Thursday, January 3, 2013

Car Seat Safety Series Part 3: Extended Rear Facing and Extended Harnessing

This is the third in a series on car seat safety, written by Megan Arce, CPST (Certified Child Passenger Safety Technician) and mother to 2 little princesses. My daughter, Bethany, introduced us and I was thrilled when she agreed to write this series for me. So, for the next few weeks, make sure you check back in on Thursdays for more important information all parents, and grandparents and other caregivers, need to know to keep our precious little ones safe!


“Her feet touch the back of the seat.” “My pediatrician told me to turn him around.” “His legs are all scrunched into his chest- he can’t breathe like that!” “She wants to be able to see me.” “All the other kids in the car are facing the front, so he feels left out facing the back.” “She needed to see the DVD screen.” Yep, I have heard pretty much every excuse there is for why a parent felt they needed to turn their child forward facing at age one, the (pathetic) legal minimum. My next-door neighbor just “prefers” her daughter forward facing -- no particular reason why, she just does. Regardless of the excuse a parent can come up with, here is the bottom line FACT: car crashes are the number one cause of preventable death in children (major emphasis on preventable). Another FACT: REAR FACING IS 500 PERCENT SAFER THAN FORWARD FACING.  Need I say more, really? 

The American Academy of Pediatrics recommends that toddlers ride rear facing until the minimum age of 2, or until the child outgrows the seat in rear facing position.  The law will soon catch up to this. The current law of 1 year and 20 pounds is just not sufficient for our children.  Simply put, infants and toddlers do not have a strong enough spine to withstand crash forces. Their spine, which protects the spinal cord, doesn’t even begin to fuse (into harder bone) until the child is between ages 2 and 5.  Proportionately, toddlers have large, heavy heads for their body size, which will pull away from the spine in a frontal collision (which 72% of crashes are), possibly resulting in severing of the spinal cord, or “internal decapitation.” The rear facing position allows the child to ride out the crash more safely and for the car seat to absorb the energy of the crash, not the child, and not their neck/spine.
Age 2 is the absolute minimum that a child should go forward facing. Your child will continue to reap the benefits of rear facing as long as it is possible to do so. A child has outgrown a seat when either A) they have exceeded the weight in rear facing position, OR B) their head is 1 inch from the top of the car seat shell. Car seat manufacturers are creating seats to accommodate children well over age 2, in all price ranges. There is no reason, no excuse, to NOT use the car seat you took the time to research and paid a significant amount of money for to its full potential. They are designed for maximum use, not to make your child a minimum.

What about the squished legs? Kids are flexible and will figure out what to do with their legs as they grow -- cross-legged, propped up on seat back, dangling over the sides, etc. Children are actually far more likely to suffer broken limbs when forward facing. Regardless, broken legs and arms will heal, broken necks will not. You only get one chance with a baby’s neck and spine -- there aren’t any do-overs.  

Here is my 2 ½ year old daughter (35 inches and 30 pounds), comfortably rear facing in her car seat. The space above her head allows for at least 2 full inches of growth, which will easily take her until age 4 to hit:

And here you see my 4-year-old daughter, all 42 pounds and 42 inches of her.  The only time she complained about rear facing was when she outgrew her seat in rear facing mode.  She would stay rear facing indefinitely if she could:

Which looks more comfortable to you:


Or this? 

And if the need arises for a DVD screen for your extended rear-facing toddler, well there is a solution to be found for that too (I’m a mom, I get it):

Like many households, we have invested a great deal of money into our car seats, and we plan to use them as they are intended for as long as we possibly can! Which brings me to my next topic: extended harnessing.

Just as toddlers are being turned forward facing much too soon, children are going into belt positioning booster seats prematurely as well. A forward facing car seat is outgrown when A) a child has exceeded the weight limit of the internal harness, B) their shoulders are above the highest harness slot, or C) when the top of their ears are above the top of the car seat shell. Children will likely outgrow their convertible car seat in forward facing position long before they are ready to booster. Moving them into a Combination seat then is advised, which allows for the child to remain in a 5 point harness until 60-85 pounds, then later convert to a high back booster when the harness seat is outgrown (either by weight or height). The very minimum criteria to use a booster seat are 4 years AND 40 pounds, but there is absolutely no reason to rush into a booster seat. Most children lack the maturity to sit properly in a booster seat until they are 5-7, and most children will need to stay in a booster seat until age 10-12, (or 4 foot, 9 inches) when they can properly fit into an adult sized seat belt.

When a child is too small for a booster they risk “submarining” under the seat belt, and suffering internal injuries to the belly and esophagus where the seat belt does not fit properly. Children often will tuck the shoulder portion behind their back when an ill-fitting belt is rubbing on their neck, leaving them vulnerable to spinal injury or complete ejection from the seat. Older children often still fall asleep on car rides, and when they do they slump out of position, making the seat belt relatively useless for them. Even if the perfect seat belt fit is attained with a belt positioning booster seat, the child absolutely has to be able to stay in that position the entire car ride, every single ride, hence the need for booster maturity more than height and weight. Sure your 6 year old might complain about being the only child in his class still in a “baby seat”, but you can go ahead and tell that big boy that there is only one of him in this whole world and you aren’t willing to risk losing him. He’ll get it.

Above all else remember this: every upgrade you take (turning the baby forward facing, moving from a harness to a booster, etc), is actually a major downgrade in safety. Don’t rush it- ride to the MAX!

“When you know better, you do better.”

Click here to read the 1st installment in the series: Airplane Safety

Click here to read the 2nd installment in the series: Car Seats and Winter Coats: How to Keep the Little Ones Warm (and SAFE)

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