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Announcing the changes in the child safety-booster seat and restraint recommendations this week seems to have caused more confusion than controversy among parents of children who ride as passengers in cars.

The National Highway Traffic Safety Administration (NHTSA) and the American Academy of Pediatrics (AAP) released their recommendations on March 21, 2011 and parents’ heads have been spinning ever since.

The new guidelines and policy statement suggest that:

  • Children under the age of two years ride in rear facing child safety seats;

  • Children older than two, ride in safety/booster seats with harness straps, until they reach a height of 4 feet, 9 inches—(between the ages of 8 and 12 years);

  • For children over two in booster seats with five-point harness straps (for children up to 80 lbs.), parents should go with the height, weight recommendations of the manufacturer of the booster seat;

  • All child shoulder and lap restraints should fit appropriately and safely within the limitations of the seat; and

  • Children under 13 need to ride in the back seat.

Dr. Dennis Durbin, AAP, lead author of the policy statement (AAP) and the study, says: "For larger children, a forward-facing seat with a harness is safer than a booster, and a belt-positioning booster seat provides better protection than a seat belt alone until the seat belt fits correctly." Scratching your head yet? And there are a whole lot of "what if’s" for parents that accompany these guidelines, such as: What if your daughter is only 4 feet, 8 inches tall? Exactly where does she ride? She may not want to ride in the booster seat. And, at 13, trying to get your child, to ride in the backseat, even while reciting aloud the safety statistics, will certainly be a challenge. Some younger children (younger than but not yet two years old) do not like to ride rear facing. However, Dr. Laura Jana in a recent ABC TV News interview by Tanya Rivero says essentially, that kids don’t miss what they haven’t had—so if they haven’t been riding face forward already they won’t mind riding backward.

Sitting rear facing, Dr. Jana says, however, can reduce the threat of a child’s death in an automobile accident of up to five times. That’s significant. Automobile accidents are "still the leading cause of death for children ages 4 and older. Counting children and teens up to age 21, there are more than 5,000 deaths each year. Fatalities are just the tip of the iceberg; for every fatality, roughly 18 children are hospitalized and more than 400 are injured seriously enough to require medical treatment. Of course, for parents, the safety of their children is the first concern—and all parents want to make sure to do the right thing.

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