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From USA Today, March 21, 2011

Previous recommendations said parents could switch babies to forward-facing seats at 12 months old or 20 pounds. Switching to a forward-facing seat on a child's first birthday was a common rite of passage.

But new recommendations from the American Academy of Pediatrics say babies and toddlers should ride in rear-facing car seats until at least age 2 — even longer if the child is small enough.

The pediatrics group is changing its recommendation because research shows children under 2 are 75% less likely to die or be severely injured in a crash if they're in rear-facing car seats, according to the policy statement, published today in the journal Pediatrics.

Car accidents are the leading cause of death in children over age 4; about 1,500 kids under 16 die in car crashes each year, the statement says. In Sweden, many children ride in rear-facing car seats until age 4.

Rear-facing seats do a better job of supporting the head, neck and spine in an accident, because they distribute the force of the collision over the entire body, says study author Dennis Durbin, a pediatrician at Children's Hospital of Philadelphia Center for Injury Research and Prevention.

The new guidelines are "a fantastic step," says Jennifer Hoekstra, who coordinates a child safety program at Helen DeVos Children's Hospital in Grand Rapids, Mich.

Hoekstra says parents of toddlers under age 2 who already are using forward-facing seats shouldn't panic, because forward-facing seats still provide good protection.

"If you are using your forward-facing car seat correctly, your child is safe," Hoekstra says. But 73% of car seats are installed incorrectly, according to a 2005 study in the journal Accident Analysis and Prevention.

Parents won't necessarily have to buy new car seats, which range in price from about $40 to more than $300,

Thirty of the 35 convertible car seats now on the market can accommodate a 2-year-old, even up to 35 pounds, which is at the top of the weight range for that age.

Owners of convertible car seats may be able to follow the new advice simply by turning the seats around, so that kids face the back.

Yet some of the greatest objections may come from toddlers themselves.

An 18-month-old, newly allowed to face front, may not agree to turn back around — at least without a lot of crying — especially if the child has an older sibling who is allowed to face front.

Bottom Line: For the safety of your child, have them face back until age 2.

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