Rear-facing til 2 years old now recommended in America as well as here.

[FrozenNorthPole]

Two years after the BMJ [[http://www.bmj.com/content/338/bmj.b1994.full recommended rear-facing car seats for toddler to two years, American doctors finally make the same recommendation:
Article in Pediatrics

Of course, until shops and carset manufacturers make the seats more available, and affordable it's not going to be a good option to many parents

Argh, that will teach me not to preview posts.

BMJ article

Pediatrics press release

And what are parents supposed to do with all these bored, cramped and travel-sick children? Staring at the back of a seat instead of facing forward sounds horrible... where are their legs supposed to go?

Last time I looked at a 2 year old they had knees in the middle of their legs which meant that they could bend them! So they sit with their legs bent and hey presto they fit in a rear facing seat. But I do agree that this just isn't a viable option for many parents due to the cost of the seats. Then again their seems to be a subset of parents here who seem to think that car seats for toddlers aren't necessary at all anyway and let their children rattle around unrestrained in the back of their cars

Admittedly a sample of only N = 2 but my children both rearface and neither is cramped or travel sick. And they're not staring at the back of the seat - both can see through the rear windscreen and look out of the side windows.

Interestingly, sitting with your legs dangling is actually quite uncomfortable (as one's legs would be in a ff seat) versus having them loosely bent but resting on something.

Is there actually a problem with the current design? Is it 'unsafe'? Is the BMJ addressing something that is causing real concern or simply suggesting that there is a next level belt to add to the braces? For example, I'm sure if all road drivers adopted rally-car-style harnesses, roll-bars and helmets there would be fewer fatalities but it's unlikely we'll adopt them as standard.

The evidence is that it makes a small risk of injury and death even smaller, so you're right that current car seats aren't unsafe. They are less safe. Mind you, we take a lot of safety precautions against very small risks all the time e.g. cot death.

There is another, bigger point about ff vs rf here and that is that parents often turn their children around before they 'need' to i.e. before due to height and weight restrictions the seat stops being suitable.

From the AAP release:

?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. Durbin 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.?

So what I'm getting from that is the longer children are kept in seats that better support their bodies, the better the protection. For the very youngest children, the safest way is backwards. I think that's because their heads are disproportionately large compared to their neck strength and the rest of their body.

"While the rate of deaths in motor vehicle crashes in children under age 16 has decreased substantially ? dropping 45 percent between 1997 and 2009 ? it is still the leading cause of death for children ages 4 and older. Counting children and teens up to age 21, there are more than 5,000 deaths each year. Fatalities are just the tip of the iceberg; for every fatality, roughly 18 children are hospitalized and more than 400 are injured seriously enough to require medical treatment."

"New research has found children are safer in rear-facing car seats. A 2007 study in the journal Injury Prevention showed that children under age 2 are 75 percent less likely to die or be severely injured in a crash if they are riding rear-facing."

Car accidents are really really rare and I hope this doesn't come across as scaremongering as it's definitely not. After all I think it's probably a balance of lots of factors that would make someone decide one way or the other about the seat i.e. the likelihood of injury in a car is really low anyhow, it costs a lot to get a seat, most of us don't actually drive our children significant distances in the car anyhow ...
BUT
given that the seats ARE definitely safer in the event of the average crash bad enough to injure a child, and that I had to save perhaps an extra £100 to get one over the forward facing model I was otherwise going to buy, for me personally it was the right decision. Fully accept it's not the right decision for everyone.

I completely understand the arguments for rear facing car seats but they are just too expensive. And we need a seat in each of our cars because I drop DS at CM and DH collects.

It's curious that Britax manufactures rear facing car seats for sale in Sweden, and states they are safer, but they don't feature them at all on their UK website.

As I understand it, deaths of young children in car accidents in Sweden is virtually zero due to RF seats.

They really are pricey, aren't they? It gets me angry with the manufacturers and the major retaillers to be honest - if they could just give parents a fair choice out of the seats that they make, both ff and rf, then people would be free to decide based on their circumstances. If the seats were more widely distributed then the prices would probably come down.

