Top 5 Myths About Rear-Facing
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The AAP (American Academy of Pediatrics) updated their recommendations in April to state that children should ride rear-facing until 2-years-old (or until they reach the maximum height and weight for their seat), and remain in a booster seat until the age of 8.
Alisa Baer, M.D., also known as “The Car Seat Lady,” explains the new recommendations in the following video, and why it’s so important to follow them. Dr. Baer also took the time to talk to us about the Top 5 Myths associated with rear-facing car seats in the article, below.
The Car Seat Lady explains the new American Academy of Pediatrics Car Seat Recommendations from The Car Seat Lady on Vimeo.
Top 5 Myths about Rear-Facing
Myth #1: My baby’s legs are too long for rear-facing – he’s uncomfortable & if we’re in a crash he’ll break his legs!
Fact: Rear-facing kids can ride safely and comfortably with limited room for their legs.
Your 6-month-old happily sucks his toes, your 18-month-old plays happily sitting on the floor with his legs in a “W”, but you, however, couldn’t even imagine getting your legs into either of these positions (let alone doing it comfortably), even if you are a yoga master! Having installed rear-facing car seats for many 3 & 4 year-olds I can tell you from experience that these older kids, who have far less leg room than your 18-month-old does, do not complain of their legs hurting. Still not convinced? Ever watch a 5 year old sleep in the car with his chin down on his chest and wake up several hours later without a care in the world? If you did this, you wouldn’t move your neck for a week! Kids are more flexible than we are because their joint spaces are not fully formed.
2-year-old, 28 lb. boy
What about a broken leg? Surprisingly, studies show that forward-facing kids break their legs more often in crashes than rear-facing kids. A broken leg, however, is easy to fix; brain and spinal cord injuries are typically unfixable. Rear-facing virtually eliminates any chance of your child suffering a brain or spinal cord injury.
Myth #2: My 14-month-old hates riding rear-facing – and wants to ride forward facing
Fact: Your 14-month-old hates being strapped down – she doesn’t care about the direction she is facing
As a pediatrician, I can tell you that it is not developmentally appropriate for your 14-month-old to be happy about being strapped down. She is curious, newly mobile (crawling, cruising, walking) and wants to explore her world; car seat straps take away her independence and she is likely to protest. Like other phases (remember how much fun colic was) she will outgrow this also. In my experience helping families over the past 14 years, I find that the age of hating the car seat is worst from 12-15 months of age, and gets a lot better by 18 months of age.
15-month-old, 26 lb. boy
If your 14-month-old found a book of matches and wanted to play with them, you wouldn’t let her no matter how much she tantrumed because you knew that the risks were too great. So too with the car seat; riding forward facing is 5 times more dangerous than riding rear-facing, and increases her chance of injuries we don’t know how to fix, namely those to the brain and spinal cord.
Myth #3: My baby gets motion sick riding rear-facing and needs to turn forward-facing
Fact: Forward-facing kids get motion sick just as often as rear-facing kids
Motion sickness happens when the brain gets mixed messages about motion and can’t reconcile them – your body feels stationary as you sit in the car but your eyes tell your brain that your body is actually moving. When the brain can’t figure out how to make sense of these seemingly contradictory messages, the body feels sick. Volvo did a large survey of several thousand toddlers and found no difference in the rates of motion sickness between those riding rear-facing and those forward-facing. But statistics don’t help when it is your child who is throwing up! Here are some suggestions.
The most important thing is to make sure your child has the best view possible out the BACK window. Kids and adults who get motion sick will tell you that looking out the side windows is a quick and easy way to feel very sick, very fast because things move very quickly out the side windows – which confuses the brain even more. Looking out the back window (for rear-facing kids) or the front window (for forward-facing kids or adults) makes it seem like you are moving slower than the side windows make it seem. For rear-facing kids, sit their car seat as upright as the manufacturer allows and, when possible, remove the vehicle’s head rest to give the child the best possible view out the back window. If possible, have the child ride in the center of the back seat as this spot typically gives the best view out the back window. You may want to consider trying to block your child’s view out the side windows – since you can’t really tell a 2-year-old not to look out the side window! This sunshade will do just that.
