The American Academy of Pediatrics (AAP) takes car seat safety very seriously. Automobile accidents are one of the leading causes of death for children younger than 4 years old but a correctly installed car seat can reduce injuries and save lives. For optimum safety, car seats for the smallest children must face the rear of the vehicle but an alarming number of parents ignore this recommendation.

Since the academy updated its recommendation for car seat installation in 2011, a two-part University of Michigan (UM) study revealed most parents install their infant’s and toddler’s car seats in a forward-facing position long before it’s safe to do so. Lead author of the study is Michelle L. Macy, of UM’s C.S. Mott Children’s Hospital where she is a professor of emergency medicine and a member of the Institute for Healthcare Policy and Innovation.

One original AAP recommendation was that children ride only in rear-facing infant car safety seats until their first birthday or until they reached 20 pounds in weight. In 2011, the recommendation was extended to keep children facing the rear until they were 2 years old or until their weight and height exceeded the infant car seat manufacturer’s limits.

Macy’s research team surveyed parents in 2011, one month after the extended AAP recommendation was issued. The researchers surveyed parents again in 2013. They discovered parents are getting better at keeping the littlest passengers facing the rear of the vehicle but there’s still plenty of room for improvement.

In 2011, the survey revealed:

  • 33% of parents of children aged 1 to 4 had turned their child’s car seat into a front-facing position before the child was 12 months old.
  • Only 16% waited until the child was 2 to turn the seat forward.

In 2013:

  • 24% of parents had changed their infant’s car seat into a forward-facing position before the child’s first birthday.
  • Only 23% waited until the child was at least 2 years old.

Macy’s study is the first of its kind to produce a national assessment of when parents actually transition their infant’s car safety seats from rear-facing to forward-facing positions. Some car seats are convertible so parents can install them to face backward until the child reaches the correct age or weight to turn it around for continued use.

All car seats come with manufacturer’s limits for weight and height rather than an age limit but these limits aren’t always honored:

  • Many children ride without benefit of any restraints at all.
  • Approximately 20% aged 1 to 3 ride in car seats that don’t fit them.
  • Almost half the children 4 to 7 years old use restraints that don’t fit them.

Installation can be tricky but help is close at hand. Many hospitals, police stations, and fire stations offer free installation of car seats and many will inspect the seats that parents install themselves and make any corrections that are necessary. Look online for car seat installation inspection locations by ZIP code.


  1. University of Michigan Health System. "Almost three-quarters of parents turn car seats to face forward too early.” Press release. EurekAlert! American Association for the Advancement of Science (AAAS), 6 Jan. 2015. Web. 19 Jan. 2015.
  2. "How to Install a Rear-Facing Only Infant Car Seat." Parents Central., n.d. Web. 19 Jan. 2015.


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