DOREL POSITION: Minimum Age Criterion for Facing Forward
Dorel Juvenile Group manufactures rear-facing child restraints (RFCRs) and forward-facing child restraints (FFCRs) that provide protection at affordable prices. Our early leadership led to higher industry-wide rear-facing weight limits, higher forward-facing harness limits, color-coded instructions, and more. Our decisions have been based on internal and external research, along with feedback from customers. In mid-2016, we made the decision to discontinue our phase-in of a minimum forward-facing age of 2 with our products. This summary explains what we did and why.
Based on a variety of research, the American Academy of Pediatrics (AAP) and the National Highway Traffic Safety Administration (NHTSA) updated their best practice recommendations for child seat selection in March 2011. The AAP recommends that infants and toddlers should ride in RFCRs until they are 2 years old or until they reach the upper height or weight limit indicated for their child seat. The NHTSA recommends that children should ride in RFCRs until they reach the upper height or weight limit indicated for their child seat and at least until age 1.
Only one statistical study comparing the effectiveness of RFCRs to FFCRs in real U.S. crashes has been published. This 2007 study by Henary et al used 1988-2003 data from the National Automotive Sampling System (NASS) Crashworthiness Data System (CDS) to compare injury risk. Based on about 300 belted children ages 12-23 months and seven moderate to severe injuries (ISS 9+ ), the study concluded that 1-year-olds are much safer in RFCRs than in FFCRs.
New research conducted by Jeya Padmanaban et al in 2016 attempted to replicate the Henary analysis from 1988-2003, and then update it to include data from 2004-2014. The goal was to expand the sample size of the original study and ensure that the research reflected the most current CR models and users. This study analyzed the data for comparative safety in all crashes and in just frontal crashes. For both 1988-2003 and for 1988-2014, the researchers found that 1-year-old children were significantly safer in FFCRs than in RFCRs in all impact types, and these conclusions are in direct conflict with the Henary study. In fact, it is Dorel’s understanding that no one who has tried to recreate the Henary study’s conclusions has been able to do so, which strongly suggests that the Henary study simply got it wrong.
Exploratory sled testing conducted by Dorel has suggested a possible reason why rear-facing seats may have a higher serious injury rate for one-year-old children. Federal safety standards test child restraints on a rear bench seat without a front seat. When Dorel conducted tests using a fixture containing a front seat exemplar, the head injury criteria for test dummies in a rear-facing convertible seat went up dramatically. It appeared that rear-facing convertible seats may lodge up against the front seats of vehicles, which may prevent the child occupant from achieving meaningful ride-down of the accident forces. This testing is experimental only, but its results have been provided to NHTSA for review.
In 2015, Dorel brands began phasing in a requirement that children must be at least age 2 before riding facing forward in their convertible models. That proactive decision was based on a single study (Henary) with a limited sample size, along with updated AAP recommendations. The additional and conflicting information provided by the 2016 Padmanaban analyses caused us to reverse our previous decision for age 2 minimums until further research is performed and industry consensus is reached. At present, our forward-facing requirements match the NHTSA-minimum age recommendation and we continue to advise consumers of the guidelines provided by the AAP, but we do not require a minimum of age 2 in our instructions.
It is important to note that both the Henary study and the Padmanaban study demonstrate that car seats are very effective at preventing injury for children. In fact, the differences in safety for rear-facing or forward-facing children between 12 and 24 months are slight. For example, in the Padmanaban study 0.4% suffered serious injury rear-facing and 0.2% suffered serious injury forward-facing. Using the same group of children in the same study, that means fewer than 1% of children were seriously injured when restrained either forward-facing or rear-facing. This perspective is very important to understand when discussing the subject of direction with parents of a child between 12 and 24 months. As often indicated by car seat technicians, the most important factors of car seat safety is the right car seat is selected for the child, positioned and installed correctly in the vehicle, and that the child is harnessed right every time. The NHTSA curriculum and Car Seat Technicians do an excellent job focusing on those factors so that families correctly use car seats. Dorel proudly supports their efforts.
Child Restraints: Comparison of Forward Facing and Rear Facing Child Seats
Jeya Padmanaban and Justin Stocks-Smith
Currently under peer review for publication
Technical Report – Child Passenger Safety
American Academy of Pediatrics (AAP) Committee on Injury, Violence, and Poison Prevention (2011)
Pediatrics, 127(4), e1050-1066
New Age-Focused Guidelines Help Parents Make More Informed Choices
Car safety seats for children: rear facing for best protection
B Henary, C P Sherwood, J R Crandall, R W Kent, F E Vaca, K B Arbogast, M J Bull
Injury Prevention 2007;13:398-402
Convertible Seat testing results with Consumers Union test fixture (summary available from Dorel)