Why We Should Keep Kids In Rear-Facing Car Seats As Long As Possible

My extended family treated it as if they were politely tolerating my parenting eccentricities, on par with banning the Disney channel and an insistence my kids were allergic to red food dye (except they actually are). Most of the other parents in our family gratefully flipped their kids’ carseats at a year old, before the new AAP guidelines to rearface until age two went public, though a few held out until two even before the recommendations.

But I’d done research through organizations like Carseats for The Littles and The Car Seat Lady. I knew rear-facing was up to five times safer than forward-facing, that the British Journal of Medicine, in an article published in June 2009, says it is safer for children to ride rear-facing until they are 4 years old. Yes, you read that right: 4 years old.

My children rear-faced until they were, respectively, a very small five, a medium-sized four, and an average-sized four. They were the last kids in their age group, among their friends, to flip their seats. Yes, for a very brief time, I had three rear-facing seats across the back of my car. Then we flipped my oldest, and I had two flipped seats. It stayed that way for two years.

Yes, their legs got long. They crossed them. And no, we didn’t worry about them breaking in a crash. Allana Pinkerton, Certified Child Passenger Safety Technician and Global Safety Advocate for Diono says that, “We do not see statistics of rear-facing children breaking their legs. Children are more flexible and pliable than adults. They are actually very comfortable rear facing.”

Yes, they cried rear-facing when they were babies: partly because of reflux, and partly because they couldn’t see me. A mirror helped, as did medication for the reflux (but that’s a separate issue). But by the time they reached one year, their crying stages had long passed. They were mostly content in the car unless they were bored or needed something (attention, food, a diaper change). Non-chokable snacks helped a lot, as did juice boxes. Sticker books. Toys.

Rear-facing was all they knew, so they had no comparison. They never, to my knowledge, got car sick. And most importantly, I knew they were as safe as humanly possible during a car crash.

How much safer than a forward-facing kid? Much safer. As the BMJ says, “Excessive stretching or even transection of the spinal cord can result if a child is involved in a head-on crash while in a forward facing car seat.” Translation: in a head-on crash, your forward-facing kid’s head whips forward and then back. This whiplash motion can cause injury inside the neck — up to and including internal decapitation, which is when the spinal cord detaches from the rest of the brain. Paralysis or death results. This happens because kids have bigger heads relative to their spinal cords, and can’t hold them up as well.

Even in side-impact crashes, according to The Car Seat Lady, rear-facing kids are four times safer than forward-facing kids.

The leading cause of death for U.S. children age 2-15 is “accidents.” According to the Insurance Institute for Highway Safety and Highway Loss Data Institute, ¼ of those are the result of car crashes. But there’s a place where child death and injury in car crashes is nearly unheard of. That place, according to Rear Facing For A Safer Future, is Sweden. Swedish children rear-face to a minimum of four years, and Sweden is well known for having some of the lowest number of traffic deaths in the world.

Basically, as Pinkerton says, “When a child rides rear-facing the entire shell of the car seat protects the head, neck and spinal column during a frontal collision. It is considered the optimal position for all types of collisions.”

When Scary Mommy asked her what she would say to a parent reluctant to rear-face their child past age two, she thought carefully before she answered.

“I would ask them why they are reluctant? There could be many reasons,” she said. “Then I would give them the information they need to make an informed decision. I like to give them a rating scale of good, better, and best. They are not a bad parent if they turn them around at two. I tell them they are investing in their child’s life when they are making the best decisions for them.”

And the best decision, data says, is extended rear-facing until at least age four, or until the maximum height or weight allowed by your particular seat. You can do research to find out which seats allow the longest rear-facing.

I’m glad I kept my kids safe for as long as I could, no matter the weird looks I got from relatives and, yes, from friends. My babies were safe. And in the end, that’s all that mattered.