Make sure you aren’t inadvertently making your child feel sick – if you are giving him toys or books that require looking down and concentrating, this will likely make him feel sick. Try occupying your child with songs and games that require looking out the window. If you can, travel at naptime or bedtime as your child will not feel sick while sleeping.
Many parents use food as an activity during long car rides – but for a child who gets motion sick, this will only make matters worse. Feed your child something starchy like bagel or crackers about 1-2 hours before the car ride – and then try to not feed him in the car.
If you have to take a long trip, talk to your pediatrician about using an anti-nausea medication. You can also try some natural, homeopathic remedies including accupressure wrist bands (but make sure the one you get is not a choking hazard for a young child!) and ginger.
Some kids are going to get motion sick regardless of the direction they are facing – and the worst part, besides watching your child feel ill, is having to clean the car seat when it is full of vomit. To decrease the clean-up, have your child wear a “puking poncho” – this way their clothes and the car seat stay clean, and all you have to wash is the poncho. Here are two different examples of products that can work well as “puking ponchos” (I’m sure my mother wished she had these when I was a kid!)
- Bibbitec
- Terry Cloth Cape (wear it in front, instead of in back)
- The Car Seat Poncho (for winter time)
- FlipOverMe Poncho (for winter time)
Myth #4: My 20-month-old is in the 95th% – he’s too big for rear-facing!
Fact: Nearly every convertible car seat (including the inexpensive ones) can accommodate even very big toddlers rear-facing until at least the age of 2.
One of the key reasons that the American Academy of Pediatrics chose the age of 2 for their recommended minimum age to go forward facing is that the 95th% 24-month-old weighs 35 pounds – and since nearly every convertible seat goes rear-facing until at least 35 pounds, every parent can follow the new recommendations and keep their child rear-facing until at 2.
19-month-old, 33 lb. girl
When we talk about older kids riding rear-facing, we are talking about in a convertible seat – the one that starts rear-facing and then goes forward facing – not in an infant seat. While many infant seats now have weight limits as high as 35 pounds, we are not suggesting that your toddler ride in an infant seat as even if they are within the height requirements they are almost certainly too tall (their head is closer than 1 inch from the top of the seat) and definitely don’t like riding as reclined as they are forced to in the infant seat.
Myth #5: But my pediatrician said it is OK for my under-2-year-old to ride forward-facing, therefore it must be safe
Fact: The American Academy of Pediatrics recommends that ALL kids stay rear-facing until at least age 2 – and ideally longer, until reaching the maximum height or weight for rear-facing in their convertible seat
As a pediatrician myself, I can tell you that it is humanly impossible for us to stay current on all the topics we are required to know. Not only that, but many pediatricians never received ANY training on car seat safety either in medical school or residency. Here are the links to several medical journal articles on the topic of older kids riding rear-facing – so you can read the evidence for yourself.
1. American Academy of Pediatrics, Committee on Injury, Violence & Poison Prevention. Child Passenger Safety. Pediatrics. 2011; 127: 788-793.
2. Henary B, et al. Car Safety Seats for Children: Rear Facing for Best Protection. Injury Prevention. 2007; 13 (6): 398-402.
3. Bull M, Durbin D. Rear-Facing Car Safety Seats: Getting the Message Right. Pediatrics. 2008; 121 (3): 619-20.
4. Watson E, Monteiro M. Advise Use of Rear Facing Child Car Seats for Children Under 4 Years Old. BMJ. 2009; 338: b1994.
5. Arbogast KB, et al. Injuries to Children in Forward Facing Child Restraints. Annu Proc Assoc Adv Automot Med. 2002; 46: 213-30.
