Check Up: American Academy of Pediatrics pushing for change on child car seats

Five months ago, the American Academy of Pediatrics updated its car-safety guidelines, advising that children stay in rear-facing car seats until age 2 - twice as long as previously recommended.

The challenge now is to get the word out.

A May survey by University of Michigan researchers found that 73 percent of parents turned their child's car seat forward before age 2 - and 30 percent did so before the child was a year old.

"This will take a pretty concerted effort on the part of pediatricians and others to counsel parents," said Dennis R. Durbin, a pediatric emergency physician at Children's Hospital of Philadelphia and lead author of the revised recommendations.

The change was prompted by car-crash studies, including some by the Children's Center for Injury Research and Prevention, that show a toddler is less likely to be injured in a rear-facing car seat than a front-facing one. The reason is that during a crash, the impact forces are spread out over the entire back of the rear-facing child, while a front-facing child's head and limbs are flung forward.

To be sure, the risk of injury such as a broken arm or concussion is small either way: One in 100 for children in front-facing seats; one in 200 for rear-facing seats.

"But when you multiply it by tens of thousands of kids in cars, we're talking a real difference in the number of injuries that could be averted," Durbin said.

For the last decade, the Academy of Pediatrics has said children should stay rear-facing "at least" until they weigh 20 pounds or turn a year old.

"It was meant as a minimum, but as you can imagine, people took it as an absolute," Durbin said.

The new advice may raise practical concerns for parents. How to keep rear-facing tots entertained? How to keep an eye on them? Won't they be uncomfortable as their legs grow?

Nonetheless, Durbin said, safety should trump those considerations.

He noted that current "convertible" car seats are designed to be rear-facing until the child is 30 or 35 pounds - well above the average 2-year-old's weight - and then to be turned to the front for a couple more years.

The Academy of Pediatrics has a guide to car seats and a list of 2011 products on its website: aap.org.

- Marie McCullough