Front-Facing Car Seats: Is Your Child Ready?

As many discussions about our son do, it started with one innocent question on a long car ride: when should we turn his car seat around? He’s almost three and finds great joy in kicking the back of the back seat, happily yelling, and waving at trucks and buses he sees along the road. Then we spiraled… Is he too tall for the back seat? His legs are bent but he’s not complaining. Is it bad for his hips to have his legs splayed out to the side? Is it ok that his feet touch the back of back seat? Would he be happier if he could look out the front window like his parents or if I could turn around in the passenger seat and make eye contact with him?

Surely, I’m not the only parent whose mind works like this, right? Carrie Rhodes, Passenger Safety Program Coordinator at Nationwide Children’s Hospital, recommends the following:

• Check your car seat manual. The manual lists the weight and height ranges where children can ride rear- and forward-facing. Some seats may also have minimum ages. There is usually some overlap between modes, and it is safest to stay rear facing until the maximum height or weight is met. If you have an all-in-one car seat, the manual will list guidelines for rear-facing, forward-facing, and booster.
• Follow federal guidelines. The National Highway Traffic Safety Administration (NHTSA) and the American Academy of Pediatrics (AAP) both recommend children stay rear-facing as long as possible – until they reach the upper height or weight limits for their specific car seat.
• Follow the 1-inch rule. If your baby’s head is within an inch of the top of the car seat shell, or if he or she weighs more than the highest weight limit of the car seat, you will need to transition to the next stage (either from an infant carrier to a convertible or all-in-one car seat, or by turning their convertible or all-in-one from rear- to forward-facing).
• Bent legs are okay. Although families often worry that keeping their child rear-facing is putting them at risk for broken legs, research shows that the risk is actually lower than for kids who are forward-facing. From a comfort perspective, remember that little kids are really flexible. They can cross their legs, toss them over the sides, prop them up on the seat back – whatever they want is fine!

Why is it important to keep your child rear facing as long as possible?

• In the event of a crash, rear-facing offers the best protection for the head, neck, and spine of infants and young toddlers. The car seat’s shell cradles the child, instead of allowing the head to move forward separately from the body – Carrie often tells families it’s like going through a crash on a backboard.
• For children with special needs, staying rear-facing may have extra benefits:
  • Rear-facing allows for more recline than forward-facing, offering additional support to kids who have low muscle tone or airway concerns.
  • The increased support and protection of rear-facing is important for children with Down syndrome who often have low muscle tone and increased risk for cervical instability.
  • The increased safety of rear-facing is extra important for kids whose bodies are fragile, like kids with osteogenesis imperfecta, hydrocephalus, or spinal muscular atrophy.

Long story short? We’ll keep my son rear facing until he reaches the maximum weight or height listed for our car seat. The longer he can be rear facing, the safer he’ll be, bent legs and all.