How long should my child ride rear-facing?

MacKenzie - posted on 01/03/2009 ( 6 moms have responded )




The question of when a child can safely ride facing the front of the car is probably the largest misconception in child passenger safety today. The recommendation changed about 3 years ago, but has been very slow disseminating to parents. The current recomendation is that your child stay RF until they can no longer ride RF due to their height or weight. That means all children should ride RF until they weigh between 30-35 lbs. (depending on the RF weight limit of their convertible seat) or until the top of their head is within 1" of the top of the hard plastic shell of their car seat

Even many doctors are unaware of the latest recommendation and continue to tell parents to turn babies FF at one year, or even earlier if they have long legs. This is incredibly dangerous, and is very poor medical advice. Many parents worry about thier child's legs hitting the vehicle seat back, and the possiblity of broken legs/hips. There is no evidence of increased leg/hip fractures in RF children. In fact there is not a single documented case. In Europe they routinely RF to between age 4-6. It is one of the reasons they have a much lower mortality rate in children in crashes. Kids have knees and they will use them! They will just sit cross-legged or even hang their legs over the edges of their seat. While it may look uncomfortable to an adult, kids are much more flexible than we are.

It is harder on parents than on children to leave them RF. As parents we look forward to the day we can turn our kids to the front of the car. We like being able to see them and interact with them. But kids don't know the difference. They have never been FF in the car, and they are just fine staying RF. Many kids go through a phase of kicking/crying/whining/complaining about being in the car seat. This generally happens when a child becomes mobile and doesn't like being restrained in a car seat period. Parents often mistake this as a sign that the child "wants" to turn around in the car. Rest assured that it is a phase, and they will get over it. Kids are safest facing the rear of the car and should stay that way until they can no longer ride RF.

Why is it important to stay RF? There are many reasons, but the most important has to do with your child's anatomy. A child's head is about 1/3 of their total body weight. By comparison, an adult's head is about 6% of their total body weight. A child's spine also does not fully ossify (or harden) until about age 4, nor do their vertebrae do not fuse until about this age. So their heavy head combined with a weak spine are a recipe for disaster in a car crash.

When RF, a child's car seat cradles their head/neck and the whole seat moves with the child during the crash. This allows the child's body to "ride-down" the crash forces gradually, rather than all at once. In comparison, when a child is properly restrained in a FF car seat, their body is strapped snugly into the harness, and the seat is firmly anchored to the vehicle seat. The seat does not move with the child in a crash. Rather the child's body remains anchored in the unmoving seat, but their head extends out between 28"-32" (28" if the top strap on the car seat is properly used, 32" if the top strap is not used or is improperly used). Considering it only takes about 1/4" of spinal stretch before a child suffers severe and irreparable spinal injury, this is extremely dangerous. In addition, the child's abdomen is thrust against the harness with extreme force (the crash force experienced by a person's body is equal to their weight TIMES the speed the car was traveling upon impact. So a 20lb. child in a 30 MPH crash would experience 600 lbs. of force!). This can lead to severe injuries to the internal organs due to belly injury.

What can you do to protect your child? Keep them RF as long as possible. When they outgrow their infant seat (typically between 22-30 lbs, depending on the seat) move them to a RF convertible seat. Read the manual for your convertible seat to see what the RF weight limit is (on all new convertible seats, the limit is between 30-35 lbs). Older seats may have lower limits (remember that ALL car seats expire after 6 years and must not be used after they expire).

If you have already turned your child FF, turn them back to RF. Most kids don't care, or get used to it quickly. A RF seat reduces your child's risk of death in a crash by about 72%. A FF seat offers only about a 50% reduction in risk of death. That is a HUGE increase of risk of death. Keeping your child RF a year or two longer may be less convenient for you, but if you are in a crash, it could mean the difference of having your child survive or not.

