Experts back car seat guidelines

American Academy of Pediatrics releases new safety rules

Almost a year after Connecticut strengthened its laws about children’s car seats, advocates are throwing support behind new guidelines from the American Academy of Pediatrics which are even stricter than the state regulations.

In the November issue of the journal Pediatrics — published online in August — the AAP recommended children remain in a rear-facing car safety seat as long as possible, until they reach the highest weight or height allowed by their seat. Previously, the academy recommended children should remain rear-facing at least to age 2. The new recommendation removes the specific age milestone.

The recommendation makes sense to Gerald Rakos, chairman of pediatrics at Stamford Health, which includes Stamford Hospital. He said car crashes are one of the leading causes of child deaths.

“If you think about it from the perspective that every transition in car seat safety is a decrease in protection, it kind of makes sense that you would want to stick with the highest level of protection for as long as possible,” Rakos said.

Others who support the AAP guidelines include Fran Mayko, AAA Northeast spokeswoman and a certified child passenger safety technician. She said AAA, Yale New Haven Hospital and other organizations helped push for Connecticut to have a stricter law about car seats — a law that went into effect Oct. 1, 2017.

The law requires children to ride rear-facing in vehicles until they are at least 2 or weigh at least 30 pounds. The previous regulation said children’s car seats could be turned forward by the time children are 1 and weigh 20 pounds.

“At that time, the AAP had already come out and said (the earlier guidelines) were too low, and we agreed,” Mayko said. “We worked really long and hard to get that law upgraded.”

But Mayko said the new AAP guidelines offer even more protection than Connecticut’s updated law, as many car seat manufacturers state that children can remain rear-facing in their product until they weigh up to 40 pounds.

As a child passenger safety technician, Mayko said, she tries to get parents to keep their children rear-facing for as long as possible. Securing infants and young toddlers in a rear-facing seat offers more protection to the head, neck and spine — the most vulnerable parts of their bodies.

Experts said switching to a forward-facing seat too soon can allow a small child’s head, which is disproportionately large and heavy relative to the rest of the body, to be thrown forward, resulting in severe spine injuries and potentially fatal brain injuries.

Using the proper seat lowers a child’s risk of death or serious injury by more than 70 percent, Mayko said.

According to the Centers for Disease Control and Prevention, motor vehicle injuries are one of the major killers of children in the United States. The CDC reported that in 2016, the most recent year for which numbers were available, 723 children ages 12 years and younger died as occupants in motor vehicle crashes and more than 128,000 were injured.

In Connecticut, 2,274 children younger than 16 were injured in car crashes in 2017, according to the University of Connecticut Crash Data Repository, which collects accidents statistics in the state. Of this number, 29 were seriously injured and there was one fatality.

Mayko said in 2017, 214 children ages 7 and younger (the ages that kids are required to be restrained in a car seat or booster seat) were injured because they were only restrained by a seat belt.

AAA Northeast recommends parents read the instruction manual or car seat labels to determine the manufacturer’s weight and height limitations of their car seat. Once the child meets the requirements to start facing forward, he or she should remain in a 5-point harness seat until they reach the height and weight limitations. Most forwardfacing seats accommodate children up to 65 pounds or more.

Rakos applauded the new AAP guidelines, and plans to recommend that the parents of his patients follow them.

“It just makes common sense,” he said.

Gabrielle Lurie / The Chronicle In the November issue of the journal “Pediatrics” — published online in August — the AAP recommended children remain in a rear-facing car safety seat as long as possible, until they reach the highest weight or height allowed by their seat. Previously, the academy recommended children should remain rear-facing at least to age 2. The new recommendation removes the specific age milestone.