At what point should a child stop using rear-facing car seats? Past recommendations suggest using the seats until a child is 2 years old, but new ones dropped the age limit for maximum safety.

New Child Seat Recommendations

The previous recommendations on the use of rear-facing car seats for children was partly based on a study wherein researchers found lower injury risks for children 1 and 2 years old in rear-facing car seats compared to those in forward facing car seats.

However, re-analysis of the data revealed that the injury numbers were too low to be considered statistically significant, thereby suggesting that there is still no certainty when it comes to the safest age to transition a child from rear-facing to forward-facing car seats.

As such, from the recommendations to have children use rear-facing car seats until 2 years old, the American Academy of Pediatrics (AAP) updated its recommendations to having children use rear-facing car seats for as long as possible.

Specifically, this means that children are recommended to use rear-facing car seats for as long as their height and weight are within the seat’s set limits, even if the child is older than 2 years old.

In rear-facing car seats, the child’s head, neck, and spine are protected and supported by the seat’s hard shell, which absorbs most of the crash force and protects the body.

On the other hand, in front-facing car seats, the child’s body is merely restrained by harness straps, but their disproportionately larger heads may be thrown forward, resulting is possible serious injury to the neck, head, or spine.

Reducing Serious Injury And Death Risks In Cars

In the last decade, there have been significant reductions in the number of children killed in car accidents, but such incidences remain to be the top cause of death in children below 4 years old. According to policy statement lead author Dr. Benjamin Hoffman, MD, FAAP, there still isn’t large enough data to determine the right age to make the transition from rear-facing to forward-facing car seats, so it is best to keep children in rear-facing car seats for as long as possible.

“We hope that by helping parents and caregivers use the right car safety seat for each and every ride that we can better protect kids, and prevent tragedies,” said Dr. Hoffman, also noting that using the right car safety seat could lower the risk of serious injury or death by up to 70 percent.

The same recommendation is also made for front-facing car seats, in that children must also use the safety seat for as long as the seat’s height and weight limit allow. And when this limit has been reached, children must be given a belt-positioning booster seat so that they are properly harnessed by the vehicle’s seat belt until they are tall enough to do without it.

The policy statement and accompanying technical report are expected to be published in the November 2018 issue of Pediatrics.