[Kellster]

Children should face the rear of the vehicle until they are at least 1 year of age and weigh at least 20 lb to decrease the risk of cervical spine injury in the event of a crash. Infants who weigh 20 lb before 1 year of age should ride rear facing in a convertible seat or infant seat approved for higher weights until at least 1 year of age.3,4 If a car safety seat accommodates children rear facing to higher weights, for optimal protection, the child should remain rear facing until reaching the maximum weight for the car safety seat, as long as the top of the head is below the top of the seat back.3

Premature and small infants should not be placed in car safety seats with shields, abdominal pads, or arm rests that could directly contact an infant’s face or neck during an impact and injure the child.5

For optimal protection, pediatricians should counsel parents of most children (those who weigh more than 12 lb at 4 months of age) to encourage use of a convertible car safety seat that will accommodate them rear facing at higher weights.

A convertible car safety seat is positioned semi-reclined and rear facing for a child until at least 1 year of age and at least 20 lb. The seat is positioned upright and forward facing for an older and heavier child who weighs up to 40 lb and may be used as long as the child fits well (eg, tops of ears below the top of the car safety seat back and shoulders below the seat strap slots).6

HTH

Kelly