Many parents turn their child's car seat to face forward before the age of two

The American Academy of Pediatrics updated their guidelines for child passenger safety in April 2011, recommending children stay in rear-facing car seats until the age of two. But a new report from the C.S. Mott Children's Hospital National Poll on Children's Health shows that many parents turn their child's seat to face forward before their second birthday.

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 use of rear-facing car seats. The study found that 73 percent of parents switched their child from a rear-facing car seat to a forward-facing car seat before the age of two. Thirty percent of parents turned their child's seat to face forward before their child reached one year of age.

"Research has shown that riding in a rear-facing car seat is up to five times safer for toddlers than riding in a forward-facing car seat," says Michelle Macy, M.D., M.S., a clinical lecturer of emergency medicine at the University of Michigan Medical School. "Parents want to keep their children safe, but they may not be aware of the safety benefits of keeping their child rear-facing beyond their child's first birthday."

According to Dr. Macy, rear-facing car seats can prevent serious injury to children involved in front end motor vehicle collisions.

"When a child is sitting in a rear-facing car seat, the stopping forces are spread out over their entire back. The back of the car seat is a cushion for the child," says Dr. Macy. "However, in the forward-facing position, all of the crash forces are focused on the points of the body that come into contact with the car seat straps. The child's head and limbs keep moving forward, pulling against the seat."

The National Poll on Children's Health also asked parents what sources they look to for information about when to turn their child forward-facing. Most parents (72 percent) refer to the car seat packaging for this information and two-thirds (68 percent) get this information from a doctor or nurse.

Dr. Macy offers these tips for parents about car seats for infants and toddlers:

•Car seat instructions often say that the seat can be used forward-facing when the child is 20 pounds. However, this does not mean the car seat should be used in the forward-facing position if the child is still under the height and weight limits to continue riding rear-facing.

•Most children will outgrow a rear-facing infant carrier style seat well before their first birthday, but that doesn't mean it is time to turn the baby to face forward. The next step is to get a larger convertible car seat that can be used both rear-facing and forward-facing.

•Newborns who weigh at least five pounds can start out using a convertible car seat in the rear-facing position. If money is tight, parents should consider forgoing an infant carrier for a convertible car seat that their child can use from birth into the pre-school years.

•Contact a local car seat inspection station to make sure your child safety seat is being used properly. Visit seatcheck.org and enter your zip code to find an inspection station close to your home. Local inspection stations can also point you toward resources in your community that offer assistance to parents in need of obtaining proper car seats for their children.

•The American Academy of Pediatrics and the National Highway Traffic Safety Administration keep up-to-date information for parents about child safety seats.

•The Insurance Institute for Highway Safety has a listing of child restraint laws across the United Sates. For the most current information about laws, parents should check with their state.