Car seat safety: Rear vs. front facing

Car seat stock photo

Is my child too tall? What weight should they be? What’s the safer option? 

These questions run through parents’ minds when it comes to their child’s car seats. There’s no one-size-fits-all answer, but Cindy Hamilton, the Child Passenger Safety program coordinator at OSF HealthCare Children’s Hospital of Illinois, has some consistent guidelines parents can follow.

Pay attention to the car seat manufacturer’s guidelines

"The child wants to max out the height and weight for the seat they are using, which is going to be different for every seat based on the manufacturer. So, if this seat goes 40 pounds rear-facing; when they're 40 pounds, we want to turn them around then,” Hamilton says.

How do height and weight play a role?

"A lot of parents might say 'well my child is uncomfortable, their legs are long, but they're still not two,' or they're low in the weight range. Our best advice is that you can heal from a leg injury. A spinal cord, neck or brain injury, maybe not. So that's a key determiner of keeping them rear facing,” Hamilton says.

Illinois state law requires infants to remain rear facing until at least two years old. But Hamilton says, “rear facing longer is always best,” which is also advised by the National Highway Traffic Safety Administration, which recommends keeping kids rear facing until they’re three.

"When you're in a crash, the shell of the body of a rear-facing seat will absorb the shock. It protects the head, neck and spine more than when you are forward facing," Hamilton points out. 

When it comes to forward facing, Hamilton says you want to make sure your kids have full control of their head and neck. This is another “milestone” you can add to your list when you consider making the switch.

Steps to safely secure car seat

When you install the car seat rear facing, install with the seat belt or the seat’s anchors, but not both. Always check both the manufacturer guidelines and the vehicle owner’s manual which lists the locations of the car’s anchors and tethers for car seats.          

Make sure the harness is fitted to the child securely.

Clip the chest clip at armpit level. The lower clip should be snug across the area where the diaper is.

You don’t want to be able to pinch any fabric around the child’s neck and shoulders, Hamilton says.

The rear-facing seat should have a recline angle indicator. You want to make sure that whatever the indicator is, it’s aligned and level with the seat.

If your child has made the switch to forward facing, make sure they can hold their head up and they’re sitting more upright. Connect the top tether to hold the seatback to the seat and install with either lower anchors or seat belt. If you do choose the seat belt, Hamilton says make sure the seat belt is properly locked, which can be done by pulling all the webbing out from the retractor. You can find these locations in the owner’s manual as well.

“We don't put coats or blankets under (the straps) for safety. With a child that's rear facing, we want the straps at or below (the child's shoulders) because that's how they're crash tested,” Hamilton says. “With forward facing, all the same with the harness, but we want the strap at or above (the child's shoulders).”

OSF HealthCare offers a low-cost car seat program. Families who need a car seat can call 1-877-277-6543. There are also community car seat checks and free car seat installation checks held throughout central Illinois.