About Alisa J Baer, MD:
Alisa graduated from NYU School of Medicine in 2006, completed her pediatric residency at the Children’s Hospital of Philadelphia in 2009, and is currently living in NYC working as a pediatrician in the NICU (Neonatal intensive care unit) at Columbia University Children’s Hospital of New York – all the while continuing her role as “the car seat lady.”
The epidemiological research Alisa conducted on parental knowledge about and attitudes towards booster seats culminated in a publication in a professional journal in addition to a presentation at a national conference. As a certified instructor for the National Highway Traffic Safety Administration’s 32-hour car seat course, she has educated nurses, doctors, social workers, police, firemen, and many other community members about car seat safety so that they can provide information and services through their professional roles. This website, dedicated to providing accurate, up-to-date information along with how-to videos to anyone worldwide is a dream of Alisa’s that has now come to fruition.
Pediatrician & Nationally Certified Child Passenger Safety Instructor
Comment by Mary on Jul 07 2011 09:24:54:
What about if your vehicle has a very short seat in the back and the only ones that fit according to safety rules are forward facing?
Comment by AMANDA BOSE on Jul 08 2011 12:45:48:
I live in the North Dallas (TX) area. My vehicle is not equipped to keep a rear-facing child cool in this 103° heat. I can’t afford to purchase a different vehicle at this point in time, but would like to keep my 8 mo old as safe as possible, and rear-facing. Does anyone have any suggestions on how to keep him cool back there? I have tinted windows and shades on both sides already. How can I provide a traveling environment for my son, that’s comfortable, not just merely tolerable? Even though I always have the Max a/c on full blast, and all the vents in the car pointed in his direction, he always seems to be drenched with sweat upon arrival, following the 9 minute drive to the grocery store (or anywhere else it takes at least 5 minutes to get to).
Comment by michele on Jul 08 2011 07:10:37:
Hi Amanda, By the way love your named its also my oldest name, any ho…Have you consider buying a portable car fan. I had the same issue couple of years ago. So I got a portable fan from walmart that plugs into the cars cigerette lighter, and attached the fan near my daughters rear-facing car seat. It not only worked, but the slight mumming sound of the fan would put her to sleep. Good Luck. Also try putting a small towel behind him to soak up the sweat…could be the materiel the car seat is made of. Again good luck.
Comment by Ariana on Jul 12 2011 03:44:26:
Try throwing a white towel over the car seat when youleave the car, it should keep the car seat cooler for when you get back in.
Comment by Melissa on Jul 12 2011 03:59:14:
Amanda-I live in Texas too. I keep ice packs in the seats while we are shopping/etc. I just don’t place them directly on the buckles or chest clips. Helps when they get back in. Also, they sell shower cap style covers for them too. Clip on battery powered fans on the back of the seat work well. While they are a projectile that is a parental decision. Just a plain old vehicle sun shade is nice in a pinch and pointing air vents up instead of straight back will help air get to kiddo.
Hope that helps!
Comment by Katie on Jul 12 2011 04:17:23:
One of my 3 boys gets car sick. (severely)We travel over 6 hours each way to Grandma/Grandpa’s house 4 or 5 times per year. Plus, we travel over 9 hours each way at least once per year. I tried everything homeopathic before turning to motion sickness medication, but in the end, that’s where I ended up. I just wanted to put that on here in case others were dealing with this issue. One hour before we leave the house, my son takes a dose of children’s benadryl (not to put him to sleep but because it has the same active ingredient as dramamine…this is what a pharmacist told me anyway). Dr. Baer, is this true? Thanks!
Comment by Ashley on Jul 12 2011 05:04:10:
Amanda…I would think it would be difficult for any car to cool down for short trips like the 9 minute trip to the grocery store you mentioned. Have you tried letting the car run for a little bit to cool down before yall load up? Love all the other suggestions…never thought about a white towel before!!!
