This week is Child Passenger Safety Week, an annual reminder of the importance of keeping children safe while riding in vehicles. Despite recent improvements in child passenger safety, car crashes remain a leading cause of injury and death among children. One of many ways that we can help reduce the often devastating effects of car crashes is by assuring proper use of car seats, booster seats and seatbelts.
But choosing and installing the proper child restraint can be confusing. There seem to be countless car safety seats on the market, not to mention the complexities woven into the installation process. These factors may contribute to the results of multiple studies finding that the majority of car seats are either used or installed incorrectly.
As a pediatrician, I frequently discuss child passenger safety as a part of my well-child care. One common misconception related to child restraints that I encounter occurs at the one-year visit, during which many caregivers mention that they are going to switch their child to a forward-facing seat. There is often excitement about taking this step, almost similar to that of a developmental milestone being met.
What many parents don't realize is that each step in the child restraint transition process -- from rear-facing to forward-facing to booster seat -- is associated with a decrease in protection. Therefore, each of these transitions should be delayed for as long as possible.
According to U.S. crash data of children younger than 2 years old, those riding in rear-facing car seats were significantly less likely to die or be seriously injured than those riding forward-facing, regardless of crash type. The benefit of a rear-facing seat is related to its ability to distribute crash forces over the young child's entire body, rather than focused on harness contact points. This allows the child's head and neck to move with the seat, rather than abruptly forward, reducing the risk for neck and spine injury. Organizations such as the American Academy of Pediatrics took into account this safety data and updated their recommendations in 2011 to include keeping infants and toddlers in a rear-facing car seat until they reach the top weight or height allowed by their car seat manufacturer or until they are at least 2 years old.
Despite these recommendations, many children are transitioned to forward-facing seats prematurely. A study published earlier this year found that almost one-quarter of children were transitioned to forward-facing at or before their first birthday. Reasons for this early transition may include caregivers' desire to see their child's face while driving or the easier nature of removing their child from a forward-facing car seat. These are valid concerns, but most of us would agree that the decreased risk of injury or death in the rear-facing position outweighs their conveniences. Parents act in the best interest of their children, so I assume that many may just not be aware of the risk. We as a community can be more effective at sharing the information with them.
Keeping children in a rear facing car seat until they reach the top weight or height allowed by their car seat manufacturer is just one of many ways to help promote child passenger safety. Other factors, such as seat selection, installation, harnessing and avoidance of distracted driving are also important. If you want to learn more about how to keep children safe while riding in the car you can start by turning to your health care provider, car seat and vehicle manuals, and the AAP and National Highway Traffic Safety Administration websites. There are also trained child passenger safety technicians available as a resource in many communities to provide education on the correct seat selection, installation and use. A list of local CPS technicians can be found at the National Child Passenger Safety Certification Website, and information about inspection stations and community car seat check events during Child Passenger Safety Week and throughout the year can be found at NHTSA's Parents Central website, or locally at the Alaska Child Passenger Safety Coalition website.
Let's all take a step toward ensuring the safest car ride possible for our children. Even a small adjustment in the use of a child restraint could save a life.
Dr. Theresa Dulski is an Anchorage pediatrician and child passenger safety technician.
The views expressed here are the writer's own and are not necessarily endorsed by Alaska Dispatch News, which welcomes a broad range of viewpoints. To submit a piece for consideration, email commentary(at)alaskadispatch.com.