Each step you take toward the adult seat belt is a drastic reduction in safety for your child. Going from RF to FF, from the FF harness to a booster, and from the booster to an adult seat belt significantly reduces your child's ability to survive crash. Keep them at each stage as long as you can before moving on.

There is so much information about car seat safety that unless car seats are your area of expertise, it is nearly impossible to have all the latest info. That is why Safe Kids Worldwide ( trains hundreds of child passenger safety techs (CPST) every year to help educate parents about the latest recommendations, safety improvements, and the safest way to transport your child. CPST's must complete a 32 hour course on child safety in the car, and have at least 6 hours of continuing ed every recertification cycle. Most of us do many more hours than that! Technology changes rapidly, and recommendations change based on the current technology.

We recommend that you have your car seats checked by a CPST regularly (at least every time you make a change...infant seat to convertible, adding a child to the family, getting a new car) . It is a free service, typically offered by your local hospital and sometimes local police or firestations. Be aware that while most firestations/police will happily "check" your car seat, many firefighters/police ae not CPST's and are not educated about the proper use of car seats. Make sure a CPST is on staff and insist that they be the one to check your seat. Anyone else, while trying to be helpful, may actually endanger your child by giving improper advice. We see this a lot in seats coming in from stations without CPST's.

Car crashes are the #2 killer of children under 1 year of age, and the #1 killer of children 1-14.

Here are several links to support keeping your child rear facing for as long as possible.

Here's an article reinforcing WHY Rear facing is BEST

Here are a few crash test links to show you the difference in rear facing vs forward facing:

Here is a crash test of a 12 month old RFing">¤t=video06A_MGA_213_RearFace-Convertib.flv

Then, here is the SAME 12 month old FFing">¤t=video06B_MGA_213_ForwardFace-Conver.flv

42% of accidents occur in rural settings. 25% of them occur within 5 minutes of your home.

Autopsy reports have shown that children under 2 years old are at 4 times the risk of Internal Decapitation when forward facing. What is Internal Decapitation??

Wikipedia says this:

Internal decapitation, atlantooccipital dislocation, describes the rare process by which the skull separates from the spinal column during severe head injury. This injury is nearly always fatal, since it usually involves nerve damage or severance of the spinal cord. Hanging relies on allowing the subject to break their neck under their own weight.

When a child is RFing, the BACK of their carseat--the part that goes behind their back and head--take the brunt of the crash force. In a FF car seat, the CHILD takes the brunt of the crash force.

Let me know if you have any questions!


View replies by

Van - posted on 12/14/2010




Thanks for posting this. I am only a mother of an 8 month old and I am always so worried about being in an accident. I read and read more and more about extend rear-facing and how to actually harness your child in correctly. I try to spread the word as much as I can so every baby is as safe as possible. Whether people choose to listen is up to them.

Sunshine - posted on 09/26/2010




Wow.. Thanks for the info I was wanting to turn him around so bad at ONE.. he is 10 months now & he will SCREAM the WHOLE time he is in the car seat & there is NO way to stop him unless I get him out & I have a 20 hour drive ahead of me soon all by myself..

Kim - posted on 11/15/2009




MacKenzie you are awesome! I love to see other people so eager to spread this knowledge. It's inspirational and motivational. I am trying to get a non profit started in my area to benefit the kids in my community...So I just wanted to say thanks for motivating me a little more! =)

April - posted on 02/22/2009




My son is 25 months, 26 lbs and still rear facing! It the safest means of transportation!

Jennifer - posted on 01/21/2009




Thank s so much for this information!  I am a mother of 3 teenagers, a home daycare provider and a foster mom for infants.  This information is so helpful. 

I would love to become a CPST..  I have came across some very uneduacted parents over the years.  Some that think putting a child in a car seat not even buckled in, is perfectly safe. 

I would love to be able to volunteer my services to parents and feel confident that I was teaching them the correct way to install and use their car seats.  

 I will be turning our 1 yr olds car seat back around first thing in the morning!!   Thanks again!  Jenn

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