Rear-facing car seats spread frontal crash forces over the whole area of a child's back, head and neck; they also prevent the head from snapping relative to the body in a frontal crash. Rear-facing carseats may not be quite as effective in a rear end crash, but severe frontal and frontal offset crashes are far more frequent and far more severe than severe rear end crashes.
Motor vehicle crashes are the #1 overall cause of death for children 14 and under. Still, much of best practice is based on statistics, and how to have the best chance to reduce injuries. Best practice may also be based on crash forces and physics. Both are very important regarding the use of rear facing seats.A few factors govern the physics of crashes as they relate to children in carseats. The longer the "ride-down," the more time your skeleton and organs have to absorb the crash energy. Longer time means less power is transferred to your body, and less chance of injury. The odds of being in a frontal crash with a fatality or very serious injury are many times greater than being in a severe rear-end crash. Rear-enders are more common at lower speeds, though most injuries in these crashes are not as severe - typically, whiplash injuries to adults, especially passengers lacking proper head restraint. In many cases, one vehicle is stopped or nearly stopped, and the other hits it from behind at a relatively low speed.
Other times both vehicles are traveling in the same direction at similar speeds when one is bumped from behind. Lower energy means less chance of injury. For the reasons listed, rear-facing not only turns out to be safer for infants, but for people of all ages. In fact, we would all be safer rear-facing in cars, airplanes, trains and elsewhere. Of course, this would not be acceptable to most adults. Fortunately, adults are somewhat better able to withstand the forces on the head and neck in a severe crash when they are front-facing. Babies have very immature bones and connective tissue, and this is especially the case when they are younger than 1 year or under 20 pounds. For that reason, front-facing babies face a particularly serious risk of spinal cord injury in a frontal crash. The height limit of a rear-facing carseat may be listed in the owner's manual. Most of these models are taller than average. Such limits are acceptable only for those models listed by the manufacturer or in the owner's manual. If a manufacturer's limit seems to conflict with one of these general guidelines, please contact the manufacturer for instructions. Make sure you are using harness slots at or below the child's shoulders. Make sure the chest clip is positioned correctly at the child's armpits and holding the straps across the center of the shoulders. Since the child this tall is likely to have very good neck strength for head support, adjust the angle of your carseat to be more upright, perhaps as little as 30 degrees from vertical. Make sure you have no aftermarket accessories that put padding under the harness straps. This includes head supports and comfort pads. Unfortunately, some carseat advocates and even some pediatricians are not fully aware of the important safety benefits that rear-facing carseats provide. Some still adhere to obsolete recommendations from many years ago.
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