Every now and then a pop science article or research paper comes out stating forward-facing is safer than rear-facing (it isn’t), or insisting boosters are just fine for 2 year olds (they aren’t) or that preschoolers are just as safe in seat belts as they are in car seats (that’s wrong too). Unfortunately, with the influence corporations and ad dollars have over the dissemination of information in the United States, it’s quite easy to get tricked into believing nonsense (or “fake news”, to use recent parlance). Fortunately, good ideas remain good ideas no matter whether we believe in them or not. Let’s see what best practices look like by people who practice them.

Here’s a look at what the NTF, the Swedish National Society for Road Safety (their version of the NHTSA) has to say about car seats and car seat safety. As the Swedes continue to have the best record in child traffic safety as well as in overall traffic safety (two titles they’ve held for decades), I’ll continue to follow their lead and not the outdated or just plan bad advice bandied about in the US (where the AAP only recently began recommending rear-facing until 2, and where almost all states continue to require it only until 1).

How Long Should Children Rear-Face, Per Swedish  Recommendations?

Per the NTF, children should rear-face as long as possible and be turned forward facing earliest at 4-5 years of age.

Note how the response doesn’t state that children should stop rear-facing at 4 or 5; it says they should be rear-facing as long as possible, but no earlier than when they are 4 to 5. In other words, if you can rear-face past 4 or 5 due to a child continuing to fit in his or her car seat, that’s a good idea. But your baseline goal should be 4 to 5. As I’ve noted in previous articles, that means preschool. That means kindergarten. It means prioritizing rear-facing and not forward-facing earlier than necessary, regardless of what fellow parents or family members are saying. It’s easier in Sweden since fellow parents and family members will be doing the same thing. But whether in Sweden or in the US, these are best practices.

What About Rear-Facing Safety For Side and Rear Impacts, Per Swedish Recommendations?

Per the NTF, rear-facing is always the safest position for young children. They note it would also be safer for adults, but that because we have stronger necks, we’re slightly more capable of handling crash stresses. They then note that forward-facing might be slightly safer for rear-impacts, but because most collisions are frontal collisions, while rear-enders are typically not at the high speeds inherent in frontal collisions, it’s best to always rear-face. They add that the best position for a side impact is away from the point of impact, but that this is of course impossible to predict. They concede that other factors are probably more important than rear- or forward-facing in side impacts, but that rear-facing is still not a bad position in such collisions.

This recommendation is in line with those I’ve made indicating that rear-facing is still overall the safest orientation for a car seat when aggregating all crash positions and risks. By extension, it supports the argument that the 3rd row is a safe one for child and adult passengers (I posit the safest). The Swedes additionally believe that the front and back rows are equally safe for rear-facing children as long as the frontal airbag can be disabled. This isn’t the case in the US for 99% of passenger vehicles, so on this side of the Atlantic, the back rows are safer.

How Long Should Children Use Booster Seats, Per Swedish Recommendations?

Per the NTF, children should remain using booster seats until they are 10 to 12 years old. They note this is because children’s hips aren’t fully formed until then and that controlling the belt path around the child is necessary to keep the lap belt from penetrating a child’s abdomen and causing internal injuries. They note that the amount of time a child will be able to sit on a booster seat will depend on the child’s length as well as on the vehicle one uses. If the shoulder belt path is affected, they suggest bypassing the booster seat and ensuring that the shoulder belt path is appropriate.

This recommendation is directly in line with those from the 5-step test, which most children are typically not able to pass until they are between 10 and 12 years old. While the 5-step test is not specifically mentioned, the principles are the same, as are the risks of bypassing the recommendation (internal organ damage).

What Makes a Car Seat Dangerous, Per Swedish Recommendations?

Per the NTF, what makes a car seat dangerous is allowing a child to forward face from age 1. They recommend car seats capable of rear-facing up to 25 kg, or 55 lbs, and state once again that the safest way to travel in a car is rear-facing. They then state that children should rear-face for as long as possible, and preferably until they are 4-5 years old.

This section is rather self-explanatory. To the Swedes, the main danger in a car seat is using it to forward face young children. They explicitly recommend rear-facing for all occupants and car seats that allow rear-facing until 55 pounds. Such seats don’t yet exist in the US as of 2017, but as late as Spring 2014, there was only one car seat sold in the entire country that allowed rear-facing until 50 pounds (the Clek Foonf). Now there are many more–the Clek Fllo, the Clek Foonf, the Diono Rainier, the Graco Extend2Fit, the Graco Extend2Fit 3-in-1, the Graco 4Ever Extend2Fit, the Nuna Rava, the Safety 1st Advance EX 65 Air+, and the Safety 1st Grow and Go EX Air. Things have improved immensely, but we still have a ways to go in all elements of transportation safety and in child traffic safety. The key takeaway is to max out your seat to its height and weight limits, and ideally to do whatever possible to rear-face until at least 4 or 5.

What Do I Do With This Information? What If I Want To Know More?

There are more questions to answer, but this is a good start. You can read far more on the NTF site; if you don’t read Swedish, you can use built-in browser translators or head over to Google Translate or your favorite translation tool. But the answers are rather clear in most cases. Resist the urge to follow one breathless study after another suggesting something’s good one week and bad the next. Rear-facing is what’s safest no matter how young or old a passenger vehicle occupant is. Aim for at least 4-5, and continue to booster until 10 to 12. Beyond that, drive as little as possible, and choose safe speeds and choose safe roads whenever you do. None of these steps require any money whatsoever aside from that for convertible or all-in-one seats, which are available for well under $200 (e.g., the Graco Extend2Fit, the Graco 4Ever Extend2Fit, the Safety 1st Advance EX 65 Air+, and the Safety 1st Grow and Go EX Air). The driving techniques are completely free and will far, far, far more of a difference than the safety benefits from buying the latest and greatest vehicles.

If you find my information on best practices in car and car seat safety helpful, you can do your shopping through this Amazon link. Canadians can  shop here for Canadian purchases. Have a question or want to discuss best practices? Join us in the forums!