AAP Recommends Rear Facing Car Seats Until Age Two

In a change of direction, the American Academy of Pediatrics (AAP) now says that children continue to be <"http://www.yourlawyer.com/practice_areas/accidents">secured in rear-facing car seats until they are either two years of age or they grow larger than seat specifications, according to revised guidance. Said MedPage Today.

Since 2002, the AAP recommended children be secured in rear-facing car seats for as long as possible, said MedPage Today. The new guidance does not provide a minimum threshold for turning the seats around, said Dennis Durbin, MD, a pediatric emergency physician at the Children’s Hospital of Philadelphia. Prior guidance set minimums at either one-year of age or when the child reaches 20 pounds, said Dr. Durbin, the policy statement’s lead author and author of an accompanying technical report published online in Pediatrics, said MedPage Today.

Meanwhile, the National Highway Traffic Safety Administration (NHTSA) just released new guidelines for child passenger safety based on age and are considered in line with AAP’s recommendations, according to a statement, noted MedPage Today. In a recent interview, Dr. Durbin said that the AAP’s committee on injury, violence, and poison prevention opted to revise the child passenger safety policy following its 2007 reaffirmation, explained MedPage Today.

In Sweden, said MedPage Today, children generally remain in rear facing seats until they reach the age of four; new data from Sweden and the United States has revealed that there are benefits in reducing serious injury risks in children over the age of one. Durbin pointed out that today’s car seats and restraint systems are easily able to accommodate this new guidance, wrote MedPage Today.

“The academy is really hoping that these recommendations do a good job of getting all pediatricians up to speed on what the recommendations are because they’re really viewed as a major source of information for families,” said Durbin, quoted MedPage Today. Durbin said that the policy statement also includes an algorithm to help “guide clinical decision making,” said MedPage Today. “We hope that this enables [clinicians] to feel confident that they can be providing the best available advice for their families as they possibly can,” Durbin said, quoted MedPage Today. “I think one of the main messages that’s coming out of these recommendations is that those transitions should be delayed for as long as possible, because with each transition you make you give up a little safety in the event of a crash,” said Dr. Durbin, quoted MedPage Today.

In addition to saying that children remain in rear-facing car seats until the age of two or when they outgrow seat height and weight criteria, updated AAP recommendations say:

• Once they outgrow the seats, children should be placed in forward-facing seats with harnesses, until they outgrow those seats’ height and weight specifications

• When forward-facing seats are no longer feasible, place children in belt-positioning booster seats until children are able to be fitted in the car’s lap-and-shoulder seat belt so that the lap belt fits low across the hips and pelvis and the shoulder strap fits across the middle of the child’s shoulder and chest. This tends to occur when a child is 4 feet 9 inches tall, around eight-to-12 years of age.

• When booster seats have been outgrown, children must always wear lap and shoulder straps and all children under the age of 13 must ride in the back seat.

Meanwhile, following a Chicago Tribune investigation on child safety seats in 2009, the U.S. Transportation secretary announced plans for carmakers to crash-test child safety seats and recommend restraints considered safest, by vehicle. Baby car seats are designed to shield children from injuries in an accident; however, problems continually involve defective handles, sudden releases, weak construction, unanticipated rotation, and others. Many hundreds of injuries to infants have arisen since 1998 on recalled car seat models and millions of baby car seats sold since 2001 have been recalled because of design flaws, including weak shells, flammable materials, base/shell separation, and defective harness systems. From March of 1998 until May of 2001, four major manufacturers of child safety seats announced five recalls involving nearly 10 million car seats.

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