The car seat situation in America is different to here anyway. Because a lot of states have laws stating children must be 20lbs (9kg) AND one year old (ie more than ours which states they must be 9kg but no law on age, just a 'guideline' minimum of 9 months) they already have more extended RF seats than we do - in fact their stage 2 category (ie our Group 1) are all convertible seats, similar to the ones you can get here for 0-4 years which do RF and FF

But whereas ours are usually RF until 13kg and FF until 18kg, and are a specialised seat rather than a standard, so you'd only have one if you bought it specifically, the US Stage 2/'convertible' bracket is RF until 15kg and FF until 22kg. And they are high up so children can see out of the windows etc instead of being stuck down low in a baby seat. There are also some now, retailing at only slightly more than the others, which are RF until 18kg and FF with harness until 29kg. I've just got this from the Target website - Target is a mainstream shop like, say, Argos - is is not a specialised store. A seat like this would be perfect, why don't they sell them here? They all have the chest clips on too which make more sense than the harnesses here without where children can escape far too easily. (I understand the reasoning why we don't have these, I just don't agree with it :))

FNP - I was able to keep DS rear facing in his car seat until he was about 17mo, then he was to tall. And this is only because he is weeny for his age. If I could have kept him in longer I would have.
There is a dearth of affordable childseats that can be used rear facing for longer.

Never had an issue with DS not liking rear facing - it is not as though he knew any different! I always had him in the front with me, with the airbag switched off and the seat itself pushed back as far as possible.

Same Kara - DS fitted in his until 18 months. He went forward facing occasionally if we got a lift from a friend and used their car seat, and always in his dad's car from about 13 months (XP's decision, not mine) and he still didn't mind. He never used to look out of the window anyway, things moved too fast.

They are out of the price range of some people.

But I think there needs to be more publicity about why they are better.

We're on a budget and bought loads of things secondhand so that we could afford the safer things - e.g. second hand crib, second hand cot, second hand pretty much everything! Except for brand new cot and crib mattresses and brand new rear facing car seats.

My toddler doesn't get sick or bored or cramped legs and she's 2.7 and on the 95th centile for height.

Expect I'll probably get loads of "ooh have a medal" comments, but I do think if parents knew that these were safer they'd prioritise buying them over a smugaboo or whatever.

agree that the pricing is a prohibitive factor.

dd1 was rear facing until she was 3.6 (she is a big girl - 95th centile for height/weight). we only moved her then because she was permanently getting her feet stuck when I tried to lift her out (dd1 is severe ASD, and spatial awareness is not a strong point for her! she also had huge feet ) and I was worried about wrenching her knee, especially since she was unable to tell me when she was in pain (at the time), and was unable ot learn a different way of sitting to prevent this occurring.

dd2 is 4.2, and is still rear-facing. she is a tiny petite little thing, and by current calculaitons will be rear facing until she is about 6

I have to agree that dd2 looks far more comfortable in her seat, with support under her thighs, knees and lower - she crosses her ankles, and her legs are fully supported. whereas dd1, in her high backed booster (dd1 is now 6.8, and very tall) has her legs dangling, cannot reach the floor of the car, and looks quite uncomfortable on long journeys, tbh. dh and I often comment that we wish we could rig up some sort of foot support ofr her, a la Tripp Trapp footplates!

THe thing that got me about the new guidelines in the US was the comment in one article that medical people (like ambulance crew) call the RF seat the "orphan seat" because in catastrophic crashes the only person alive is the occupant of the rear facing seat. Horrible.

Then I went to research RF seats and was shocked at the cost.

Roughly what age is 13kg? I've been given a second hand carseat that says rearfacing to 13kg/forward facing to 18kg on the back of it but I'm not clear on what sort of ages those are.

The only RF seats we found were £500 each. We needed two, but couldn't even afford one at that price. Had we known about the RF/FF thing when we were buying baby stuff before I went on maternity leave a year before we might have been able to afford one with careful budgeting.

I just don't understand Britax's behaviour though. Why don't they recommend RF seats on their UK website if they know they're safer?

Quenelle - I think there are several reasons why Britax don't recommend them. Firstly, because it will make people doubt the safety of their ff seats i.e. lose them sales and secondly, because it's out of many people's price range and the money made back from selling them would not compensate for the lost revenue from point one.

Basically, despite the pretty obvious safety benefits, there isn't enough of a market for them. Some people would argue that that's because people don't want them, but I think I'd argue that most people aren't aware of them - if they were, then a fair number of people might consider them.

But I could be totally wrong there.

FWIW, with a lot of searching and some luck we got two iZi Combi Isofix seats for about £250 each. It was financially painful, but luckily we persuaded the grandparents to give money for the car seat for christmas instead of a big gift, and my own grandparents sent money too. We also decided not to go on holiday so that helped. But we're lucky that we had those avenues available to us - most people are priced out of buying one, and that's a massive shame because for most people there's no genuine choice available.

One thing that gets me cross is that the government doesn't have a policy of promoting rf seats either. If they did, there would probably be lots more pressure on large retaillers like mothercare and halfords to stock at least a couple and, as I mentioned, prices might go down and Britax etc. would see a gap in the market to be filled.

That makes sense Frozen.

Unfortunately neither of our cars fit Isofix. Perhaps we will look again when/if we change one of our cars.

