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American Academy of Pediatrics Issues Simplified Car Seat Guidelines

Danielle Dent-Breen's picture
Car Seat Guidelines

The American Academy of Pediatrics recently updated their guidelines on car seat safety and usage. These new guidelines attempt to provide concise, clear-cut information about the best practices for car seat usage.


Striking through the confusion about car seat guidelines

In the United States, laws vary from state-to-state, leaving many parents confused about what is best for their children. Well-meaning parents are understandably confused when it comes to the myriad of choices when shopping for car seats. Studies have shown that children under the age of two are safest when rear-facing in the back seat, but even that can be confusing. Beginning in 2002, vehicle manufacturers in the United States were mandated to include the universal “Lower Anchors and Tethers for Children” system (LATCH) to improve car seat compatibility and safety. However, parents may not realize that these LATCH systems are rated only for a combined weight of 65 pounds. That’s 65 pounds total, for the child and the car seat. According to the National Highway Traffic Safety Administration (NHTSA), regardless of the stated upper weight limit of the car seat, once the combined weight of the child and the seat reaches 65 pounds, parents should use the vehicle’s seat belt system to secure the child seat in lieu of the LATCH system. The two systems should never be utilized simultaneously. (Upper tether systems may still be used to prevent a forward-facing seat from tipping forward in a sudden stop.)

Updated guidelines

The AAP issued the following chart to assist parents in choosing the best seat for their child at any age, updated with their latest guidelines:

Here’s the breakdown of recommendations for each age:

Infants and Toddlers should always ride in a rear-facing infant seats or convertible car seats until they are at least 2 years old, or until they reach the car seat manufacturer’s limit for either height or weight. Remember that the weight limit must be noted for snap-in infant carriers, and no child over 1 year of age should ride in an infant seat. Never place a rear-facing car seat in front of an active air bag.

Toddlers and Preschoolers should ride in convertible car seats, and should remain rear-facing for as long as possible. Once they have either reached the maximum weight or height limit determined by the manufacturer for rear-facing, or once their shoulders are above the top harness slots, or once the tops of their ears have reached the top of the seat, their convertible car seat may be turned around front-facing. Toddlers and preschoolers should always be secured with a five-point harness.

School-aged kids who are kindergarten aged and up, and who exceed either the weight or height limits of a forward-facing car seat with a five-point harness should then ride in a belt-positioning booster seat until the vehicle seat belt fits them properly. This is typically when their height has reached at least 4 feet 9 inches, and sometime between 8 and 12 years of age.

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Older children may move to using the vehicle lap and shoulder belt exclusively only when the belt fits them properly, even though no state requires them to be used after the age of 8 years old. It should be noted that the AAP and the NHTSA insist that children up to age 12 are safest in a belt positioning booster, depending on their height and weight. In addition, they stress that in order for a vehicle lap and shoulder belt to fit properly, it must be able to be worn low across the upper thighs—not the abdomen—and the shoulder strap should rest firmly across the chest and clavicle, and not in contact with the child’s neck. Children should be able to sit firmly against the back of the seat with their knees fully bent over the front edge of the seat, ideally with their feet resting on the floor. Due to the design differences from one vehicle to another, the age at which all of these goals are accomplished can vary greatly. Children under the age of 13 should never ride in the front seat.

Choosing a car seat wisely

When parents are in the market for a new car seat, the choice can be daunting. Many seats seem to fit multiple purposes, so it is important to know which seat will best meet your needs both now and in the future.

Rear-facing only seats are to be used exclusively rear-facing. These all have a five-point harness. They may also be called infant carriers or infant seats. Most seats of this design are made to accommodate children in their first year of life. They support an infant who does not yet sit independently in a reclined position, come with snap-in-place bases that allow the entire seat to be removed easily to carry or snap onto a stroller while an infant is sleeping. These seats are very convenient for parents, but are generally only used for a relatively short time, as the upper weight and height limits mean that the baby will outgrow it quickly.

Convertible seats are those that can be used rear-facing as well as forward facing. All of these seats will also come with a five-point harness. Some convertible seats can accommodate a newborn baby, but others have a minimum weight requirement, up to as high as 14 pounds. Always check the manufacturer’s rating for these seats.

3-in-1 seats are designed to work as a rear-facing seat, a forward-facing seat, and finally as a high-back booster. Many of these are safety rated to follow a child from birth through childhood, with weight ratings from 5 up to 120 pounds. Each manufacturer rates their seats differently, so always read the labels to know how to use the seat safely.

Combination seats are designed to be used forward-facing only, and have the ability to use a five-point harness, and serve as a high- or low-back booster as the child grows. These seats are only designed for children over 2 years of age who can ride forward-facing.

Belt-positioning booster seats come in two basic styles: high-back and backless. A high-back booster is especially helpful for smaller children who require additional assistance with proper placement of the shoulder strap. Generally, children over approximately 40 pounds will be able to use the backless booster, however this may vary depending upon the make of the vehicle.

The AAP has published this extremely helpful product listing guide that is current as of the date of this publishing, listing every available car seat that meets NHTSA standards, including approximate pricing for each model. Parents can use this guide to prepare prior to shopping.

When it comes to car safety seats, it’s important to remember that second-hand is usually not best. A car seat should never be used past its expiration date, as the integrity of the plastic used during manufacturing degrades over time. There is an expiration date stamped on every car seat sold in the United States. Also, a car seat should always be replaced if it has been involved in an accident, even if there is no visible damage to the seat.

Remember, there is no one car seat that is the best or the safest. Parents should not necessarily equate a higher price with higher safety. The most important thing to look for is a seat that fits your child best, and safely in your vehicle, and that you will use every single time you get into the car.



Great article, but there seems to be a bit of confusion on when toddlers and preschoolers outgrow their rear facing seats. The information you have in the paragraph, shoulders above the top harness slots and tips of ears above the top of the seat, are actually guidelines on when they outgrow a forward facing harness seat. For rear facing the general guideline is that when the top of their head is an inch from the top of the seat. There are actually a couple seats with a different rule, but that's generally accepted as a safe guideline.