AAP comments on rear-facing car seats. There is a well known myth that toddlers in rear-facing car seats whose feet can reach the back of the vehicle seat are more likely to suffer injuries to their legs in a car accident, however these injuries are NOT common in rear-facing seats.
New research indicates that children under 2 years of age are 75% less likely to die or experience serious injury when they ride in a rear-facing car seat and, toddlers between 1 and 2 years of age are 5 times safer than toddlers who ride in a front-facing car seat.
The reason behind this conclusion is pretty simple. When an accident occurs and a child is rear facing the force of the accident is distributed evenly over the entire body, forward facing children, because the force of the car crash is concentrated on seat belt contact points, can suffer from neck and head injuries because children's necks are weak and their heads are disproportionately large for their little necks. Dr. Bull, who wrote the commentary for Pediatrics, states, "...it is far better to send children to orthopedic specialists to have lower extremities treated, than to send them to neurological specialists to have cervical spine injuries treated." Makes sense!
According to the AAP, all infants should ride rear-facing in an infant car seat or convertible seat. If an infant car seat is used, baby should be switched to a rear-facing convertible car seat once the maximum height (when the infant's head is within 1 inch of the top of the seat) and weight (usually 22 pounds to 32 pounds) are reached for that infant seat, as suggested by the car seat manufacturer. Toddlers should remain rear-facing in a convertible car seat until they have reached the maximum height and weight recommended for the model, or at least the age of 2. To see if your car seat is installed properly and to find a certified passenger safety technician in your area, visit www.SeatCheck.org or www.nhtsa.dot.gov/cps/cpsfitting/index.cfm. You also can call 866-SEATCHECK (866-732-8243) or 888-327-4236.