Comment by Autumn on Jul 12 2011 05:41:37:
Can a 6 year old sit in the front seat if there is no other place to put him as long as I keep him in his booster? I drive a Mazda 3 and just recently had baby #4. I have the 3 younger ones in carseats in the back and my 6 year old in a booster in the front. I know a van is more ideal for my family, and we are saving for one; but for the next year, I have to make due with what we have.
Comment by Juliana on Jul 12 2011 06:21:06:
Autumn if there is no other choice you can put him in the front. Go to the dealership and ask for them to turn the airbag off and push the passenger seat as far back as it will go.
Comment by Cathy on Jul 12 2011 11:05:11:
Mary- What kind of vehicle do you drive? As long as it is a legal seat to instal a car seat on- there will be a car seat that will work. The back seat of an extended cab Ford Ranger or similar is actually considered a jump seat and not legal to instal a car seat on (that goes for any vehicle with a jump seat).
Amanda- I have a special needs daughter (she is now 4 and still rear facing) that has heat intolerence. My van does not have vents in the back. We purchased a fan that plugs into the cig outlet and used zip ties to make sure it doesn’t become a projectile. We also make sure the freeon is full in the AC. Pointing the vents towards the ceiling help it to travel into the back better.
Rear facing is not something to think of as a pain. It is keeping your child safer. My daughter is 4. She will be staying rear facing until there is no seat she can fit any longer rear facing in.
Comment by Rebecca on Jul 12 2011 11:31:38:
Mary- the Combo Coccoro will fit rear facing in a Toyota Corolla or a Honda Civic.
Comment by Alice blouin on Jul 13 2011 04:57:20:
I use a Sunshine Kids Radian rear facing, you can move the foot an inch or two from the bight and tighten good to achieve an extremely tight more upright install. Using this I have successfully installed rear facing in an Alero, Civc (2 and 4 door), Golf and small mazda truck. The truck was in the front seat (airbag off) but the others all in the back passenger side without the passenger being extremely cramped. I am 5 foot 7 and have been comfortable each time, as well as larger male passengers.
Comment by Beth on Jul 13 2011 09:21:07:
I want to continue rear facing my 21-month-old as long as possible, but am concerned about height issues. She is getting fairly close to the max height in her current seat (she is a tall girl!), and I would like to find a new seat that is taller and will give her more time RF. However, my husband is very tall and must have the front seat pretty far back to fit in my Honda CR-V. Any (reasonably priced) suggestions for a seat that is taller but that will still allow the front seat to be far back?
Comment by Amy on Jul 13 2011 11:38:11:
I have a 2006 Toyota Corolla and the Evenflo Symphony 65 fits comfortable rear facing behind my drivers seat. Im 5’6 and my husband is 5’10…neither of us have issues with the seat position. It rear faces to 35lbs, forward faces with a 5pt harness to 65lbs, and serves as a belt assist booster up to 100lbs. We have our Chicco Keyfit30 behind the passenger side, which serves as a rear facing seat up to 30lbs/30inches.
Comment by Jacque on Jul 14 2011 10:57:47:
I am amazed by all the excuses to not rear face. I live in AZ in 119 degree heat and my son is fine rear facing. Check out Cold Seats on Amazon, great product.
Comment by shelia on Jul 16 2011 07:08:30:
Great post and comments. I turned my little back to rear facing after reading the recommendations and seeing a few videos about injured children related to forward facing car seats.
Comment by jaimewvu on Aug 05 2011 07:35:40:
Beth, we have 2 Honda CRVs and 2 Britax Marathons. The big reason we bought the CRVs was that they have center LATCH points. The Marathon has a clip that lets you tether RF too, which works well. The drivers seat can actually recline when the car seat is installed so I am assuming the seat can go the whole way back too. LO is still safely and happily RF at 20 months.
