An About Child Safety Car Seats

The nation's biggest organization of pediatricians is telling its members and parents that children riding in cars should stay in rear-facing child safety seats at least until their second birthday - and if possible even longer.

This reverses advice many pediatricians gave parents for years that children's car seats should be turned just about shortly after their first birthday.

The new policy from the American Academy of Pediatrics, published Monday in the Pediatrics medical journal, is bolstered by investigate that shows children under 2 are 75% less likely to die or be severely wounded in a crash if they are in rear-facing child restraints.

Similarly important, the academy recommends that children remain in seats with five-point safety harnesses as long as possible and should change to booster seats that rely on adult seat belts only when they exceed the height and weight limits for the five-point harness.

Five-point harnesses, which run across children's shoulders and hips and buckle between their legs, provide more safeguard than seat belts because they distribute the crash forces evenly over the strong, bony parts of children's bodies.

Even when children are tall sufficient to change the adult seat belts, the academy's policy is that they should ride in the back seat until age 13.

Every parent wants their kids to accomplish things as fast as they can, said Dr. Ben Hoffman, a University of New Mexico associate professor of pediatrics who helped write the new policy. "That's extraordinary for developmental milestones or for school. But for child passenger safety, that's the in the wrong attitude to have."

The federal government is locating to issue updated child seat guidance Monday that echoes the pediatricians' advice.

Although the use of child car seats has significantly reduced deaths and injuries in the last decade, vehicle crashes remain the leading cause of death for children 4 and older. About 1,500 children under age 16 die in means of transportation crashes each year in the U.S., the Pediatrics report said.

Dr. Dennis Durbin, an emergency room pediatric physician at the Children's Hospital of Philadelphia and the Pediatrics report's chief author, recognized that some parents and children might balk at aspects of the new policy. Durbin is a father who said he understood that older children were professional negotiators.

There are certain things I'm willing to negotiate — bedtime, teeth brushing, broccoli for dinner — but safety is invariable, he said. If parents begin that early in life, they'll get less pushback over time.

Rear-facing seats act like cocoons, cradling children's heads, torsos, arms and legs, and spread crash armed forces over a bigger area.