New child passenger safety seat guidance advises kids to ride rear-facing as long as possible; drops age criterion

New child passenger safety seat guidance

The most dangerous thing that U.S. children do as part of daily life is ride in a car. Motor vehicle crashes remain the leading cause of death for children 4 years and older.

Using the correct car safety seat or booster seat can help decrease the risk of death or serious injury by over 70%, and parents look to their pediatricians as a trusted source of guidance.

New evidence over the past decade prompted the Academy to update the policy statement and technical report Child Passenger Safety. The documents are available at and, and will be published in the November issue of Pediatrics.

The impact of the revised policy should be minimal, as the only significant change is the removal of a specific age, 2 years, as a criterion for when a child changes from a rear- to a forward-facing car safety seat.

Guidance for families

Pediatricians should be prepared to provide advice at every health maintenance visit to ensure that children are as safe as possible. The evidence-based recommendations call for the following:

  • Children should ride in a rear-facing car safety seat as long as possible, up to the limits of their car safety seat. This will include virtually all children under 2 years of age and most children up to age 4.
  • Once they have been turned around, children should remain in a forward-facing car safety seatup to that seat’s weight and length limits. Most seats can accommodate children up to 60 pounds or more.
  • When they exceed these limits, child passengers should ride in a belt-positioning booster seat until they can use a seat belt that fits correctly.
  • Once they exceed the booster limits and are large enough to use the vehicle seat belt alone, they should always use a lap and shoulder belt.
  • All children younger than 13 years should be restrained in the rear seats of vehicles for optimal protection.


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