Parents turning car seats to face forward too early

September 19, 2011 Volume 13 Issue 5
  • 73% of parents turned their child forward-facing before their child was two years old.
  • 30% of parents turned their child forward-facing before their child reached one year of age.
  • Parents most often look to car seat packaging and health care providers for information on when to turn their child’s car seat to face forward.

Motor vehicle crashes remain a leading cause of death and injury among children but with the proper use of child safety seats many injuries can be prevented.  In April 2011, the American Academy of Pediatrics updated their guidelines for child passenger safety.  Because children in a rear-facing car seat are five times safer in a crash, the guidelines now recommend families keep their infants and toddlers rear-facing at least until two years of age.  Prior to this, parents were encouraged to use a rear-facing car seat for a child until at least one year and 20 pounds.

While parents are often eager to have their child face-forward, it’s important to optimize safety of child passengers by keeping children rear-facing as long as possible. 

In May 2011, the C.S. Mott Children’s Hospital National Poll on Children’s Health asked parents of children 7 to 48 months old about their experience turning their child from a rear-facing to forward-facing car seat and which information sources they used to learn about when to turn their child’s car seat to face forward.

Turning Children Forward-Facing

One in three children (30%) were turned to face forward before one year of age.  Just 13% of children were turned to face forward after age two (Figure 1).  Of the children who haven’t been turned forward-facing (14%), the majority are younger than age one.

Sources of Information about Forward-Facing Car Seats

Most parents (72%) refer to the car seat packaging for information about when to turn their child’s car seat to face forward and two-thirds (68%) get information from a doctor or nurse. About half of parents receive information from national organizations (57%) such as the American Academy of Pediatrics or the National Highway Traffic Safety Administration, or family or friends (52%) on when to turn a child’s car seat to face forward.

Implications

Child safety seats must be used correctly and consistently in order to reduce the number of children injured in crashes.  The new guidelines for child passenger safety from the American Academy of Pediatrics provide direction to parents on the optimal restraints for children from birth to adolescence.  Child passenger safety experts now recommend infants and toddlers remain rear-facing as long as possible.  Currently, many parents are turning their children forward facing before one year and very few families are keeping their toddler rear facing until age two.

While most children start out using a rear-facing infant carrier, many will outgrow this type of car seat well before their first birthday.  After outgrowing the infant carriers, children should use a “convertible” car seat in the rear-facing position.  Many newer model convertible car seats can hold larger infants and toddlers rear-facing beyond their second birthday, until they reach a weight of 35 or 40 pounds.

Parents should continue to refer to packaging instructions for information on how to safely install and use their child’s car seat.  However, parents need to know that packaging instructions do not necessarily match up with the best recommendations for safety regarding the decision to turn a child to face forward in their vehicle.  Health care providers and national organizations have an important role to play in communicating these important changes in optimal child passenger safety to parents.

Data Source

This report presents findings from a nationally representative household survey conducted exclusively by Knowledge Networks, Inc. (KN), for C.S. Mott Children’s Hospital via a method used in many published studies.  The survey was administered in May 2011 to a randomly selected, stratified group of parents  age 18 and older (n= 526) with a child age 7 to 48 months from the KN standing panel that closely resembles the U.S. population.  The sample was subsequently weighted to reflect population figures from the Census Bureau.  The survey completion rate was 54% among parent panel members contacted to participate.  The margin of sampling error is ± 4 to 5 percentage points.

Director: Matthew M. Davis, MD, MAPP
Faculty Collaborator: Michelle Macy, MD, MS
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MPH
Web Editor: Anna Daly Kauffman, BA

This Report includes research findings from the C.S. Mott Children's Hospital National Poll on Children's Health, which do not represent the opinions of the investigators or the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.

Questions were answered by parents with a child age 7 months to 4 years; if parents had more than one child in this age range, parents were asked these questions on their youngest child.

This next set of questions is on car seats.

Q1:  At what age did you first have your [x-month/year old] child ride in a car seat that faced forward instead of backward?

  • Younger than 6 months
  • 6 to 9 months
  • 10 to 12 months
  • 13 to 15 months
  • 16 to 18 months
  • 19 to 23 months
  • 2 years or older
  • I don’t know
  • I have not turned my [x-month/year old] to face forward in the car

Q43d.  From what sources did you get information on when to face your child’s car seat forward?

  Yes No
National organizations (such as American Academy of Pediatrics, National Highway Traffic Safety Administration, Safe Kids)    
Friends and family    
Doctor or nurse    
Daycare provider or teacher    
Police officer or firefighter    
Car seat packaging information    
Guidance from stores that sell car seats    
Books and magazines    

Participants were also asked demographic questions on gender, race/ethnicity, annual household income, education and insurance status.

All information is the sole property of the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health.  It can only be used if there is an acknowledgment that "The information came from, is copyright by and is owned by and belongs to the Regents of the University of Michigan and their C.S. Mott Children's Hospital National Poll on Children's Health. It cannot be republished or used in any format without prior written permission from the University."

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Faculty Collaborator: Michelle Macy, MD, MS
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MPH
Web Editor: Anna Daly Kauffman, BA
 

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Parents Turning Car Seats to Face Forward

Contributing Faculty

Michelle Macy, MD, MS

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