AAP and NHTSA -- new guidelines for car seats

In the April 2011 issue of Pediatrics, the American Academy of Pediatrics (AAP) advised parents to keep their children in rear-facing car seats until age 2 or until the child reaches maximum height and weight limit for the seat. The National Highway Traffic Safety Administration (NHTSA) released new child seat safety guidelines shortly after AAP's publication was released.

Both AAP and NHTSA suggested parents check the maximum height and weight limit on their child's seat before moving them up to the next type of seat. They also suggested older children should ride in a booster seat until they reach 4 feet 9 inches and are between the ages of 8 and 12 years old. At this time, a regular seat belt should fit them properly.

“A rear-facing child safety seat does a better job of supporting the head, neck and spine of infants and toddlers in a crash, because it distributes the force of the collision over the entire body,” Dr. Dennis Durbin, MD, FAAP said. “For larger children, a forward-facing seat with a harness is safer than a booster, and a belt-positioning booster seat provides better protection than a seat belt alone until the seat belt fits correctly.” Previous policy cited age 12 months and 20 pounds as the minimum for transitioning a child out of a rear-facing car seat.

NHTSA Administrator David Strickland pointed out that while all car seats sold in the U.S. must meet federal child restraint safety standards, he said, "Selecting the right seat for your child can be a challenge for many parents. NHTSA's new revised guidelines will help consumers pick the appropriate seat for their child."

As always, children should ride in the backseat of a vehicle until they are 13 years old. Learn more at AAP's Health Children site.

New research in Pediatrics shows 26 crib-related injuries per day

A study in the March issue of Pediatrics shows that as many as 26 infants and toddlers are rushed to emergency rooms each day for injuries involving cribs, play yards or bassinets. Most of the injuries (83%) are crib related. One of the lead authors on the study was Dr. Gary Smith, KID's Best Friend Award Honoree in 2010.

Much attention (rightly) has been focused on suffocation and strangulation deaths in poorly designed cribs or those with hardware problems. But this study highlights that most injuries involving cribs are related to falls. Some of the falls are also hardware related when a side rail comes loose or may be caused by mattresses set too high, children still sleeping in cribs when they can attempt to climb out or soft bedding that provides a foothold for climbers.

Parents can prevent injuries by

• checking their crib for loose or missing hardware,
• making sure their crib hasn't been recalled,
• Lowering the mattress setting to the lowest level when a child starts to push up on hands and knees,
• keeping the drop-side* in the top position,
• removing any soft bedding that can provide a foothold or suffocation risk,
• moving the child to a toddler bed or even a mattress on the floor as soon as they reach 2 years, 35 inches or show signs of attempting to climb out.

Check KID's or CPSC's crib pages for more information.

The data in the study will be useful to CPSC and ASTM International as they look for design changes or stronger warnings to prevent falls and other injuries.

*The drop-side is dangerous for many other reasons too.