Babies should be in rear-facing car seats for as long as possible, to the limits of the car seat. Extended rear-facing, beyond one year and 20 pounds, has big safety advantages that parents should strongly consider. In fact, the most recent study on this subject shows that toddlers are up to five times safer if they remain rear-facing until age two.
Turning baby's car seat around isn't a milestone to rush on. It's actually a step down in safety, so don't be in a hurry to make the big switch.
You've probably heard the one year/20 pounds advice from many well-meaning sources. That's the old standard, though, and it is a bare minimum standard. All children are safer if they remain in a rear-facing car seat beyond a year. Thanks to higher rear-facing weight limits on car seats, nearly all toddlers can remain rear-facing to age 2 and beyond.
Why Rear-Facing? Car seats are designed to absorb some crash forces and spread remaining crash forces over a larger area of the body. For adults, seat belts distribute force to the strongest parts of the body, the hips and shoulders. Infants don't have many body parts that are strong enough to withstand crash forces, so the rear-facing car seat distributes the crash force along the entire back, neck and head, putting less stress on any one part of the body. The infant's head, which is large and heavy for a still delicate neck to support, is also better supported with a rear-facing car seat.
According to a report in the April 2011 edition of Pediatrics, the bones and ligaments of a young baby's spine can stretch up to 2 inches, while the spinal cord itself can only stretch about 1/4 inch. That means if the spine is forced to stretch in a crash, the spinal cord is at risk of breaking, leaving the baby with brain damage or paralysis. The incidence of severe head and neck injuries for babies and toddlers is greatly reduced in rear-facing car seats.
The additional support plus the way a rear-facing car seat moves in a crash gives your baby the best chance for survival and less chance of injury in a crash. The simple way to estimate crash force is weight times speed. A 10-pound baby in a 30 mph crash would experience an estimated 300 pounds of force. A rear-facing car seat spreads that 300 pounds of force over a greater body area, causing less injury to the baby. If you'd like a quick demonstration of the difference, check out this video comparing rear-facing and forward facing car seats in a crash test.
My Baby Wants to Be Front-Facing! Even if your baby's legs are touching the seat back, or the baby cries when rear-facing, you should still keep baby rear-facing until he or she reaches the rear-facing weight or height limit of the car seat. Most convertible car seats have rear-facing weight limits of 35-40 pounds now, so you should be able to keep your toddler rear-facing to age 2, if not longer. Some children never like sitting in a car seat, and they may cry. However, being properly restrained makes it more likely that a baby or toddler will survive a crash to cry another day. You can browse the Extended Rear-Facing Car Seats Gallery to see photos of older toddlers comfortably and safely riding rear-facing.
Many parents worry that their baby will suffer broken legs in a crash because baby's legs touch the seat back or look cramped when rear-facing. It's important to remember, though, that in a crash severe enough to break baby's legs, there would also be enough force to cause severe neck injuries if your baby or toddler was forward-facing. While it's never fun to choose between injuries, the chance of full recovery is greater for broken legs than broken necks. Similarly, if your baby fusses while in a rear-facing car seat, it may seem easy to turn baby around to keep him or her happy. Again, though, you're choosing between a fussing baby or the chance of severe head, neck and spine injuries.
My Baby is One Year Old and 20 Pounds! Now What?
Car seat safety advocates recommend that babies stay in a rear-facing car seat to the weight limit of the seat or at least until age 2. The American Academy of Pediatrics recently revised their car seat policy to recommend rear-facing to age 2, as well. Several car seats today have rear-facing weight limits up to 40 pounds, which might accommodate the average child through age 3 and maybe beyond. A few car seats have rear-facing weight limits above 40 pounds! You should also check the manufacturer's rear-facing height limit to be sure baby is not too tall to safely stay rear-facing to the weight limit. My advice is to simply leave your baby rear-facing at this point. The safety advantages far outweigh any convenience.
My recommendation is to choose a car seat with a high rear-facing weight limit and tall shell, and then to use it rear-facing as long as possible. For many toddlers, that would keep them rear-facing beyond age two. My daughter was three before she reached the rear-facing weight limit on her car seat. Now that there are car seats with even higher rear-facing limits, even my tall toddler son is comfortably rear-facing at almost 3 with plenty of room to grow before he needs to switch.
Why would you want to keep your child rear-facing? Crash data shows us that anybody is safer in a crash when riding rear-facing for the reasons we outlined above. Even though your baby's neck may now be strong enough to withstand some types of forward-facing crash forces, he or she is still better protected in a rear-facing car seat because that seat still distributes the force over a greater body area and still gives better support to their young head and neck.
A rear-facing car seat offers the best protection for babies and toddlers, and should be used for as long as possible, to the limits of the car seat. It is no longer recommended to turn your baby around immediately at one year and 20 pounds, thanks to new research that shows the safety advantages of extended rear-facing. A 2007 study in the Journal of Injury Prevention showed that rear-facing toddlers under age 2 are 75 percent less likely to die or be seriously injured in a crash. According to NHTSA, a rear-facing car seat is 71 percent safer than no restraint at all, and a forward-facing car seat is 54 percent safer than no restraint at all. Keeping your baby rear-facing to the limit of the seat is the safest choice. You can check your car seat instruction book or the labels on the car seat sides to find the rear-facing weight and height limits.
Heather Corley is a certified Child Passenger Safety Technician-Instructor.