Written by SMH Mother-Baby Nurse Sheera Thomas
The American Academy of Pediatrics (AAP) is encouraging families to keep babies and toddlers in rear-facing car seats for as long as possible.
Late last year, the AAP updated its car-seat safety recommendation, advising parents to keep children in rear-facing car seats until the child reaches the maximum height or weight allowed by the car seat manufacturer. Most convertible car seats have height and weight limits that will accommodate children rear facing beyond their second birthday; in fact, many are designed to be rear-facing until the child reaches 40 pounds.
Previously, the AAP had recommended that babies be kept in rear-facing car seats until age 2.
Young children have disproportionately large heads compared to their bodies, as well as under-developed ligaments and vertebrae, making the risk of a spinal injury during a crash much greater than it is for adults and older kids. In the rear-facing car seat, the seat’s shell cradles the child’s neck and back while spreading out the force of an impact, decreasing the risk of serious injury.
In countries where children are kept rear facing until age 4, it is very rare for serious injury or deaths to occur from car accidents. Though other factors such as driving and environmental conditions make it challenging to compare the rates, data suggests, children in the US would benefit from staying rear facing as long as possible.
As always, be sure to follow the manufacturer’s instructions and have a certified car seat technician assess car-seat installations to determine what’s best for your child in your vehicle.
To find a certified car seat technician in our area go to, visit SafeKids.org or the NHTSA website.
SMH Mother-Baby Discharge Facilitator Sheera Thomas, RN, has been an OB nurse for more than 20 years. She is an internationally board-certified lactation consultant, a certified childbirth educator, and—perhaps her most demanding role—a mother of four.