Comment by Caresse Funk on Nov 03 2011 12:45:51:
New and older mama's and must read, one that can save you baby's life.
Comment by Jodi on Nov 02 2011 09:39:14:
Amanda:
I live in South Australia, it gets between 35-45 degrees celcius here in the summer, one trick I use on occasion (works for shortish rides) is to dampen my son’s hat with water. Simple, but effective for when you’re in a bind.
Pointing the vents towards the roof also works very well.
Comment by Kasey Harris Mueller on Nov 03 2011 03:56:01:
thanks I needed all the reasons…..good read.
Comment by Alison Wendel Jones on Nov 03 2011 06:42:07:
Very good information for rear-facing carseats!
Comment by Amanda Antico Webb on Nov 03 2011 09:00:36:
This is FANTASTIC! So many parents complain about the chemicals in our food or the harm that cigarets can cause but they over look the life saving possibilities that a simple car seat when used APPROPRIATELY can do…
Comment by Amanda Antico Webb on Nov 03 2011 09:01:40:
I wish I could put my 456 month old rear facing sometimes!
Comment by Bevin Stricker King on Nov 03 2011 09:35:01:
Makes this mommy not seem so crazy
Very good RF and booster info watch the video too.
Comment by Anna Maijala on Nov 04 2011 03:28:31:
Love this! My sons both ride rear-facing in identical Radian XTSL's. Yup, even the one who's about to turn three is still rear-facing. With how much room he has left to grow in that seat, he will make it to at least four years old before we have to think about turning him forward-facing. Rear-facing is so much safer. NOT doing it for as long as possible, simply isn't an option in this family.
Comment by Anna Maijala on Nov 04 2011 03:28:31:
Love this! My sons both ride rear-facing in identical Radian XTSL's. Yup, even the one who's about to turn three is still rear-facing. With how much room he has left to grow in that seat, he will make it to at least four years old before we have to think about turning him forward-facing. Rear-facing is so much safer. NOT doing it for as long as possible, simply isn't an option in this family.
Comment by Erin Consuegra on Nov 04 2011 04:01:26:
Not for us either!!!! Julian is 26 months and RF in a Radian XTSL also. He will rear face until he outgrows the weight limit, whenever that might be.
Comment by Erin Consuegra on Nov 04 2011 04:01:26:
Not for us either!!!! Julian is 26 months and RF in a Radian XTSL also. He will rear face until he outgrows the weight limit, whenever that might be.
Comment by Heather on Nov 04 2011 10:36:50:
For those wondering about good RF seats for tight spaces, I recommend the True Fit. It has a removable headrest for when babies are younger; then for older toddlers, when you can have it slightly more upright anyway, the headrest goes on. But what’s really nice is that it is *angled* so it doesn’t just keep going forward towards the front seat. The shape of the seat on the ‘inside’ is still straight and comfortable for the child, but the outer part barely adds any overall length to the seat. It’s really well engineered.
We have a Radian which we turned FF as soon as DD was 2, since it was rammed up against the front seat, even when it was all the way forward, and that’s actually not considered safe… nor was it safe for 5’11″ me with my legs wedged in under the dash. But in our other car (which my daughter is in more frequently), we had the TrueFit and were able to keep her RF until she was 3.5yo and that was with the front seat all the way BACK and still room to spare!
Comment by Heather on Nov 04 2011 10:42:13:
If ‘affordability’ is an issue, the True Fit is more expensive than some seats. BUT consider that you can use it from birth until age 5-6, and you realize that it’s a bargain in the long run. My daughter is now almost 5 and still has a couple inches of growing before she’s too tall, and is nowhere NEAR the max weight limit. When she finally outgrows it, she’ll be ready to move straight into any booster seat. It cost us I think about $300 at the time (shipping included), I’m guessing she’ll outgrow it around age 5.5, so over 5.5 years that’s less than $55/year. A bargain for keeping her safe.
