Forward-Facing Car Seat: When Is Baby Ready to Make the Switch?

My six-month-old daughter weighs 20 pounds and is ready to be moved into a "big" car seat. I've heard conflicting views on which way she should face in this larger car seat. Some say that once a baby reaches 20 pounds he or she can face forward. Others say they must be 20 pounds and one-year-old before they can face forward. What is safest for my baby?

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

You ask an excellent question because this issue gets confusing for many parents. This comes up again when the child gets to about the age of four and it becomes time to move her out of the car seat and into the booster seat. The problem is that the manufacturer's weight limits on the individual seat do not necessarily coincide with the appropriate time the infant should be turned to forward facing.

Car seats for infants are placed facing the rear because in a head-on collision the muscles of the neck of an infant are unable to adequately support the head as it violently lurches forward. If the infant were facing forward during a head-on collision, significant head and neck injury could occur even though the baby remained adequately seated in the car seat. These muscles become strong enough at about two years of age. Therefore, to turn the car seat around, the child ought to have had her second birthday. But what about the 20 pound rule? This rule is set because most children at 20 pounds are tall enough to fit into a forward facing car seat. Notice I said most children. There are some shorter children who reach 20 pounds before the restraining system of the forward facing seat correctly fits. When this occurs, an infant car seat that allows for higher weights, but can also be used rear-facing, should be purchased. I always suggest putting your child into the seat in the store before purchasing one. "Trying on" the car seat is a good idea before spending a lot of money on one.

The next common recommendation is to switch from a car seat to a booster seat when the child reaches four years or 40 pounds. Again, this is a generalization. Most children at four years or 40 pounds are tall enough to have the safety belt fit correctly when they are in a booster seat. However, there are plenty of taller children who reach this point before their fourth birthday. Conversely, there are numerous children who ought to stay in their car seat for a while after their fourth birthday until they are taller. Of course, this implies that the car seat can hold a child greater than 40 pounds. A child fits correctly in a booster seat when the lap part of the belt fits across the hips not the abdomen and the shoulder portion fits across the chest and not the neck.

The American Academy of Pediatrics recommends that the child be two years old, or have reached the maximum height and weight for their car seat, before switching them to a forward facing car seat. There are many car seats out on the market which allow for them to be switched from rear to forward facing. In addition, there are some car seats that can be converted from a toddler car seat to a child booster seat. According to a new study, researchers suggest car seats should be used only for protection during travel, and not as replacement for cribs.

As always, I suggest you read both the instruction sheet of the car seat and the owner's manual of the car to see if there are any quirks pertaining to your car or car seat that you should be aware of.

Good luck to you.

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