Sunday, June 20, 2010

Premature Forward-Facing?

Premature Forward-Facing is what I think it should be called. Extended Rear-Facing (ERF) is what is it called now. ERF is what should be the norm.  Should we not do what is safest for our children and keep them rear-facing for as long as possible? 

Happy Girls! 
Rowan 3yrs 30lbs Sunshine Radian XTSL
Kiernan 22.5lbs Britax Boulevard suggest:
Rear-facing is the safest position the child can ride in.   It is strongly recommended that all children stay rear-facing beyond the minimum requirements of 1 year and 20 lbs. Children should not be turned forward-facing until they reach the maximum rear-facing limits of a convertible seat (that allows rear-facing to at least 30 lbs).  These limits are either the maximum rear-facing weight limit or when the top of their head is within one inch of the top of the seat shell, whichever comes first.  While most parents are aware that they must keep their children rear-facing "until they are AT LEAST 1 year old AND 20 lbs", very few are told that there are significant safety benefits when a child remains rear-facing as long as the seat allows.  For most children, rear-facing can and should continue well into the second year of life

I hear all the time how a police department or a fire department will install seats and turn a convertible seat around because the kid is 1yr AND 20lbs instead of keeping the seat RF until its max. These departments need to be informed of what is recommended by the AAP "Toddlers should remain rear-facing in a convertible car seat until they have reached the maximum height and weight recommended for the model, or at least (yes it says at least which is the minimum) the age of 2."  Then if the parent request the child to be FF then educate the parent. But they do have to follow the law which is one year AND 20lbs if the parents insist after being informed of the benefits of ERF. 

Safety experts and the American Academy of Pediatrics recommend that children remain rear-facing as long as possible and never travel forward-facing before they are 1 year old and also weigh at least 20 pounds to reduce the risk of serious neck injury and lifelong disability. All new convertible seats available today allow a child to remain rear-facing until they weigh up to 30 or 35 lb, depending on the model.
When the child is rear-facing, the head, neck, and thorax are restrained together by the back of the CR in a frontal crash. There is little or no relative motion between the head and torso that could load the neck. If the same child were facing forward, the harness would restrain the torso, but the head and neck would pull and rotate forward, leading to the potential for serious upper spinal injury (ie child may become paralyzed or worst case death).
There are many misunderstandings and misconceptions about rear-facing vs. forward-facing that lead even the best intentioned parent or pediatrician to believe a child is "safe" facing forward when he is still very young. These come from obsolete ideas and advice that may still appear in older pamphlets and pediatric literature and are not the current recommendations of the American Academy of Pediatrics.
Real-world experience has also shown that a young child's skull can be literally ripped from her spine by the force of a crash. The body is being held in place, but the head is not. When a child is facing rearward, the head is cradled and moves in unison with the body, so that there is little or no relative motion that might pull on the connecting neck.
The most common misunderstanding is that a child is ready to travel facing forward when his neck muscles are strong enough to support and control his head. However, when a car hits something at 25 to 30 mph, it will come to a stop at a negative acceleration rate of from 20 to 30 G. Because of the time lag between when the vehicle stops and an occupant stops, and the fact that the head of a forward-facing adult or child is still free to move relative to the restrained torso, the head may experience as much as 60 or 70 Gs acceleration for a brief moment. Even the strong neck muscles of military volunteers cannot counteract such forces. Instead, the rigidity of the bones in the neck and strength of the connecting ligaments (not the muscles) hold the adult spine together and keep the spinal cord intact within the confines of the vertebral column.
Very young children, however, have immature vertebrae that are still partly made of cartilage. These are soft and will deform and/or separate under tension, leaving just the spinal cord as the last link between the head and the torso. According to documented research, autopsy specimens of infant spines and ligaments allow for spinal column elongation of up to two inches, but the spinal cord ruptures if stretched more than 1/4 inch. Real-world experience has shown that a young child's skull can be literally ripped from her spine by the force of a crash.
Another aspect of the facing-direction issue that is often overlooked is the additional benefit a child gains in a side impact. Crash testing and field experience have both shown that the head of a child facing rearward is captured by the child restraint shell in side and frontal-oblique crashes, while that of a forward-facing child may be thrown forward, around, and outside the confines of the side wings. Field data show better outcomes for rear-facing children than forward-facing children, even though most CRs are not specifically designed to protect children in side impact.

A lot of parents feel like their child will be uncomfortable with their legs all squished up against the seat. BUT if you watch a child sit on the floor you will notice they draw their legs up as it is more comfortable for them.  What about the safety of their legs in a crash? Well there are no documented cases of legs or hips fracturing in a crash because of extended rear facing.  My thought on it is if my kids leg breaks I can fix that. If their spine breaks and they are paralyzed which is not something I can fix nor can I bring them back from death. 

