“A rear-facing child seat reduces the risk of injury in a head-on collision by more than 80% when compared to a conventional forward-facing seat with harness system, as the force of an impact is distributed evenly over a large area.”

- VTI – Swedish Road and Transport Research Institute (Rapport 489A, 2003)

The reason to rear face is simple, it’s safer.

In order to understand the safety benefits of rear facing, it is important to see the difference in the forces of a car crash on a child in a front facing versus a rear facing car seat. This frontal car crash video shows this difference in forces: click here to view.

Children are not just small adults; their bodies are still developing and those developmental changes make them more vulnerable than an adult.

In a child’s spine the vertebrae are connected via cartilage rather than bone as they have not completely fused to form the protective spinal column present in adults. It is the spinal column that protects the spinal cord and due to the cartilage, a child’s spine is hypermobile and flexible.

Additionally, a child’s immature spine must support a larger head compared to an adult’s developed spine. The average nine month old child’s head is 25% of its body weight compared to an adult’s head being only 6% of its body weight.

The relatively large head mass and differences in the anatomy of the cervical spine in young children can lead to excessive stretching or even transection of the spinal cord if a child is involved in a frontal (head-on) crash while in a forward facing car seat. 

During a crash, occupants will travel towards the point of impact. When a child is forward facing in a 50km/h frontal accident, the force of the crash pushes the head forward at 180-300kg and thrusts the neck, arms and legs forward while the harness holds the child’s underdeveloped rib cage in the seat. In crash tests, the neck of the crash test dummy has been stretched as much as 2 inches. However the spine cannot be stretched more than a quarter of an inch before transecting/snapping. This in conjunction with force of the car crash can lead to catastrophic injuries, internal organs damage, paralysis or even death. This is one of the main risks associated with using forward facing car seats.

In a rear facing car seat the force of the frontal accident is only 40-80kg and spread evenly along a much greater area. The child’s back, neck and head are protected by the rear facing car seat’s back because it absorbs the impact and the rear facing car seat helps to hold the neck and spine in line.

A child’s spinal development and head size has been likened by medical professionals to that of an apple on a stem. This difference in development and proportion only increases the need to protect the spine of a child.

Benjamin Hoffman is a Professor of Pediatrics at Oregon Health & Science University School of Medicine in Portland and a child injury prevention specialist. He states that:

“Younger children tend to have relatively bigger heads, weaker necks and muscles in general and looser tendon and ligaments. Facing forward, the head and neck are thrown forward violently in a crash and the same forces that can lead to whiplash in an adult can actually cause the spine of a young child to separate and injure the spinal cord.”

A 2009 study by BMJ (British Medical Journal), titled Advise use of rear facing child car seats for children under 4 years old, investigated why it is safer for children under 4 to travel in rear facing car seats. The study included analysing prior research on rear versus forward facing and had the following recommendations:

Rear facing seats are safer than forward facing seats for children under 4 years old. Excessive stretching or even transection of the spinal cord can result if a child is involved in a head-on crash while in a forward facing car seat. Parents and guardians should be advised to keep young children in rear facing seats for as long as possible. Healthcare professionals should advise that rear facing seats are safer than forward facing seats for children aged under 4 years.

The American Academy of Pediatrics (AAP) recommends that children remain in a rear-facing car seat for as long as possible; until they reach the highest weight or height allowed by their seat (August, 2018). Previously, the AAP specified children should remain rear-facing at least to age 2; the new recommendation removes the specific age milestone. The AAP stated that there is not a large enough set of data to determine with certainty at what age it is safest to turn children to be forward-facing and that keeping your child rear-facing as long as possible is the best way to keep them safe.  

Further research published in 2017 in the BMJ in Injury Prevention re-evaluated the American National Automotive Sampling System Crashworthiness Data System (NASS-CDS) database and included data from 1988 to 2015. It concluded that Non-US field data and laboratory tests support the recommendation that children be rear facing for as long as possible.

Car Seat manufacturer Joie also recommends rear facing for longer based on their consultation with doctors and child safety experts worldwide to better understand the effects of a car crash on a child’s growing body. Joie carried out Internal ECE testing in 2015 with Q1.5 dummies. Based on performance averages of all Joie rearward and forward facing car seats, the testing found that rear facing versus forward facing, there was 70% less risk of head injury, 73% less tension on the neck and 34% less rotational force. The Joie campaign for rear facing incorporates the slogan “Look Back Longer. Because every rearward day is a safer day”.

For further research on the safety benefits of Rear Facing click here and for Rear Facing frequently asked questions click here.