Car seat changes keep babies rear-facing longer

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 rear-facing.”

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 or 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.

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