My Newest Passion...

Is car seat safety. It seems like I do so much research to keep Logan the safest possible, and in the process I turn into this maniac that wants to save all the children of the world. Well, I can't possibly do that. I can only do what is best for my child, that's enough to worry about as it is...I can't concern myself with the parenting choices of other people, but maybe, just maybe, if I write about the facts that I've found someone will pass it along and it may just save a life in the process. I know most of you that actually read my blog do not have children of car seat age, but maybe someday you can pass this info along to someone at church, to your children when they have children, a friend...maybe word will spread.

According to state and federal law infants must stay rear facing in either an infant seat or convertible seat until age 1 AND 20 lbs. That is the minimum requirement. The AAP and other car seat safety advocate groups are now recommending rear facing your toddler until the limits are reached on the convertible seat. The limit on Logan's seat is 35 lbs or less than 1 inch of hard plastic shell above his head. Some car seats can go to much higher limits with rear facing, some up to 45-50 lbs. Keeping your child rear facing past the first birthday is called extended rear facing.

Research has shown that rear-facing child restraints provide greater protection for children in the event of frontal/frontal offset and side impacts. Frontal/frontal offset crashes are by far the most frequent type of crash and are usually of much more severity then any other type of impact. Frontal and frontal offset impacts account for 65.1% of fatal injuries in motor vehicle crashes and side impacts 29%. Because these types of crashes account for the majority of fatalities and injuries in motor vehicle crashes, this is why statistically the longer you rear-face, the better.

While some rear-facing restraints may not perform as well in rear impacts, it must be noted that rear and rear offset impacts account for approximately only 5.9% of fatal injuries in motor vehicle crashes and are usually of far, far less severity then frontal impacts. This is because typically in a frontal crash there are two vehicles travelling in opposite directions at high speeds. When these two cars collide with each other, both stop very abruptly, in a fraction of a second, with a tremendous amount of force and energy. Or, it may be just the one vehicle travelling at high speed and colliding with a stationary object. Rear impacts however most often occur when one vehicle has stopped (say at an intersection) and another car hits it from behind and usually this is at a very low speed, often causing minimal damage. Of course, severe rear-impacts do occur, but as discussed above, are far less common then frontal and side impacts.

The most important parts of a child that we need to protect are the head, neck and spine. Rear-facing is the best protection for all of these important body parts. The rear-facing child has the frontal crash forces spread over their back, head and neck (a large portion of the body) in a crash. The rear-facing child is also supported by the back shell of the car seat meaning there is little stretching of the neck. However, how a forward-facing child is restrained is quite a contrast to that of a rear-facing child. In a frontal crash, the forward-facing child's torso is restrained by their harness straps. The head of the child however is restrained by nothing and thrusts violently forward, this places them at a much greater risk of serious head, neck and spinal cord injuries resulting in death or paralysis. Infants heads are larger and heavier in proportion to its body than that of an older child, or adult. Their shoulders are also more narrow and flexible. This is important to know for proper placement and tightening of the harness straps.

An infants heads is relatively large in relation to their body. In fact, an infant's head accounts for approximately twenty five percent of the child's body mass. This is a far cry from the mere six percent of body mass for a developed adult. Children are "top heavy" which is why they are far more susceptible to injury, in particular head, neck and spinal injuries.

When the heavy head of the forward-facing child is thrust forward in an accident, this puts an enormous amount of stress on the child's neck, which is trying to hold back the head. The heavy weight of the child's head can stretch the spinal cord. "According to documented research, autopsy specimens of infant spines and ligaments allow for spinal column elongation of up to two inches, but the spinal cord ruptures if stretched more than 1/4 inch. Real-world experience has shown that a young child's skull can be literally ripped from her spine by the force of a crash." (source: CPSTE ).

If the spinal cord stretches too far in an accident this can cause it to tear, thus resulting in paralysis or death of the child. This is often described as "internal decapitation". Even babies who ‘appear’ to have strong neck muscles and good head control are susceptible to these risks.

Young children have immature cervical vertebrae (neck bones) that are not strong enough to protect the spinal cord adequately in an accident when forward-facing in a frontal crash. The vertebrae are still in pieces joined by cartilage. These pieces are soft and have not yet ossified into a complete circle of bone which will enclose and protect the spinal cord.

Because the vertebrae are still in pieces (joined only by cartilage), a child that is forward-facing faces a heightened risk of damage to the spinal cord when their head and neck pull forward and back in a frontal crash.