Child car seat advice questioned:

Ask any parent about graduating their infant from a rear-facing car seat to a forward-facing one and you’ll likely hear this common refrain — at least 20 pounds and at least one year (although some estimates say a full 30 percent of parents go against this guideline and actually face their children forward earlier).

This advice is generally what our doctors tell us and it’s the car seat safety mantra that’s been drilled into our heads from organizations such as the American Academy of Pediatrics and the National Highway Traffic Safety Administration.

Two years ago, however, the American Academy of Pediatrics quietly added this wording to its guidelines: If a car safety seat accommodates children rear facing to higher weights, for optimal protection, the child should remain rear facing until reaching the maximum weight for the car safety seat, as long as the top of the head is below the top of the seat back.

There’s a growing body of evidence, however, that this lesser known guideline, which is considerably different from the well-known minimum guideline, will soon take center stage.
“In Scandinavian countries it’s common to keep children rear facing up to 3 or 4 years old and there’s some good data there that proves it’s effective,” says Chris Sherwood, a research scientist who is studying the issue at the University of Virginia Automobile Safety Laboratory. Yet, until recently, Sherwood says there was not U.S. data to prove that keeping an older child rear-facing would result in significantly less injuries.
As part of a project sponsored by the federal Centers for Disease Control and Prevention, Sherwood and colleagues recently completed a study looking at the benefits of keeping children in car seats that face rear. Sherwood’s research is now undergoing the necessary stage of being published and peer reviewed but the outcomes look intriguing.
His study, presented at a recent meeting of the American Academy of Pediatrics, involved 870 children under age 2 who had been in either rear-facing or forward-facing car seats at the time of an automobile accident. He found that the children in forward-facing seats were more than four times as likely to be injured in side crashes as opposed to the children in rear-facing seats. The study also found a small but not statistically significant benefit for facing rear in frontal crashes.
“The findings from the other countries and in Chris Sherwood’s work, although preliminary, should be considered carefully,” says Kristy Arbogast, associate director of field engineering with Traumalink at Children’s Hospital of Philadelphia and a leading researcher in the field. Arbogast notes that in general the newest evidence appears convincing that keeping children facing rear longer is probably the safest way to go.
Why is rear-facing safer?Since the 1970s with the introduction of the first seat belt and child safetyseat laws, there’s been an increased focus on how to make children safer in cars. In the last decade improvements have been made in computer modeling and child-size crash test dummies to give researchers a clearer understanding of what happens to children in car crashes.
What we know is that children aren’t just pint-sized adults. Their anatomy differs significantly from an adult’s and puts them more at risk for certain serious injuries. 
“The biomechanics of their necks facilitate the birth process — there’s a lot of flexibility in a child’s neck compared to an adult’s,” says Arbogast. “The youngest kids have a neck or cervical spine that doesn’t have the strength to withstand the forces they’d experience in many crashes.”
When a child is placed in a rear-facing seat there is less chance of trauma to the highly 

vulnerable neck and head areas during the most common crashes. Arbogast notes, too, that even older children — up to age 12 — still haven’t fully developed. They — along with adult passengers — would also probably be safer sitting rear-facing. Of course, this isn’t feasible. Adults and older children won’t do it or they can’t because the car seats won’t allow it. So the question safety experts are trying to answer now is how long we can get our very youngest children to do it.
The answer is a lot longer than many parents might think, says Kathleen Klinich, a senior research associate at the University of Michigan Transportation Research Institute.

Left to right Austin 6months, Rowan almost 3yrs, Kiernan 1yr

Girls dinner out!

Today I got the privilege to go out to dinner with my two beautiful girls. Rowan asked me before nap time if we could go to a restaurant and I told her we could for dinner. So we went to a fantastic restaurant called Taco Boy. I found this restaurant though my Summerville Natural Mom's group. The food here is just amazing. It is so fresh and delicious. They use local products when available.  The take home boxes are cardboard and the kids cups are biodegradable.  I love a restaurant that is moving towards bettering this earth.  They can have my money any day. I ended up getting the Shrimp Tempura Taco and the Grilled Chicken Taco. The girls got a Chicken Quesadilla.  The girls entertained themselves by playing with playdough.

Can you guess what it is?????

Well if you guessed POOP you would be RIGHT!
Yes she made Poop at dinner with her purple playdough. 

Then the wonderful Rowan requested to go on a bike ride. SOO WE DID! Got the drink and lovey and off Mommy rode to burn off her two tacos. ;-)