Cruising for a Bruising: Car Seat Recommendations Too Strict?

Filed under: Research Reveals: Toddlers & Preschoolers, Research Reveals: Big Kids

Forget the first birthday car seat switcheroo.

Infants and toddlers riding in forward-facing car seats are five times more likely to be injured in crashes than those in rear-facing ones. Those facing front are more than 75 percent more likely to suffer fatal and severe injuries. More than 1,500 children under age 16 die in auto accidents each year.

No wonder the American Academy of Pediatrics' new car seat policy recommends children ride backwards at least until their second birthdays. Before you unlatch anything, though, let's look at those car-seat crash stats.

They come from a 2007 study analyzing auto accidents registered in the National Highway Traffic Safety Administration database between 1988 and 2003. Researchers drew a sample of 870 children, all younger than age 2, 40 percent of whom rode forwards during the collisions, 60 percent backwards.

True, the youngsters stuck looking out back fared better overall, but here's what the media neglected to mention -- most children weren't hurt at all.

That's right -- 90 percent facing forwards and 85% backwards sustained not so much as a scratch. Including those with only minor boo-boos (scratches, mild bruises), 99.5 percent and 98.9 percent, respectively, came out unscathed. That's a whopping .6 percent difference.

Let me rephrase -- only .5 percent of the backward-facing and 1.1 percent of the forward-facing kiddies suffered more than truly mild injuries. Thus serious injuries were extremely rare.

Critical injuries occurred in .16 percent of rear-facing versus and .02 percent of forward-facing children. Fatal injuries in .02 percent and .00 percent. Although none of the children facing the back died, their fatality risk was lower by a mere .02 percent.

What's more, those car accidents happened over a 15-year span, some over two decades ago. Fatal crashes for children under 16 have decreased 45 percent since 1997, according to the American Academy of Pediatrics.

Surely today's car seats are safer than those manufactured during Reagonomics. But the researchers didn't account for differences in car seats, be it manufacturing year, harness type or weight-limit. Nor did they consider how a child's weight, height or precise age (in months) impacted injuries -- nor the possibility that safety-conscious parents might keep kiddies backwards longer and also drive more cautiously.

So, that's how we arrived at "significant" risks that -- outside of academia and the media -- might not mean much, particularly for families with car seats, cars or genetics that don't readily accommodate rear-facing 1-year olds.

A less than 1 percent risk might not be enough to justify policy changes or a new car seat. Apparently, however, it is enough to rebuke people who pooh-pooh the new policy (check out the nastiness over at The New York Times).

Here's what should make us worry: one in five kids isn't in a car seat at all. The researchers looking into the national accident data had to disqualify over 20 percent of the infants and toddlers from the study because they didn't ride out the crash in any car seat -- not a rear-facing, forward-facing, three-point or five-point harnessed, latched, convertible or FAA-approved one.

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AdviceMama Says:
Start by teaching him that it is safe to do so.