Pediatricians say rear-facing best; moms say, 'We'll see …'

Abby Mazzei started putting her daughter in a forward-facing car seat when she turned 1. The little girl had begun to get antsy facing backward, and it was clear to her mother that it was time.

But like many parents, Mazzei faced a fresh decision after the American Academy of Pediatrics published new recommendations Monday citing strong evidence that children are safer remaining in rear-facing car seats until age 2, and in booster seats as late as age 12.

For now, with her daughter at 20 months, she doesn't plan to reverse course — or the car seat.

"I understand the science that's behind these suggestions," said Mazzei, of Countryside. "But if it came down to science, you couldn't leave the house."

Parents are bombarded with recommendations, from what plastics children should stay away from to what foods they should eat to how much television or video game time is appropriate. Many of those digesting this newest advice say they will do what they always have: filter and apply it in a way that makes life livable for both them and their children.

But parents who study the recommendations on car seats closely will find that the data is compelling: forward-facing kids are far more likely to die.

The American Academy of Pediatrics, in the journal Pediatrics, referenced research that shows children under 2 who ride in rear-facing child restraints are 75 percent less likely to die or be severely injured in a crash.

Dr. Kyran Quinlan, an associate professor of pediatrics at Comer Children's Hospital at the University of Chicago, said he understands that it might take parents some time to assess these new recommendations, but he emphasized that they are data-driven and worthwhile to ensure child safety.

He said parents have had to readjust each time the laws and recommendations changed in the decades since seat belts and restraints were first introduced.

"Each step of the way there has been a little bit of reluctance as the message first enters the populace," Quinlan said. "So there may be some adjustment as this gets started, but I hope the message gets out there."

Along with keeping kids in rear-facing seats until age 2, the academy also suggests children remain in a seat with a five-point safety harness until they reach the weight and height limit of that harness. For older kids, the academy says children should use boosters until they are 4 feet 9 inches tall, likely between the ages of 8 and 12 years old.

Victoria Lavigne, a child psychologist and an assistant clinical professor of psychiatry at Northwestern University Feinberg School of Medicine, said she believes parents should take the academy's recommendations "very seriously," but she recognizes the difficulties enforcing such rules might present.

"My first thought when I heard that was, 'Oh my gosh, how are you going to get them to comply with that? That's not an easy one,'" she said. "Parents are going to have to decide if this is an important thing and it's important for safety, then they're going to have to be strategic in figuring out how to get their kids to comply."

But, she said, parenting is a balancing act.

"I think parenting is a thought-out process, people actually sit down and think, 'What do I want to accomplish with my child and how does what I'm doing help me accomplish those goals?'" Lavigne said. "You give some thought to what you want. And then you kind of take the characteristics of your child into consideration."

That's how Julie Willoughby, of Oak Park, has handled her four children, who range in age from 4 months to 7 years.

"I can tell you that the rear-facing seat, with my older kids, became really difficult to do," she said. "They were getting bigger, their legs were getting longer and smashed up. We have always turned the kid around when they hit either the age or the weight requirement, whichever comes first."

With her youngest, Willoughby said she'll follow the instructions that came with their car seat regarding when it's appropriate to switch from rear-facing to forward-facing.

"I'm going to do it the way that I've done it with my first three kids," she said. "For me, what I think about the most is driving safely … drive defensively, pay attention when you're driving with your kids in the car. I feel like doing that kind of thing will go a lot further than the additional year of a kid jammed in backward in their car seat."

Emily Ruby, a River Forest mother of three, said: "I appreciate the vigilance by these organizations that do all the studies, but I also think it's a little too much. It's overwhelming to constantly change things to the point where (kids) might as well have helmets on them when they're in the car."

Heather Ondersma, a mother of three who lives in the Uptown neighborhood, said that just the other day her husband faced their 14-month-old daughter forward for the first time.

She said they will likely abide by the new recommendations from now on, helped by the fact that at such a young age, their daughter isn't likely to complain.

"For us, with her, there's no real reason not to," Ondersma said. "I think it'll be trickier if you've got a kid who's really accustomed to going the other way."

She said whether it's car safety or other information about keeping kids safe, she and her husband try to study suggestions and adjust their lives accordingly.

"Our older kids used plastic bottles, but now the baby uses glass bottles," she said. "Like most parents I think that, overall, we just try to do the best we can."