Thursday, December 30, 2010

A CPST Clarifies the Benefits of Rearfacing Beyond Babyhood

Compiled by Jennifer Mann, CPST since 2007. Photos copyright Jennifer Mann.


"As you might have noticed, Facebook has been a bit bombarded by crazy people talking about how babies should stay rear-facing until at least age 2 (gasp! the nerve! the horror! how dare they!).

Oh wait. I'm one of those crazy people, also known as Child Passenger Safety Technicians (CPSTs) certified by Safe Kids Worldwide. I thought I might try to explain why techs, child passenger safety advocates, and concerned parents are so impassioned about this topic.

The Stats
Rear-facing children are FIVE times safer than forward-facing children.

Crash Dynamics
The majority of crashes are frontal collisions. In any crash, everything in the car (people, objects) will travel to the point of impact very quickly (fractions of a second). In a frontal collision, this means you, as adults, will be thrown forward with only your seatbelt and possibly an airbag to slow you down. Likewise, a forward-facing child will have only his or her harness straps to help the body slow down and stop (of course, they don't have the airbag). This leaves nothing to stop the head from continuing to travel forward.

The problem is the bones surrounding a child’s spinal cord do not ossify (harden) until ~3 years old. The spinal cord can stretch ¼ of an inch before detaching. A crash can stretch the spinal cord up to 2 inches, depending on the severity of the crash. So a younger child's spinal cord could detach from the head in a bad crash(known as internal decapitation).

A rear-facing child, however, is thrown into the energy-absorbing foam in the restraint shell, which distributes the crash forces evenly along his or her entire head, neck, and spine, keeping the body in alignment and protecting the spinal cord. This is why children in Sweden ride rear-facing until 4 or 5 years old. Incidentally, Sweden has very low injury and fatality rates as a result of motor vehicle crashes.

The Problems
Okay, so let's break all that down a bit.

1) A forward-facing seat cannot restrain a child's head (in the same way that our seatbelts cannot restrain our heads). The harness can only make contact at the collar bones and hip bones, but the head continues to travel forward.

2) The bones around the spinal cord don't ossify until age 3 on average. So the spinal cord is not adequately protected, especially in a severe crash.

3) Let's face it. Kids have big ol' noggins. My son did/does! "It's like an orange on a toothpick!" (Sorry, that's a line out of one of my favorite movies.) They're bobble heads! Actual numbers now: In a young child, the head makes up ~25% of the total body weight, whereas in an adult, the head is only ~6% of the total body weight.

And in a crash, you take the weight of the object multiplied by how fast the car/occupants are moving to determine the estimated crash force. For example: a 5 lb. head x 20 mph = 100 lbs. of crash force being flung on an inadequately protected spinal cord in fractions of a second. Ouch!


So now let's put those three problems all together:
Unrestrained big, heavy head + inadequately protected spinal cord = real potential for a broken neck/spinal cord and possible subsequent death

There is simply no comparison when you look at the crash tests. Those crash tests convinced me to turn Emily back rear-facing at ~3y8m (no, that's not a typo), after she'd already been forward-facing for two years (she did not resist the switch thankfully because she's an equal opportunist and wanted whatever little brother was getting! No joke!). She finally turned forward-facing again at 4y7m (nearly a year later), when she hit the 33-lb. rear-facing weight limit of her Britax Marathon. Her brother, Zach, was rear-facing from birth to 3y2m, when he reached the rear-facing weight limit.

The Potential
A broken neck. 18-month-old Joel was nearly killed in a crash that broke his neck. His grandfather has now thrown himself into child passenger safety advocacy:http://www.joelsjourney.org/

Micah, who also suffered from internal decapitation:

More links
A new AAP article recommends rear-facing to at least age 2:http://aapnews.aappublications.org/cgi/content/full/30/4/12-a



Awesome summary and answers to other questions, including those pertaining to rear collisions: http://www.cpsafety.com/articles/StayRearFacing.aspx

Another great summary (from overseas, which is why their harnesses look a little different): http://www.childrestraintsafety.com/rear-facing.html

If someone you know has a baby who will be turning a year old soon, please forward this information to him/her.

If you already knew all this but need some YouTube sap to get (usually well-meaning, but misinformed) family and friends off your back, check these out:

Remember that every step toward the adult seatbelt is a step down in safety. Turning your child forward-facing is NOT a milestone to look forward to and it's nothing you want to rush."


5 comments:

  1. Thank you! Great article. I'll be sharing this in Sunday Surf

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  2. Thank you so much for compiling all this info into one post! We got so many questions about leaving our daughter rearfacing for so long, I'll keep this bookmarked as we, undoubtedly, get the questions again with our son.

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  3. Thank you! My kids are all still Rear facing they are ages 5.5yr old. 4yr old, and 20mon old. This will be passed onto family and friends who question my choices.

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  4. The link about Micah is great but it doesn't explain how sitting rearfacing would have protected him from a side collision that caused his internal decapitation. Any links or info on that?

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  5. B/c rearfacing is at an angle/recline, it is thought to provide more side impact protection than forward facing. You can find some interesting discussions on this topic at www.car-seat.org.

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