 9.5″
• Outside dimensions: 27.25″ x 17.5″w x 22.5″h
• Carrier weight: 5.3 lbs, 6.1 lbs with canopy
• Carrier + insert weight: 6.7 lbs with canopy
• Handle positions: 3
• Harness height positions: 3 (2 using insert)
• Expiration: 7 years

The lite models use the same steel-reinforced PIPA base as the original model.   That includes the dual bubble recline indicators, load stability leg and belt lock-off system, plus the wonderful rigid LATCH attachments.  LATCH guides are included in the box to help with installation.

This is a pretty amazing feat of engineering, to be honest.  As with every single carseat design on the market, there are always tradeoffs and compromises. I think those with the PIPA lite are worth the reduction in weight!  Notably, the lite must be installed with the PIPA base.  They feature a single, fixed crotch strap position.  This is not a matter of cost.  It turns out that carrier-only installation and extra slots in the shell require considerably more reinforcement to meet nuna’s stringent safety standards.  That would mean adding significant weight back into the carrier design.  For parents who must have either or both of those features, the original PIPA will still be available and is a little less expensive, too!  Finally, the lite will not be FAA certified initially, but may be in the future.

Whether it’s the sleek, ultramodern design with leatherette handle or the 6 pound weight, I think the PIPA lite will be a great addition to the original PIPA that is one of our 2017 Recommended Carseats and an Editors’ Pick.  You can find our full review of the original PIPA here.  We will have a full review of the PIPA lite within the next month or so at CarseatBlog.

Editor’s Note: Updated upon request to remove information saved for future press release.  PIPA lite is now FAA certified for airplane use with the base! Owners of early production retail models can call Nuna for a replacement label kit with aircraft instructions.

Has the time come to reverse our stance on extended rear-facing and turn children forward-facing at age 1 like we used to in the olden days?

The simple answer, for the moment is, NO.

What’s going on?

Dorel Juvenile Group, the parent company of Safety 1^st, Maxi-Cosi, Cosco and other juvenile brands recently issued a position statement on their website explaining why they’ve stepped away from their recent age 2 minimum mandate for forward-facing in their convertible carseats. The short story is that they hired a statistician, Jeya Padmanaban, to replicate the original 2007 study upon which all our assumptions of rear-facing (RF) safety statistics in the USA are based. Not only was Padmanaban unable to replicate the results using the same data set as the original authors of the study, her conclusions actually led to opposite findings. She presented her findings to NHTSA and to the journal Injury Prevention. This prompted some of the original authors of the 2007 study to re-examine their analyses. When their attempts to replicate the analysis also fell short, it became apparent that there were real flaws in the study. Recently, the journal Injury Prevention issued an “Expression of Concern” regarding the original study. From the statement: “Specifically, they believe that survey weights were improperly handled in the initial analysis, which caused the apparent sample size to be larger than the actual sample size. This resulted in inflated statistical significance.” We are currently waiting for the revised study analysis and results to be reviewed and released. We will update this article when that information becomes available.

What do we know at this point?

The anatomy of the developing pediatric cervical spine predisposes children to injury of the upper cervical spine. In general, the younger the child, the more likely an upper cervical spine injury will occur. The neural arches in the pediatric cervical spine fuse posteriorly by 2–3 years of age. Until that time, the vertebrae are made of cartilage and bone and held in place by ligaments; it’s all very pliable and elastic. Traveling in the rear-facing position is inherently safe and is critical for babies less than 1 year old. (Please also read Why Rear-Facing Is Better: Your RF Link Guide, an evidence-based justification for rear-facing.)

Even though the statistics from the 2007 study are being disputed, there is agreement that rear-facing carseats cradle the head, neck, and spine to protect them in frontal and side impact crashes. We know it’s safe from basic physics, an understanding of crash dynamics and results from other countries, like Sweden.

What’s in question?

Since 2007 when the Henary, Sherwood, Crandall, et. al. study was first published, child passenger safety advocates have been told that rear-facing is 500% (or 5 times) safer than forward-facing for children under age 2. Now that statistic appears not to be true, at least not based on the data used in this one study which analyzed injuries to fewer than 300 kids between 1988-2003. Having such a small sample size makes drawing broad conclusions very difficult. Large sample sizes generally result in more accurate and reliable conclusions. We have had our own concerns about the original study and how the “5x safer” figure is presented to parents. We still don’t know exactly how rear-facing compares quantitatively to forward-facing in most situations.

There are other methods, but it can also be difficult to draw broad conclusions from specific case studies or proprietary crash testing done by manufacturers. All of this underscores the need for a more modern crash test sled and better studies on the subject. Modern vehicles simply don’t have a back seat that’s a flat bench seat of a ’70s Chevy Impala with lap-only seat belts and no floor like the standard crash test bench does. Modern vehicles have very different back seat cushions, front seats that crowd the back seat, lap/shoulder seatbelts, and they all have floors too!

What are the risks to a rear-facing child?