Suggestions for car seats, restraints to save children’s lives

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

Toddlers between the ages of 12 and 23 months who ride in rear-facing car safety seats are five times safer than a toddler of the same age group in a forward facing car seat.

Overall, children 2 and younger are 75 percent less likely to die or experience a serious injury when they ride in a rear-facing car seat, according to Drs. Marilyn Bull and Dennis Durbin in “Rear-facing Car Safety Seats — Getting the Message Right,” Pediatrics, March 2008.

Rear-facing seats support the back, neck, head and pelvis because the force of the crash is distributed evenly across the entire body.

Forward-facing children will have the force of the crash concentrated on the seat belt contact points.

Also, younger children’s heads are large related to their small bodies, making whip lash much more dangerous for their small, weak necks.

Motor vehicle crashes are the leading cause of death in children and, as new research indicates that toddlers are five times safer in a rear-facing car seat.

Here are some recommendations from the Academy of Pediatrics:

  • All infants should ride rear-facing in either an infant car seat or convertible seat;
  • If an infant car seat is used, the infant should be switched to a rear-facing convertible car seat once the maximum height (infant’s head is within 1 inch of the top of the seat) and weight (usually 22-32 pounds) have been reached for that infant seat, as suggested by the car seat manufacturer;
  • Toddlers should remain rear-facing in a convertible car seat until they have reached the maximum height and weight recommended for the model or at least the age of 2;
  • There are two websites to help you see if your car seat is installed properly. They are or;
  • All children 2 or older or those who have outgrown their rear-facing height and weight should use a forward-facing system with a five-point harness for a long as possible;
  • All children whose weight and height is above the forward-facing limit for their car seat system should use a belt positioning booster seat until the car’s lap and shoulder seat belt fits properly. This is usually when the child reaches 4 feet 9 inches and is between 8 and 12 years; and
  • All children 13 years and younger should be restrained in the rear seats of vehicles for optimal protection.

Unfortunately, a study in the American Journal of Preventive Medicine (Aug. 7, 2012) showed that child passenger restraints fall short in three specific areas: Few children ride in rear-facing seats after the age of 1 year, fewer than 2 percent of those aged 7 and older use a booster seat and too many of all ages sit in the front seat.

You can save your children from serious bodily harm or even save their lives by following these simple suggestions.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital, and Keith Bly is an associate professor of pediatrics and director of the UTMB Pediatric Urgent Care Clinics. This column isn’t intended to replace the advice of your child’s physician.

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