Comment by Steve Narwold on Nov 04 2011 05:34:16:
I didn't think rear facing was all it was cracked up to be. "What about rear-end collisions?" I thought. My wife was convinced though, so I looked for solid evidence and objective studies. All the data I found told me that rear facing is without a doubt the safest way to ride. My personal conviction is that even adults would be safer rear facing with the proper head support! Anyways, I'm a believer. Good article.
Comment by Steve Narwold on Nov 04 2011 05:34:16:
I didn't think rear facing was all it was cracked up to be. "What about rear-end collisions?" I thought. My wife was convinced though, so I looked for solid evidence and objective studies. All the data I found told me that rear facing is without a doubt the safest way to ride. My personal conviction is that even adults would be safer rear facing with the proper head support! Anyways, I'm a believer. Good article.
Comment by Dannie on Nov 05 2011 01:53:00:
@Amanda, I live in Phoenix Arizona and it too often gets super hot during the summers in the car. I would suggest not pointing the A/C directly at your child but point them UP to the ceiling of the car. Hot air raises and cold air sinks not to mention I think the ceiling would get it to him quicker without other objects in the way. Also after it’s cooled down and it’s cooler inside your car than outside turn on the recycled air symbol because it will help with the flow of the air. I have a Kia Spectra and this is what I do during the summers.
Anyways I love the RFing and I’m hoping more people will realize it’s what’s BEST for their child. I don’t understand NOT rfing or turning a child around before their 1st birthday AND 20 lbs. I just can’t understand it, if you want to do what is best for your child why not follow the recommendations? I have a small car and have to put the front seat up in order for my son to RF so I don’t drive when we go out as a family because my husband can’t sit in the front seat. It’s something I would rather do than have my son ff. He is now 14 almost 15months old and still happily rear facing. I love love love our Sunshine Radian XTSL it’s awesome and will definitely grow with him.
Comment by Lindsey on Jan 17 2012 11:35:37:
I turned my older child forward facing at 15 months. She WAS getting carsick rear-facing, even with shades to block the side windows and no toys to distract her. Turning her forward fixed that instantly. For SOME people, myself included, looking out the rear window is not helpful. I used to ride in a station wagon with a rear-facing seat. My body knew it was going one way while my eyes were seeing things going the other way. I still got sick. My child was the same. So, I respectfully disagree that the carsickness is a myth. For MY child, it was absolute fact. And lest anyone suggest, “Dramamine! It really works!” No thanks. I don’t want my child drugged 6 days out of 7.
Comment by Christy on Jan 18 2012 10:54:14:
My son was rearfaced in a Graco MyRide until he was just shy of 4 years old, he outgrew it heightwise for rearfacing and was very confused by what forward facing was. Now my daughter is rearfacing in a Graco MyRide and is just shy of 3, she is a very petite girl so will be rearfacing for much longer. My younger son is still only a young infant but will be purchasing a Radian soon so that he can rearface for many years to come.
Hotcars are hard, on really hot days I put towels over the seats, tucked into the windows and shade protectors on all the windows while its parked, that alone makes it much more tolerable. Then at home I precool the car while the kids play in the front yard. Out and about, I just blast the cool air. Friends of mine use cold straight from the freezer water bottles in to cool off their kids. Mine know how to make any liquid container spill so not an option here.
Comment by Ann on Jan 30 2012 09:28:21:
@Autumn – I don’t know if you’ll still see this or not. I would not put the 6 yo in a booster up front. Put the oldest child that is still in a 5 point harness that’s forward facing in the front seat with it pushed all the way back and keep the child in the booster in the back. Or you can put the 6yo back into a 5 point harness while he’s in the front seat.
Comment by Pam M on Feb 09 2012 12:01:27:
I live in Texas as well. I am going to look in to getting a “Cool Mee” Seat Liners, from Meeno Babies (www.meenobabies.com). It looks like a great product in addition to the white towel and ice packs.