The academy’s previous guidelines, last updated in 2002, recommended rear-facing car seats for infants until they reached the maximum weight or height allowed by the seat’s manufacturer, or were at least 1 year old and weighed 20 pounds.
As a result, many parents switch their children to a forward-facing car seat as soon as they celebrate their first birthday.
But a 2007 study in the journal Injury Prevention found that children under age 2 were 75 percent less likely to die or be severely injured in a crash if they rode in a rear-facing seat rather than a forward-facing one.
The new guidelines, published Monday in the journal Pediatrics, are meant to encourage parents not to rush transitions from one type of car seat or restraint to the next, said Dr. Benjamin Hoffman, a member of the committee that helped draft the recommendations.
“The biggest issue is the perception that moving from one stage to another in terms of child passenger safety . . . that those are positive steps forward, graduations or developmental milestones. In fact, they’re not,” said Hoffman, an associate professor of pediatrics at the University of New Mexico. “The truth of the matter is that every step you make along that continuum, you lose protection.”
The revised guidelines also state that children older than 2 should use a forward-facing child safety seat with a harness until they have reached the maximum weight or height for that seat. After that, they should ride in a booster seat until a lap-and-shoulder seat belt fits correctly, usually when the child reaches 4 feet 9 inches in height or is between ages 8 and 12. And all children should ride in the back seat until they are 13.
Though the number of children killed in motor vehicle accidents has fallen significantly since the late 1990s, car accidents are still the leading cause of death for children over 4.
“We have an incredibly effective way to decrease that risk of death if we use it correctly,” Hoffman said, adding that the National Highway Traffic Safety Administration and other organizations offer resources for parents who aren’t sure how to properly install child safety seats.
New Child Safety Seat Guidelines
• Rear-facing car seat until age 2.
• Forward-facing car seat with a harness until child reaches the maximum height or weight for that seat, usually after age 4.
• Booster seats until the child is at least 4-foot-9-inches tall and between 8 and 12 years of age.
• Lap-and-shoulder seat belts for older children who have outgrown their booster seat. All children should ride in the back seat until age 13.
Source: American Academy of Pediatrics