Today the American Academy of Pediatrics releases its 2011 Policy Statement on Child Passenger Safety. As long as I remember, motor vehicle crashes have been the leading cause of death in children.

A few years after completing my pediatric training, I was tasked with writing about child passenger safety and car seats for a nationwide public education campaign. Yet, despite having just completed my pediatric training a few years prior, this was not a subject in which I was well-versed. In the late 1990s, the science of injury prevention and child passenger safety was only just taking hold. At that time, it still took some convincing to keep kids properly restrained in car seats up until the age of four, while the first U.S. booster-seat law (which only required extra protection for children between 40 to 60 pounds) wouldn’t go into effect for several years in Washington State in 2002.

Fast forward less than ten years, and today just about every state in the country, as well as the District of Columbia all have some form of booster-seat law in place. Over the same time period, what was initially a relatively small group of trained child passenger safety professionals (I believe there were only approximately 1000 formally certified Child Passenger Safety Technicians when I got my certification 10 years ago) now numbers in the tens of thousands. We have far more data and insight into what keeps children of all ages safest when it comes to riding in motor vehicles. Fortunately, we also have many new and improved car seats.

Investing the time and effort in making sure your child is properly restrained is one of the most important things you can do as a parent to esure your child’s safety. Here’s a quick summary and explanation of the AAP’s new car seat recommendations:

  • Rear-facing until the age of two. That’s right, the age of two. Not almost one, not one, but two. Now to be honest with you, this recommendation isn’t so much a change from what I (and other trained child passenger safety professionals) have been saying since the AAP’s last set of recommendations came out in 2002. For years now, we have known that it is safest to keep children facing rear as long as possible within the limits of their seat – a recommendation that for many children isn’t so different from saying up to the age of two. In the past the recommendation also stated that children should ride rear-facing a minimum of one year and 20 pounds. Children between the ages of one and two are at five times less risk of death or serious injury when riding rear facing.
  • Forward-facing facts. After recommending that children be turned face-forward as late as possible, the new AAP policy also adds much needed emphasis on the fact that using a forward-facing seat with five-point harness straps is not only the safest option for newly forward-facing children, but for as long as possible until they reach the maximum height and/or weight limits for the harness straps. While there was a time when most forward-facing seats only allowed for harness strap use up to 40 pounds, there are now seats available with harness straps that accommodate children all the way up to 65 or even 80 pounds, making the switch to a belt-positioning booster seat unnecessary (and ill-advised) until far past 40 pounds.
  • Booster Seats until age 12. Okay, technically the policy recommendation is for children to ride in booster seats up until they reach a height of 4 feet 9 inches, but the important emphasis here is that there has long been misleading emphasis on the age of eight, whereas the new policy says somewhere between the ages of eight and 12 years. This perception problem is understandable, given that the ideal booster seat laws all reference the age of eight. What you need to understand, however, is that only 1 out of 100 eight-year olds reach the right height to safely use a vehicle’s lap-shoulder belt without a booster seat. The average child doesn’t reach 4 foot 9 inches until somewhere between the age of 10 and 12. Foregoing a booster seat before the vehicle’s lap-shoulder belt fits them correctly puts children at significantly greater risk of severe injuries.
  • Big Kids in Back. I have long been asked by parents when they can allow their children to ride in the front passenger seat. The straightforward answer is now clearly stated as age 13. But I fear that just telling parents to have their preteens relegated to the back seat until age 13 doesn’t quite get across the importance of this recommendation – especially since it’s not likely to be received well by many preteens. The somewhat harsher but data-driven answer is “when you love them 40 percent to 70 percent less.” This answer clearly gets across the fact until the age of 13, riding in the back seat significantly reduces the risk of injury (as well as the severity of injury) in both frontal and side-impact crashes.

With all that said, I am proud to report that literally hundreds of child passenger safety professionals from around the state will be attending the annual two-day Nebraska Child Passenger Safety Update this week, which includes an update on the latest AAP recommendations. Our state is truly fortunate to have hundreds of dedicated technicians who are ready, willing, and able to serve as valuable and informed resources in helping insure safe travels for all of Nebraska’s children.

I also encourage all of you to visit the AAP’s website, – not only to directly access the new 2011 Policy Report, but also to enter the AAP’s Safe Ride Sweeps car-seat giveaway. Each day for the rest of the month of March, you can enter to win a Safety 1st car seat that can help you best follow the AAP’s latest safety recommendations, courtesy of Dorel (which, for full disclosure, is the car seat manufacturing company for whom I currently consult).

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