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Posted by Dr. Monica Wonnacott | January 26, 2016

2009 Car Seat Guidelines

I wrote this article back in 2009 about new car seat regulations. Here it is:

There’s a brand new recommendation from The American Academy of Pediatrics to keep toddlers rear facing in a car seat until the age of 2.

This replaces the previously held recommendation of rear facing until 1 year and 20 lbs. The latest research indicates that the toddler is five times safer when rear facing versus forward facing. Furthermore, a child is 75% less likely to die or experience serious injury when riding in a rear facing car seat. (Henary B, et al. Inj Prev. 2007; 13:398-402)

As I have educated parents about the new recommendation, most parents have been concerned about their child’s legs fitting against the back seat. This is an understandable common complaint. However, lower extremity injuries are rare with rear facing seats. (Bull MJ. Durbin DR. Pediatrics. 2008; 121: 619-620) Furthermore, keep in mind it’s much easier to fix a broken leg than broken neck.

As for which seat to use, you can use the infant seat until you reach the maximum height (when the infant’s head is within a couple of inches of the top of the seat) and/or weight (usually 22-32 pounds) suggested by the car seat manufacturer.

In my practice, I find that most infants are transitioning out of an infant car seat by 9 months (the taller infants even earlier). After the infant seat, you will need a convertible, rear-facing car seat. Most convertible car seats will then allow you to transition to a forward facing car seat as the toddler is older (until you reach the maximum height and weight limits for the seat model). If you need help in getting your car seat installed properly, I recommend the following: