Car Seat Safety: Rear-Facing First, and When to Switch (AAP)

The rule in one line

Every ride, in a car seat that fits your child, your car, and the direction they face. All infants and toddlers ride rear-facing for as long as possible — up to the highest weight or height their seat allows. Most convertible seats allow rear-facing for 2 years or more.

Rear-facing first

• Start with the first ride home from the hospital. A rear-facing-only seat (usually up to 22–35 pounds and 26–35 inches) is fine for a newborn; when your baby outgrows it by length, move to a convertible seat installed rear-facing.
• Keep them rear-facing until they reach the seat's rear-facing weight or height limit — that limit, not a birthday, is what decides. Bent legs or feet touching the seat back are not a reason to turn a child around.
• Never put a rear-facing seat in front of a passenger air bag. The back seat is the safest place for all children under 13.

Forward-facing, then a booster

• Once your child outgrows the rear-facing limit, use a forward-facing seat with a harness for as long as possible — most seats take a child to 65 pounds or more.
• When they outgrow the forward-facing seat, use a belt-positioning booster until the car's seat belt fits properly: usually when they are 4 feet 9 inches tall and 8 to 12 years old.
• The belt fits when the shoulder belt lies across the middle of the chest and shoulder (not the neck), the lap belt is low and snug across the upper thighs (not the belly), and your child can sit against the seat back with knees bent over the edge without slouching — for the whole trip.

Getting the fit right

• Harness straps should be snug against your child's body — if you can pinch a fold in the strap at the shoulder, tighten it. Put the chest clip at armpit level.
• Route the seat belt or LATCH strap through the correct path for the direction the seat faces — convertible seats have different paths for rear- and forward-facing.
• Install with the seat belt or the LATCH system — both are equally safe, so use whichever fits your car and seat best, and use only one unless both manufacturers say both are fine. Use the top tether for every forward-facing seat.
• When installed, the seat should not move more than an inch side to side or toward the front of the car. Push your weight into the seat while you tighten.
• Read both manuals — your car's and the seat's. If you're unsure, a certified child passenger safety technician can check it free: find one at cert.safekids.org ("Find a Tech").

Common mistakes

• Bulky coats and snowsuits: they compress in a crash and leave the straps too loose. Dress your baby in thin layers in the seat and put a blanket over the harness if it's cold.
• A used seat with an unknown history: don't use it. Also skip a seat that has been in a crash, has been recalled, is past its expiration date (or more than 6 years from manufacture if it has none), has cracks, or is missing parts, labels or instructions.
• Recalls: register your seat with the manufacturer so you're told about recalls, and check with the NHTSA Vehicle Safety Hotline at 1-888-327-4236 or nhtsa.gov.
• Aftermarket extras: only use inserts, strap covers and toys that came with your seat or are approved by its maker.

After a crash

Do not use a seat that has been in a moderate or severe crash, even if it looks undamaged — a crash can weaken it in ways you can't see. A seat from a truly minor crash may still be safe to use, but only if all five of these are true: the car could be driven away, the door nearest the seat was undamaged, nobody was hurt, the air bags did not deploy, and the seat itself has no visible damage. Check your seat's manual too — some makers require replacement after any crash, and their rule wins. If anyone is hurt, call 911.

Flying

The safest way for a baby to fly is in a ticketed seat in your FAA-approved car seat. A lap infant is at risk in turbulence — the leading cause of children's injuries on airplanes.