Keep baby facing rear in car seat longer: AAP

The best way to keep your baby safe in the car is two years in a rear-facing child seat, pediatricians advise.

Updating previous guidelines, the Elk Grove Village-based American Academy of Pediatrics recommends parents keep most children in rear-facing restraints until age 2 instead of 1 or until maximum weight and height restrictions are reached.

AAP experts also suggest that most older children use a booster seat until they are 4 feet 9 inches tall and age 8 up to 12 years old.

“New studies show that the rear-facing position offers significant increased safety for babies,” said pediatrician Garry Gardner, who practices in DuPage County and is chairman of the AAP's Committee on Injury, Violence and Poison Prevention.

The group previously recommended infants and toddlers use car seats to the maximums allowed by the manufacturer. But it also listed 12 months and 20 pounds as a minimum standard, resulting in many parents switching to forward-facing at their child's first birthday.

“Our most important message is that children should be restrained every time they ride in the car. The type of restraint depends on their age and size,” Gardner said.

More than 5,000 children and teenagers a year die in vehicle crashes, but research shows the chance of babies younger than 2 dying or being seriously injured in an accident decreases by 75 percent if they are in rear-facing seats.

The AAP released five recommendations on child vehicle safety today in the journal Pediatrics. Other advice includes: keeping children 2 through 4 years old in forward-facing safety seats; putting children who no longer need boosters in lap and shoulder seat belts; and having all kids younger than 13 ride in the back seat.

Asked about older children balking at a booster seat, Gardner advised parents to err on the side of caution, especially when shoulder belts just don't fit and extend across a child's neck, for example, instead of across the shoulders and mid-chest. Lap belts should lie on the hips and upper thighs.

“Parents have to pick their battles,” he said.

Barrington Hills mom Jennifer Bulander said her 9-year-old son uses a booster seat without complaint.

“We have no issues with that because the booster allows him to see better out of the window. That's how we phrase it in our house. It's just the rule,” Bulander said.

In discussing the new policies with parents, Gardner has found positive reactions, so far.

“One mom said she was planning to keep her child in a rear-facing seat until the child was 3,” he said.

Traci Kantowski of Wheaton, who coordinates a mothers' group and has two young children, called the new policy “challenging.” Her 9-month-old daughter is 29 inches tall, which could make height a problem with the 2-year rear-facing policy.

“Obviously, you want to make sure they're very safe,” Kantowski said. But “we've already got three car seats. Will we have to buy another to accommodate the guidelines?”

The report's lead author, Dennis Durbin, said it is intended as a guideline for parents. Some children, he said, will no doubt reach maximum weight and height before age 2. Experts also note that convertible child-safety seats can have higher height and weight limits than some infant seats.

Gardner advised moms and dads to play down car seat changes. “Some parents view transitions in car safety as a promotion. It's not really a promotion, it's a transition. Every change reduces the amount of safety,” he said, noting that rear-facing seats are the least dangerous form of transportation for children. “Parents should postpone changes as long as they can.”