The irritating thing about this whole subject is that, whilst I agree that RF toddler seats are expensive, and some people cannot afford them - yet this does not stop expensive FF isofix seats form being sold, does it?

I (because I was fortunate to be able to afford it) bought a top-of-the-range isofix baby seat for dd1. it was Britax, so seat + base came to around £200 (this is going back a bit now, no idea if the prices are the same now). Birth to 13kg (which for dd1 was around 16 months, I think)

She then needed a toddler seat, (and I bought a RF one, but for the purposes of this argument - bear with me! - let's assume I bought the FF one I had to get a little later for reasons I described earlier) - a 9-18Kg seat. Again, stayed with Britax, and bought an Isofix seat. Cost around £180 again, I believe.

So total cost (and actually I spent more than this as dd1 had a Rf toddler seat too) approaching £400.

YEt you can get a RF seat that is birth to 18kg for the same price.

I know there are budgetry issues with buying in one go, and of course there are budgetry issues with paying that price at all, but there are a lot of people who buy isofix infant seats, and isofix FF toddler seats, yet never know that the RF option is even there.

if the RF option was there in a shop, with all the facts available, to cost up against buying 2 different seats to cover the same peiod of time, I do think that more people would buy the RF option.

Oops, I should have mentioned, the BeSafe iZi Combi also comes (for slightly less money) in a configuration where you can fasten it using a seatbelt. A general FYI, certainly not intended as a criticism of you Quenelle - it's this kind of information that I wish was in the public domain a bit more.

Silverfrog - When I had a quick look at ff seats I remember thinking that they didn't cost that much less (the top of the range ones at least) - my friends have, on average, paid about £180 - £200 for their ff seats. They think I'm mad for keeping them rear-facing: "don't you want to see their faces?". It's very hard to respond to that question in a way that isn't going to come out and make someone defensive, so I tend to laugh along. This is another reason that I wish rf seats were a bit more common - would make me seem less odd.

Ddn't see that one when I was looking Frozen. The only one that was available in the only shop near us that sold them was £500 and had to be specially fitted.

I honestly don't know anyone else in RL who even understands the need for them. Anyone I have mentioned it to has just said 'You don't expect them to travel facing backwards do you? And where are their legs supposed to go?'

I have only actually seen one RF car seat for toddlers in RL, when I was noseying in next to someone else's car when they were putting their toddler in.

at the noseying, I do that too. The only other rf-ers I know are either mumsnetters (waves at Kara) or my relatives whom I know well enough to browbeat speak candidly to re: the benefits.

Ouch at the £500 seat though - for that money I'd want it to be gold plated.

We got ours from here - I think the prices have come down recently. There's a recaro polaric on for £220 and a Britax Multitech for £280. We live oop North so had it delivered and they talked me through fitting it on the phone. We got their details from here.

Interestingly, sitting with your legs dangling is actually quite uncomfortable (as one's legs would be in a ff seat) versus having them loosely bent but resting on something

I wonder have you ever sat for any length of time with your legs out in front of you but unable to stretch them fully? Assuming a child can be in a car seat for a couple of hours at a time, by the end of the that two hours their legs would be pretty cramped after being bent in that position for so long.

I was also incredibly travel sick as a young child (still am) and if we had been rear facing up till those sort of ages we never would have been able to go anywhere.

I don't doubt that it is safer but I don't buy that it's more comfortable and that children would have no problem travelling backwards.

dd2 can stretch her legs fully, but chooses not to, and as she is RF, she has that choice.

I think it speaks for itself as to which is more comfortable for her.

poor old dd1 doesn't get that option, and is left looking very uncomfortable, tbh, with the edge of her high backed booster finishing before her knee joint, so the pressure on the back of her thigh there, just above her knee, must be horrid, and she gets pins and needles quite often (I think - she is not able ot articulate this due to language delay)

to be honest, no child in a car seat gets much wriggle room for long journeys - whether bending/straightening legs, or trying to ease back stiffness. they are all pretty snugly fitted these days, even the high backed boosters, with side impact protection bits hugging ribs etc.

Gwendoline - no, I've never sat like that . Ugh, I was also car sick as a child so you have my complete sympathy. My niece is car sick (ff) and it's a nightmare for my SIL (and obviously, for DN).
All I can say is that my children have no problem travelling backwards - it's all they've known. Of course, I don't know for sure that they're comfy but they seem happy enough. DD1 lets her legs sort of drop open in an open bend as she sits (sorry, I'm not describing it very well). DD2 is still too little for her to need to fold.

Obviously my N=2 sample is no guarantee that other people's children would be comfy. But it genuinely doesn't cramp them as much as one might imagine it would (I should take a photo tommorow and post it to my profile).