Small children also have poorly developed, fragile, flexible neck muscles, loose ligaments to allow for growth, small rib cages, undeveloped abdominal muscles, soft spinal columns and unprotected relatively larger abdominal organs.The vertebrae do not completely ossify until ages 3-6 years old. This is why rear-facing for as long as possible is safest, because it gives more support and protection to the incomplete vertebrae and therefore the spinal cord. (childrestraintsafety.com/rear-facing)

http://www.youtube.com/watch?v=fKIeExpDLDA This video demonstrates what happens to children in both a forward facing seat and a rear facing seat in a crash.

Some of the common questions I get are:

Aren't his legs going to be scrunched up? What if the seat breaks his leg in a crash? According to the research most children find it more comfortable to sit "Indian style" or with their legs pulled up and find it more uncomfortable to be hanging off the edge of the seat, because their legs fall asleep when not touching the floor. Others prop their legs up on the back seat or hang them over the side. Also, there have been no reported cases of broken legs in children rear facing when properly restrained. Logan is just now able to touch his feet to the back seat, and he's tall for his age, of course that differs depending on the seat you have. Although there have been no reported cases of broken legs, I would definitely take a broken leg ANY DAY over a broken neck. Also, in a study done by the Dept. of Pediatrics at Washington University, they surveyed 15 children who were involved in an accident and were properly restrained forward facing. 11 out of 15 reported lower extremity injuries. I've seen a saying many times while doing my research..."Broken leg, cast it. Broken neck, casket".

My baby cried and whined because he couldn't see out...does yours not do that? So far I've had much luck with Logan being good in the car. Plus, he can see out and he knows no difference. Also, many, many kids get fussy in the car whether they are forward or rear facing and being fussy is not going to compromise safety. For example...they may want to play with bleach, but you don't let them because it's dangerous...they may pitch a fit about it, but you don't give in. I'm not giving in over a fit that will compromise his safety.

But you can't see him, don't you want to be able to see him? I technically couldn't see him without straining my neck for the first year of his life, so what's changed now? Nothing.

Once they have reached the rear facing limit it is recommended you can either, a) get a different seat that rear faces longer, or b) switch to forward facing. Logan's seat forward facing goes to 50 lbs or 50 inches. If I had know they made seats that went to 70-80 lbs forward facing I would have bought that one instead of the seat I have and probably will end up doing so depending on his growth rate. That's many years down the line though! The law states that children must remain in a 5-point harness until 40 lbs, but it is now recommended that they stay in the 5-point harness until the weight limit is reached.

Here are some reasons why you should keep your children in a 5-point harness for as long as possible.

When used correctly, 5-point harness car seats provide significant safety advantages over securing your child in a booster seat using the adult seat belt.

• The crash forces are spread over the skeletal body over five points rather than three.
• The crash forces are spread to the strongest parts of the child's body.
• Forward head excursion (the distance the head is thrown forward) are lessened.
• The child is secured in the correct seating position rather than being able to wiggle around, lean forward etc. (kyledavidmiller.org)

This crash test video demonstrates the difference in a 5-point harness vs. a high back booster seat. http://www.youtube.com/watch?v=V2kO8AxKbrM&feature=player_embedded Notice the dummy in the foreground is in the high back booster, and the dummy in the back is harnessed. See the difference in their movement?

Once your child has reached the limit for his forward facing car seat, you have a decision to make. You can either get a car seat with a five point harness that goes to a higher weight limit or get a booster seat. You can legally switch to a booster at 40 lbs in GA, and they must remain in their booster seat until age 6 or 4'9". Also, in GA, if there is only a lap belt, a booster should not be used. Now, there are different types of booster seats. High back boosters with head supports are proven to be safer in side impact collisions. Once your child reaches the requirements to switch to the regular seat with seat belt, they should also be able to pass this 5 step test (usually around 10-12 yrs old and 5 feet tall).

1. Does the child sit all the way back against the auto seat?
2. Do the child's knees bend comfortably at the edge of the auto seat?
3. Does the belt cross the shoulder between the neck and arm?
4. Is the lap belt as low as possible, touching the thighs?
5. Can the child stay seated like this for the whole trip? (car-seat.org)

If they can't do these 5 things, they should remain in a booster.

If your child is OVER 4 years and 40 lbs, and sits properly for every ride, every time, a booster is acceptable, although a 5 point harness is still much safer AS LONG AS the child has not outgrown the seat. Children under age 4 do not possess the ability to sit perfectly at all times, and a child who leans forward to retrieve a cup or toy, or who twists around to see something or someone behind them, will not be protected in a crash and is at risk for serious injuries and possibly death. Also, children this age sometimes still fall asleep in the car. The slumping that occurs when this happens means they are not properly positioned and should be in a 5 point harness for that trip. Ideally all children should remain in an appropriate 5 point harness until age 5. (car-seat.org)

So, all in all, I am keeping Logan the safest possible. He might not always like it and I might get strange looks and comments, but to be quite honest...I don't care. I'm doing what is best for my child. Period.