One thing parents realize in the carseat debate is how children have developing skeletal systems. This is one of the main reasons rearfacing to the max of your carseat limits is important. Ossification begins around age 4 and is fairly complete around age 6.
This means proper posture is also important for shaping our children's spines. And carseats for most children are a daily, accumulative experience that can shape their spines for better or worse.
First, when purchasing a carseat at any stage (infant, toddler, preschool, etc) it's important to make sure the seat provides ample room for the hips and shoulders. Narrowing and lengthening the legs during infancy and early toddlerhood can increase complications related to hip dysplasia besides causing discomfort. Fortunately, most seats on the market have updated to provide a wide, cocoon shape much like a baseball glove that encourages a neutral spine position when rearfacing.
Incidentally, the issue of spinal health is also another reason to stay committed to rearfacing for as long as possible. When forwardfacing, the child's legs dangle. This has a tendency to encourage the pelvis to tilt forwards and downwards, following the weight of the legs and feet. This will cause increased lordosis of the lower back, which is a common modern lifestyle issue that can cause chronic lower back pain. Although your small child might only be complaining about pins and needles or feeling sore in the hips, being forced to sit forward prematurely every day can potentially mold the spinal cord into an unhealthy position, setting your child up for a lifetime of complaints.
*Before I continue, I want to note that projectiles in the vehicle are a valid concern and to research the topic of projectiles. Keeping your car clean and any moving objects secured is important to make sure they don't fly into your child during a vehicle collision. Using books and electronic devices in the vehicle is a controversial topic. Some CPSTs and carseat advocates promote a zero tolerance approach. Others feel the risks are small and having an occupied child is also important. This is something you as a parent need to research and conclude on for your own family. Since the majority of families I work with do use books and electronic devices, I want to address how to do this while promoting optimal spinal health.
When a child is sitting in her carseat, both forward facing and rearfacing, the natural tendency is to drop the book or device down onto her lap to rest it there. This causes the head, neck, and shoulders to follow course, drooping forward and tilting downwards.
The child could potentially hold this position for hours, especially during long trips or back and forth commutes. Young children are unlikely to periodically check themselves, lifting their heads up to stretch and reposition the spine and muscles. Instead, they tend to hyperfocus and remain in one position for long periods of time while their attention is on the book or device.
Think about how much time children spend in a carseat, and how long they might keep their shoulders bunched, neck straightened, and head tilted down! We are talking about a major factor in their spinal health here. As the child hunches forward and leans his neck down, his vertebrae are straightening out. This loss of cervical curve has long term consequences, including chronic migraines, tingling in the arms, and reduced muscle strength in the core and neck.
Even worse, a fresh study from February found that people with a loss of good lordosis (curvature) in their necks had smaller vertebral arteries. This means their brains are receiving a restricted blood supply. I don't even have to spell out why this is a danger to your child's developing brain!
Besides the potential damage to the development of their spines, tilting the head forward is a specific risk in a vehicle. If a child is sitting against the harness and out of the shell of the seat when a collision occurs, their head, neck, and shoulders might experience an increased jolt and move a farther distance before impacting with the carseat. So not only is this position hurting your child chronically, it can also increase acute, severe injuries if you get into a car accident!
What can you do when it comes to carseats and spines? Bring a pillow pet, or any related stuffed animal or small blanket that easily bunches up into a pile. It's cheap, simple, and easily accepted by the child. Place the item on their lap so they can rest the device onto the item. This raises their book or device up higher, allowing them to return to a neutral spine position. This works for rearfacing and forwardfacing children. Here are some before and after photos:
This rearfacing toddler is showing a down ward tilt that involves his head, neck, and upper back:
Here is a forward facing elementary aged child showing a typical head tilt to read:
With the simple addition of a pillow pet, she automatically moves her head back and releases the tension in her shoulders and chest:
Remember: Protect their necks: grab a pet! You can view this topic in vlog form here: