Clarification of Guidelines for the Proper Use of Child Car Seats

to the editor: I found the article “Discharge Procedures for Healthy Newborns,”1 in the March 1, 2006, issue of American Family Physician to be a good review of important topics to be addressed with parents before the discharge of their newborn. However, there was one error in the text regarding an issue that I have found to be a common source of confusion. Dr. Langan notes that, with regard to car seat use, an “infant should remain in a rear-facing car seat until he or she weighs more than 20 pounds (9 kg) or is older than one year of age.”¹ The original guideline from the American Academy of Pediatrics that he references states that, “Children should face the rear of the vehicle until they are at least 1 year of age and weigh at least 20 pounds.”² The article’s accompanying figure does not really help clarify this point. Although this is not really a newborn issue, I address it with parents starting when their children are in the six- to nine-month age-range because otherwise I find a general tendency in the parents to try to get children facing forward as soon as possible.