Practice Guidelines

Child Passenger Safety: AAP Updates Best Practice Recommendations

 

Am Fam Physician. 2019 Apr 15;99(8):525-526.

Author disclosure: No relevant financial affiliations.

Key Points for Practice

• Infants and toddlers should ride in a rear-facing car safety seat until they reach the highest weight or height allowed by the car seat manufacturer.

• Children who have outgrown the rear-facing weight or height limit for their car seat should use a forward-facing seat with a harness as long as possible.

• When the children have outgrown the forward-facing seat limits for the car seat, they should use a booster seat until the lap and shoulder parts of the seat belt fit correctly.

• All children younger than 13 years should be restrained in the rear seats of vehicles for optimal protection.

From the AFP Editors

Child safety seats reduce the risk of injury and death when compared with seat belts. There has been an increase in scientific evidence supporting the use of child safety and booster seats. The American Academy of Pediatrics (AAP) has updated best practice recommendations on child passenger safety based on this evidence. There are five evidence-based recommendations to improve safety in passenger vehicles for children from birth through adolescence.

Best Practice Recommendations

INFANT-ONLY OR CONVERTIBLE CAR SEAT USED REAR FACING

Infants and toddlers should ride in a rear-facing car safety seat until they reach the highest weight or height allowed by the car seat manufacturer. They have relatively large heads and several structural neck and spine features that place them at higher risk of head and spine injuries in motor vehicle crashes. Once the highest weight has been reached using the rear-facing seat, they should continue riding rear facing in a convertible seat. Most convertible seats can be used rear-facing up to 40 lb (18 kg) and up to two years of age or longer.

CONVERTIBLE OR COMBINATION CAR SEAT USED FORWARD FACING

Children who have outgrown the rear-facing weight or height limit for their car seat should use a forward-facing seat with a harness as long as possible. Most seats are appropriate up to 65 lb (29 kg) with some

Author disclosure: No relevant financial affiliations.

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Sumi Sexton, MD, Editor-in-Chief.

A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide.

 

 

Copyright © 2019 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions

CME Quiz

More in AFP

More in Pubmed

MOST RECENT ISSUE


Sep 15, 2019

Access the latest issue of American Family Physician

Read the Issue


Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article