In 2009 the British Medical Journal published an article on the significant safety benefits of keeping children in rearward-facing seating when travelling in a motor vehicle. Now, five years after this paper was released, how accessible is information regarding the benefits of keeping your child rearward-facing for as long as possible? Has the United Kingdom changed its official guidelines regarding rearward-facing car seats? And finally, are they readily available in high street stores or do parents still have to import them from abroad?

The key points from the 2009 article are as follows:

• Many babies are switched from a rearward-facing car seat to a forward facing seat at nine kilograms (eight months of age for a boy on the 50th centile for weight)
• Excessive stretching or even severing of the spinal cord can result if a child is involved in a head-on crash while in a forward facing car seat
• Rearward-facing seats are safer than forward facing seats for children under four years old
• Parents and guardians should be advised to keep young children in rearward-facing seats for as long as possible

The above points are taken from the original article which you can view here in full.

What happens in a motor vehicle accident when a young child is facing forward in their car seat?

In a young child, the head constitutes 25% of their body weight. Their bones are still developing so they are soft and consist mainly of cartilage. This allows them to tumble down stairs or fall off playground equipment and, apart from a few tears, often emerge relatively unscathed.

However, in a high-impact, frontal motor vehicle collision, this works against them in a terrible way. The weight of the head, when it is flung forward, can stretch the neck to the point where the spine snaps, causing internal decapitation. Due a child’s ribcage being soft, the internal organs are not protected against the tremendous force being pushed onto them by their car seat harness and the damage caused can be fatal.

Parent’s access to information

The internet can provide a wealth of information regarding the safety benefits of rearward-facing car seats for children up to four years of age. However:

• Many parents are not in a financial position to pay for an internet connection
• Some families do not speak English as their first language and are therefore limited to the amount of information they can access from British websites
• Lack of education and understanding can limit an individual’s ability to research and understand the information that may be available

Unfortunately, lack of accurate, easily obtainable information is one of the key reasons why even well-educated parents are unaware of the importance of keeping their child rearward-facing as long as possible.

Has the United Kingdom changed its official guidelines?

Some countries, including the United States and New Zealand, have changed their regulations and official guidelines to recommend children remain rearward-facing up until two years of age. Sweden’s official recommendations state that parents keep children rearward-facing until they are 4 years old (contrary to popular belief, this is not enshrined in law).

At present in the United Kingdom babies over nine kilograms (around eight to nine months old) can be forward-facing. However, new European Union regulations which were ratified by the UK in July 2013, known as the i-Size Regulations (or UN R129), state that children should remain rearward-facing until they are at least 15 months old. i-Size also requires that an ISOFIX click-and-go system is used to fit the car seat rather than the car’s own seatbelts. This reduces the chance of the car seat being fitted incorrectly. However, these new regulations will run alongside the existing regulations for the next few years.

Therefore, you can still buy and safely use car seats which comply with the current ECE R44/04. This is causing confusion among parents as they are no longer sure which regulations to follow. Again, uncertainty often arises due to lack of readily accessible information.

Have rearward-facing car seats become more available?

As recently as 2011 it was extremely difficult to purchase a rearward-facing car seat, suitable for a child up to four years of age in the United Kingdom. Caroline Green, mother of a three year old daughter says “The only reason I knew about the benefits of rearward-facing car seats was because my brother worked for Volvo and was involved in some of their safety testing”. She goes on to say; “It really frustrated me that I could not walk into a high street shop and purchase a rearward-facing car seat, I had to do a lot of research to find a stockist”.

Some high street retailers are now stocking rearward-facing car seat brands such as Maxi-cosi and Britax, however, the number is still fairly limited and the price is prohibitive to many individuals.

Sadly, at this point in time, many parents, especially those belonging to socio-economically deprived groups, are unable to give their child what could a be life-saving advantage in a motor vehicle accident. This is due to lack of knowledge, advice, and the current difficulty and expense of obtaining a rearward-facing car seat for children up to four years of age.

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