Monday, October 15, 2012

Car Seat Rule #2: The Whys and Hows of Rear-Facing

For the second in my sometime series on Car Seat Rules, let's talk a little bit about rear-facing. (Rule #1 is here.)

What is "rear-facing"?

We hear this term a lot. "Extended rear-facing." The AAP recommends "rear-facing" for at least two years. Use a "rear-facing" infant or convertible car seat.

It's simple, really. Rear-facing means that the child will ride facing the back of the car.

What is "extended rear-facing"?

"Extended" just implies that you keep your child rear-facing longer than the law requires. In most states, the law requires that your baby be rear-facing until at least 20 pounds AND one year old. Most convertible car seats also state that you should not turn the car seat to face forward until your child is 20 pounds AND one year of age. "Extended rear-facing" means that you keep your child rear-facing well beyond the 20-pound/one-year minimum. Most organizations interested in child safety, such as the NHTSA and the AAP, recommend you keep your child rear-facing until at least two years old, or as long as he or she fits within the height and weight limits of the rear-facing car seat.

Why is rear-facing safer?

Facing backwards is safer than facing forwards because, in a crash, inertia will cause everyone in the car to continue moving forward. (The car stops, but the people inside will still be moving forward at whatever speed the car was going when the crash happened.) The occupants of the car will be held in place (hopefully) by their seatbelts or their car seat harnesses. This puts stress on the neck, shoulders, and spine of forward-facing passengers, because the shoulders and body are held back by the restraint, but the head and arms are free to continue their forward motion. In a child, this can cause severe neck and spine injuries, shoulder injuries, and even death, as the weight of a child's head traveling forward with the force of the crash can stretch the spine as much as two inches and may break the child's neck.

By contrast, if a child is facing backwards in a car seat, the whole body will be pressed back into the seat, distributing the crash force over the body and the car seat itself, which is built to withstand these forces. The child's body will be cradled by the seat and held in a normal position, instead of the head being flung forward, as it would be when facing front.

In other words, to put it harshly, rear-facing versus front-facing can be the difference between your child's escaping unscathed or being killed in a crash.

How do I install my car seat rear-facing?

  1. You may use either LATCH or the car's seat belt (but NOT BOTH). 
  2. Find the rear-facing belt path or LATCH path by consulting your car seat manual. It should also be clearly marked on the car seat itself. Make sure the LATCH strap is fed through the right path, is not twisted, and is under the car seat padding. Locate the LATCH connectors in your car in the crease where the seat and seat back meet. (There should be a little LATCH symbol on the seat where the hooks can be found. )
  3. Make sure your seat is at the appropriate recline angle, as designated by the car seat manual. 
  4. Connect the LATCH or feed and buckle the seat belt as shown in the manual. 
  5. Tighten. If using LATCH, lean your knee or hand with as much weight as possible into the seat and pull tight the LATCH straps. If using a seat belt, pull the belt all the way out until it locks, then allow it to retract as far as you can. Put some weight into the car seat and pull that seat belt tight. 
  6. With LATCH and with seat belt, make sure the straps are not twisted at any point. 
  7. Your seat is installed when you cannot wiggle it more than one inch side-to-side or forward-and-back while grasping the seat at the belt path with your stronger hand. (In other words, the seat may still move a little bit, but it shouldn't move back and forth too much. One inch of movement in any direction is the maximum.)
Where should the straps of the harness go?

Unless you have a car seat that can be adjusted while installed (such as the Britax Boulevard or Pavilion), sometimes marketed as a "no re-thread harness", then adjust the straps before you install the car seat. Recline the seat and sit your baby or child in the seat. Find the strap slots that are closest to your child's shoulders but still BELOW them. Having the straps at or below the shoulders prevents the child from sliding up the back of the seat in a collision. Unhook the shoulder straps from the metal clip at the back of the car seat and pull them out of the slots, then thread them through the correct slots. Make sure the straps are not twisted or folded. Reconnect the straps to the metal hook. Then install the car seat. As your child grows, you will need to re-thread the straps occasionally to keep up with him, so learning this process will be helpful.

How do I buckle my child in?

  1. Sit your baby or child in your correctly-installed and adjusted seat. 
  2. Make sure his bottom is all the way back against the seat. 
  3. Put his arms through the straps and pull the crotch strap up between his legs. 
  4. Fasten the buckles of the harness and tighten the harness* until you cannot pinch and hold a fold of the strap at the child's collarbone. The straps should be tight, like a hug, but not uncomfortable. If the straps are too loose, your child could be ejected from the seat or not be restrained properly in a crash. 
  5. Now buckle the chest clip (if your seat is equipped with one - nearly every seat on the market in the U.S. has one; European seats do not). Place the chest clip in line with your child's armpits. (See Car Seat Rule #1 for more information on using the chest clip.)

*For most modern car seats, you tighten the harness by pulling on the long strap that comes out of the front of the car seat. To loosen the harness, press the button or pull the lever near where this pull strap emerges from the seat and tug on the harness to loosen it. Consult your car seat's manual for instructions on tightening and loosening the harness. Most car seats are similar and straightforward when it comes to tightening and loosening the straps.

How long can my child rear-face?

A child can stay rear-facing until he reaches the height or weight limit of his car seat. Many, many convertible car seats these days have a rear-facing weight limit of 40 pounds or more. My 3.5-year-old, who is above the 50th percentile in height and weight, is only 33 pounds, to give you an idea of how long that could be. A seat is outgrown by height for rear-facing when the top of the child's head is within one inch of the top of the car seat shell when seated in it properly.

Don't worry about your child's legs being "scrunched" or "squished" up against the back of your vehicle seat. Legs bend. Children will adapt, by crossing their legs, resting their feet up high on the back of the seat, or draping their legs over the sides of their car seat, and be perfectly comfortable. And even if, G-d forbid, you are in a crash and your child's leg breaks, a broken leg is a much less severe injury than a broken neck. For the record, there are no documented cases of a child suffering leg injuries as a result of being rear-facing in a car accident.

This YouTube video clearly (and tragically) illustrates the dangers to a baby's neck and shoulders if front-facing in a car accident.

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