Current Baby Car Recommendations

In areas like ours, most parents rely heavily on their cars to get kids dropped off to school, commute to work, run errands, or even travel. But as much time as we spend in our cars, many parents don’t realize the leading cause of death in children over four years old continues to be motor vehicle accidents.

Studies are ongoing to try and improve the safety of adults and children while in the cars. In 1968, the first seatbelt law was passed. Since then, the automotive industry has continued to focus on safety, introducing airbags, car seats, and booster seats.


Every ten years or so the American Academy of Pediatrics (AAP) revisits statistics of motor vehicle safety in collisions to change recommendation when necessary. The most recent AAP recommendations, published in 2011, had some significant changes from the previous article published in 2002.


The biggest change pertained to rear-facing car safety seats. The previous recommendation was that children remain in car seats facing the back of the car until one year old or 20 pounds. However, a study showed increased fatalities and serious injuries in children ages 1-2 that were forward facing in car seats. As a result, the AAP now recommends children remain in rear-facing car seats until two years of age or until the manufacturer’s recommended height and/or weight is reached.


All children older than two years old should remain in a car safety seat with a harness for as long as possible. The previous recommendations were until four years old, and this still is around the age that many children will outgrow the car seats, but if you have a smaller child, it is safer to keep them in the car seat longer. Each manufacturer has a different weight and height limit for their car seat, and this should be your guide for when to change to a booster seat. Another tip is to change to a booster seat once the shoulders are above the top inserts of the harness. The reason for this change is the statistic that injury to children is reduced by 71-82% and death by 28% of children in car seats compared to those in seat belts of similar age, weight, and height.


Once children have outgrown forward-facing car seats, they should stay in a booster seat with lap and shoulder seat belts until they are four foot nine inches tall, which is typically between eight and twelve years old. This reduces nonfatal injuries in the age group by 45% compared to seatbelts alone. It is safer for children and adults to use lap and shoulder belts as compared to lap belts alone, when possible. Additionally, the AAP recommends children sit in the back seat until 13 years of age or older to prevent potential injuries from front-seat airbags.


AAP recommendations will continue to evolve, and car seat manufacturers will continue to innovate, in an effort to make car rides as safe as possible for children. Children look up to their older siblings and parents, so it is good practice – and the law in many states – for everyone to buckle up! If you ever have questions about how to use car seats properly, ask your pediatrician, or even find a car seat installation facility in town that may be able to assist you!

Jennifer Adair M.D.

Jennifer Adair, M.D., was born and raised in Mobile. She graduated from Davidson High School in 2002 and received her Bachelor of Science in Chemistry at The University of Alabama in 2006. She completed her medical training at the University of South Alabama College of Medicine, and pediatric residency at the University of Nevada College of Medicine – Las Vegas and the University of South Alabama. She joined Children’s Medical Group in July 2013 and currently practices at their Airport office. Jennifer and her husband, Cory, reside in Mobile with their dogs, Fitz and Barkley.