When Dr. Karen Judy is running her pediatric clinics at Loyola
University Medical Center, she always makes sure to talk about car
seat safety. And, now that the American Academy of Pediatrics has
issued new guidelines for buckling up baby, she knows she has more
work to do.
In the April issue of Pediatrics, the AAP recommends children
remain in rear-facing car seats until age 2, or until they reach
the maximum height and weight for their seat. Previous guidelines
said children could be moved to a front-facing car seat once they
reached 20 pounds or one year.
The new guidelines also advise keeping children in a
belt-positioning booster seat until they have reached 4 feet 9
inches tall and are between 8 and 12 years old.
And, while these new guidelines might be a tough sell to
parents, consider that studies show up to 70 percent of children
are improperly restrained in the car. Plus, another study shows
children under age 2 are 75 percent less likely to die or be
severely injured in a crash if they are riding rear-facing.
"I think we're going to have to really emphasize it in clinic,
because people are in a hurry to turn their babies around to see
their cute face," says Judy, pediatric program director and vice
chair of education at Loyola. "Now we have another whole year added
on and that's going to be challenging, but it sounds like it will
keep them safer, so that's the bottom line."
AAP spokesperson Dr. Benjamin Hoffman says data shows
rear-facing is safer then front-facing, and car seats are safer
than boosters, so it comes down to convincing parents to delay
making changes until children are truly ready.
"Parents are often so focused on milestones, in the sense of
graduation and moving from one point to another, and usually it's
an unequivocally positive thing, but with child passenger safety
it's not, so we need to change that perception," says Hoffman,
associate professor of pediatrics at the University of New Mexico
and certified child safety technician and instructor.
To keep children rear-facing longer may require a switch to a
different car seat, Judy says. "If their head is coming over the
top or their feet are squished… they'll have to come out of the
infant seat and move into a seat with a harness, but still
At around age 4, children can usually move into a booster seat,
which helps reduce their risk for abdominal and spinal injuries by
holding the seatbelt correctly across their body, Judy says.
And, don't forget to bring the appropriate car seat or booster
when traveling, because people get in more accidents when driving
in unfamiliar areas than they do at home, Judy says.
If you're unsure what type of car seat your child should be in
or how to install it, visit safekids.org or seatcheck.org. There
you'll find a list of local, certified car seat technicians who can
do a free check to make sure children are safely buckled up.
Liz DeCarlo is the former senior editor at Chicago Parent.
See more of Liz's stories here.
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