A policy statement, "Child Passenger Safety," with new car seat recommendations from the American Academy of Pediatrics was published in the April 2011 issue of Pediatrics.
Car Seat Guidelines
The latest car seat guidelines from the AAP recommend that:
- Infants and toddlers should ride in a rear-facing car seat (infant-only rear facing car seat or rear-facing convertible car seat) until they are two years old or until they have reached the weight and height limits of their car seat. Although this means that some larger infants and toddlers might have to graduate to a rear-facing convertible car seat, there are several models of infant only seats with higher, 30 to 35 pound weight limits that should get you to the next car seat safety milestone.
- Once they are two years old (or, regardless of age, have outgrown their rear-facing car seat) toddlers should sit in a forward-facing car seat with harness straps as long as possible and until they reach the weight and height limits of their car seat. Keep in mind that many convertible car seats and combination car seats have forward-facing weight limits of 65 to 80 pounds when used with harness straps.
- Kids can next move to a belt-positioning booster seat when they reach the weight and height harness strap limits of their forward-facing car seat.
- The move to regular seat belts should not occur until kids are "old enough and large enough" for the seat belts to protect them properly, which usually isn't until they are 4 feet 9 inches tall (57 inches) and are between 8 and 12 years old.
- All kids under 13 years of age should sit in the back seat, using an age-appropriate restraint.
Although the new guidelines seem quite different from previous AAP car seat guidelines, which for example, recommended rear-facing car seats for infants until they had reached at least 1 year of age and weighed at least 20 pounds, it is important to realize that was a minimum recommendation. The 2010 car seat guidelines for infants went on to say that children should continue to ride rear-facing until they reach the highest weight or length limits of their convertible seat and then stay in a forward-facing seat as long as they fit.
Even the 2002 policy statement on car seats stated that "If a car safety seat accommodates children rear facing to higher weights, for optimal protection, the child should remain rear facing until reaching the maximum weight for the car safety seat." Infants and younger toddlers are at greater risk for head and spinal cord injuries if they are in a forward-facing car seat instead of a rear-facing car seat, which provides better support for their head.
Car Seat Laws
Dr. Robert Sanders, a pediatrician in Tennessee, helped pass the first car seat laws in 1978.
Next, the AAP launched the "First Ride - Safe Ride" program in 1980 to increase the use of car seats by parents of newborns.
Although a far cry from today's car seat guidelines, it was an improvement over AAP recommendations in 1962, which urged pediatricians to 'have seat belts installed in their personal cars, to use the belts regularly, and to promote their use by families of their patients.'
Today, there are many state car seat laws that need catching up to the AAP car seat guidelines to help keep kids safe. Parents should remember that they should do what is safe for their kids, even if it likely exceeds the requirements of the state car seat laws where they live. For example, in Florida, kids are only required to be in a car seat through age three years.
Best Car Seat
Is there a best car seat for your child?
With the big differences in prices for car seats, one would think so.
It is important to keep in mind that all car seats must meet the same federal safety standards and crash performance standards. According to the NHTSA, "the best car seat is the one that fits your child properly, is easy to use, and fits in your vehicle correctly." Some car seats and booster seats are easier to use than others though, either because they have clearer instructions, are easier to install, have better labels, or make it easier to secure your child correctly in the seat, which can be seen in the wide variety of ease of use ratings that car seats get.
So that you follow the latest AAP car seat guidelines, you might also try to find a car seat and/or booster seat with high weight and height limits, so that you don't have to move your child to a new seat before he is ready.
Available car seats and booster seats with higher weight and height limits include the:
- Combi Shuttle 33 - an infant only seat with rear-facing limits of 33 pounds and 33 inches
- Graco SnugRide 35 - an infant only seat with rear-facing limits of 35 pounds and 32 inches
- Britax Marathon - a convertible seat with rear-facing limits of 35 pounds and forward-facing limits of 65 pounds and 49 inches
- Evenflo Symphony - a convertible seat with rear-facing limits of 35 pounds, forward-facing limits of 65 pounds and 50 inches, and which can then be used as a belt-positioning booster
- Graco My Ride 65 - a convertible seat with rear-facing limits of 40 pounds and forward-facing limits of 65 pounds and 50 inches
- Recaro Como - a convertible seat with rear-facing limits of 35 pounds and forward-facing limits of 70 pounds and 50 inches
- Britax Frontier - a combination seat with forward-facing limits of 80 pounds and 53 inches and booster seat limits of 100 pounds and 60 inches
- Evenflo Generations - a combination seat with forward-facing limits of 65 pounds and booster seat limits of 100 pounds and 57 inches
- Safety 1st Go Hybrid Booster - a combination seat with forward-facing limits of 65 pounds and 53 inches and booster seat limits of 100 pounds and 57 inches
Car Seat Best Practices
Again, the best car seat is one that is used correctly.
- Tight is Right - make sure your car seat is installed tightly using a seat belt, or LATCH if it is available. If, when holding the bottom of the car seat, you can move the seat more than 1 inch, then it may not be installed tightly enough.
- Seat Belt Readiness - Your older child isn't ready for regular seat belts unless he can sit with his back against the seat and have his knees bent at the edge of the seat without slouching, with the shoulder belt lying against the middle of his chest and shoulder (not his neck), and the lap belt against his upper thighs (not his abdomen).
- Avoiding Common Car Seat Mistakes - in addition to choosing the wrong type of seat for your child's age, common car seat mistakes include having loose harness straps, not installing rear-facing car seats at a 45 degree angle, and not using LATCH when it is available.
- Pickup Trucks - children should never be allowed to ride in the cargo area of a pickup truck and parents should be aware that the smaller rear seats of some compact extended-car pickup trucks may not be as safe as other cars and trucks with larger back seats.
- Register Your Car Seat - you will be notified of any car seat recalls if you register your car seat.
American Academy of Pediatrics Policy Statement. Automatic Passenger Protection Systems. Pediatrics 1984 74: 146-147.
American Academy of Pediatrics Policy Statement. Child Passenger Safety. Pediatrics 2011;127:788-793.
American Academy of Pediatrics Policy Statement. Seat Belts In The Prevention Of Automobile Injuries: Report Of The Committee On Accident Prevention. Pediatrics 1962 30: 841-843.
American Academy of Pediatrics Policy Statement. Selecting and Using the Most Appropriate Car Safety Seats for Growing Children: Guidelines for Counseling Parents. Pediatrics Vol. 109 No. 3 March 2002, pp. 550-553.
American Academy of Pediatrics Technical Report. Child Passenger Safety. Pediatrics 2011;127:e1050-e1066.
NHTSA. Child Seats: Ease-of-Use Ratings. Accessed March 2011.