"So Dr. Kawan. . . I heard something on the news about car seats. Please tell me I don't have to keep my toddler rear-facing until he's two!"

As we’re sure of all of you have heard, the AAP is now recommending that children sit rear-facing in a car seat until the age of 2.  Looking at my son, who will turn 2 next month, that recommendation seems downright CRAZY!  Granted, my son is on the bigger side, but I do not see how he could possibly have continued to sit backwards for this past year.  Aside from his size, he is no longer a baby – he is my little boy – and enjoys watching the surroundings go by and interacting as a “big boy” on our many adventures. 

Whenever I struggle with a new guideline/recommendation, I always go directly to my friend, Dr. Meg Kawan.  Not only will she give me the research-based answer (as provided by the AAP), but she will also provide me with her own opinions on the topic.  Given that she has two young boys and a parenting style that is VERY similar to mine, her opinions have played a very prevalent role in the decisions my husband and I have made over the past few years – and she has yet to let us down once!  Needless to say, when the media went crazy with these new developments, Meg was the first one I ran to!     

Dr. Kawan’s Response:

Since the American Academy of Pediatrics issued their updated recommendation on child passenger safety last month,  word has disseminated quickly through the media (and parenting circles) that children under the age of 2 should ride in rear-facing seats.  Most of the parents I have discussed this new recommendation with are less than thrilled (to put it mildly).  As a mom of a two and four year old, I can definitely relate to the disappointment.  It certainly is a lot easier to get toddlers in and out of their seats when they are forward-facing, and without question, it is easier to keep them entertained during the car ride.  So why the big change? 

The AAP made their recommendation after very carefully reviewing the data on motor vehicle injuries in children, and the evidence was truly dramatic that children who are restrained in rear-facing car seats are significantly less likely to sustain a serious head injury.  It is worth mentioning that motor vehicle crashes are the leading cause of death among children, so we are not talking about a rare or isolated problem.  Among 12-23 month olds involved in motor vehicle accidents, those restrained in forward-facing seats were more than five times more likely to sustain a serious injury, compared with the toddlers in rear-facing seats.  Sweden recommends that all children travel in rear-facing seats until the age of four, and their data demonstrates a 90% reduction in serious injuries in children placed rear-facing car seats. 

"Do I have to get a new car seat?" is another question I hear often, and I am happy to report that the answer to that question is no, in most situations.  The AAP does recommend that children stay rear-facing until the age of two, or until they have reached the weight limit for their rear facing car seat.  The good news is that most of the car seats sold in the US are convertible seats, that can be used rear or forward facing.

Once I had learned of the overwhelming safety evidence, and upcoming change in AAP policy, it was an easy decision to keep my child rear-facing until he turned two.  He never knew what he missed, and pretty soon, as this recommendation takes hold among families, two will be the new normal in turning car seats around. 

After reading her answer, I agree that the risk far outweighs the inconvenience…but, between you and me, the jury is still out on what my husband and I will decide to do for Baby #3.  What will you do?  Will you keep your child rear-facing based on the latest recommendations by the AAP?