Ask The Pediatrician: What Do I Need To Know About The New Car Seat Guidelines?

father securing his son in a car seat

Meet Dina DiMaggio, MD, and Anthony F. Porto MD, MPH, official spokespeople for the American Academy of Pediatrics and the co-authors of The Pediatrician’s Guide to Feeding Babies and Toddlers. Each month, they’ll write about the latest AAP guidelines, studies and seasonal issues affecting babies and toddlers. Follow them on Instagram @pediatriciansguide.

As parents, we know how overwhelming choosing a car seat for your baby can be! There are so many car seat models available and it’s also hard to keep up with the ever-changing guidelines: How long should my child be rear-facing? When can I use a booster seat? Knowing the latest information, however, is extremely important, especially in light of some sobering statistics.

Nearly one in every 100,000 children dies in a motor vehicle crash (MVC). And approximately 20 percent of children involved in a fatal crash were unrestrained or incorrectly restrained. We’re here to help you make sure your child is restrained in their car seat properly with a summary of the latest guidelines from the American Academy of Pediatrics, updated in July.

Infants and Toddlers: Rear-Facing Seats

Old guidelines said your child could switch from a rear- to front-facing car seat after 1 year of age and if they weighed at least 20 pounds. But since 2011, the AAP has recommended remaining in rear-facing position until children are at least 2 years old or until they reach the highest weight or height limit listed on the specific car seat model. Why? Rear-facing provides better protection for baby’s head, neck and spine in an accident.

We personally recommend parents keep their child rear-facing even beyond 2 years, as long as it’s okay to do so according to the manufacturer of the car seat. Don’t worry if your child’s feet touch the back of the car seat—it’s still best to keep them in this position.

Types of rear-facing seats

There are three types of rear-facing seats: rear-facing only, convertible, and 3-in-1.

Rear-facing only seats: Also known as infant car seats, these are used for infants up to 22 to 40 pounds and often come with a base that is left in the car.

Convertible seats (used rear-facing): These can be used rear-facing, can be converted to forward-facing when a child is older, and can have higher limits in weight and height. Convertible car seats don’t come with bases and usually stay in the car.

3-in-1 seats (used rear facing): These are called “3-in-1” since they can be used rear-facing, forward-facing, or as a booster seat. Again, they don’t have a separate base but may have higher limits in weight and height.

Helpful tips

  1. Never place a car seat in the front seat of a car. The safest place for a car seat is in the center of the back seat. Make sure your baby is snug in the car seat, that the chest clip is at the center of the chest, and the seat is at the appropriate angle (the car seat instructions will indicate the appropriate angle so your baby’s head is positioned correctly).
  2. If your baby is slouching down in the car seat, the AAP says it’s okay to…

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