Car Seats: What is Safest for My Child?

Dina Burstein, MD, MPH, CPSTI, FAAP

The American Academy of Pediatrics (AAP) recently updated their car seat recommendations. Changes like this can often lead to some confusion. We want to be sure you understand the new guidelines for car seat safety.

In 2011, the AAP recommended that parents keep their child in a rear-facing car seat until their second birthday. Now, their updated recommendations state that children should remain rear-facing as long as possible. That means you should continue to use a rear-facing car seat until your child reaches the maximum weight or height (whichever comes first) allowed for that car seat.  Many children may now be able to remain rear-facing until as old as four years of age.

Why the change? 

The original recommendation for children to remain rear-facing until age two was based on research data as well as experience in some European countries. There, children ride in rear-facing car seats well beyond the age of two. When the AAP reexamined the data, it became clear that it was not possible to pinpoint an ideal age for using front-facing seats, while the safety benefit of rear-facing extended beyond the second birthday.

What about older children?

Once your child outgrows their rear-facing car seat, it is time to switch to a forward-facing seat with a harness. This seat can be used until your child reaches either the maximum height or weight allowed for that car seat. 

Next is a booster seat. Children need to continue to use a booster seat until they are big enough that the vehicle seat belt fits them correctly.  What do we mean by this?  When your child sits in the car with their back against the vehicle seat, their legs need to be long enough that their knees bend naturally over the edge of the vehicle seat and their feet rest comfortably on the floor.  When they buckle up, the seat belt should lay across the middle of their chest and not rub up on the neck.  Unfortunately, there is no set age, height, or weight for when a child is ready to stop using a booster seat.

If you’re still confused, don’t worry, there is help. You can find a certified child passenger safety technician in your community. These individuals have been trained to assist you with proper use and installation of your child’s car seat. They can also answer your questions about what is safest for your child. Here is a listing of locations with certified child passenger safety technicians in Rhode Island and southeastern Massachusetts.

We understand how important your child’s safety is. Visit our website for more tips and videos to help keep your family safe.