The reason for this change in recommendations was based upon a 2007 study published in the journal Injury Prevention (a publication of the British Medical Journal, and funded by the Centers for Disease Control and Prevention) which "showed that children under age 2 are 75 percent less likely to die or be severely injured in a crash if they are riding rear-facing." When a child rides rear-facing, the force exerted on a toddler's body during a crash is spread "more evenly across the entire body; limits the motion of the head reducing the potential for neck injury; and keeps the child more contained within the shell of the child restraint than a forward-facing seat. The benefit of a rear-facing car seat was particularly great, the study found, in side impact crashes." The following is video of a front-facing car seat crash test.
|Front-facing crash test|
|Rear-facing crash test|
A young child, relative to an adult, has a "larger head mass" compared to the body mass. They also have bones which aren't solidified. The spine and neck bones may still be soft with lots of cartilage. As a result, in a front-facing car seat in a front or side impact collision, the "larger" head can snap forward and lead to a condition called "atlanto-occipital dislocation" or "internal decapitation." While your child's head may not physically separate from its body, the head can separate internally from the spine. It can happen to children in crashes where the adults can escape without injury. This can happen to adults as well but those crashes require more force. In fact, everyone would benefit from rear-facing in an automobile, airplane, train, or any moving vehicle. I think it's no coincidence that flight attendants sit rear-facing on planes.
I honestly plan on keeping my child rear-facing as long as he meets the height and weight requirements of his car seat. We bought a car seat with a higher rear facing limit specifically for this reason. I have had many people tell me that their kids' legs are too cramped when they are rear-facing. However, in Sweden, it is recommended for children to sit rear facing until the age of 4! Many Swedish car seats will even support children up to 5 years old and 55 pounds! Many children just sit with their legs crossed. They do not look cramped and children like my baby, do not know any different sitting rear-facing. Also, if I were in an accident that would cause my rear-facing child to suffer a leg injury (which is non-existent), think of what that force would have done to their head and neck! A study done by the Children's Hospital of Philadelphia showed leg injuries in FORWARD facing children due to the impact with the seatback in front of them.
Even though my baby has been rear-facing since day 1, he still enjoys looking at the other cars on the road and even knows his way home. He surprised us last week when he got upset when we drove by our usual way home. He doesn't seem "bored" and is content with his feet up against the seat. I am also content knowing my baby is sitting in the safest position in the car.