A review of recent literature showed that auto accident injuries can be significantly if children are placed in rear-facing car seats until they reach the age of 4. The reason is that young children in forward-facing car seats are at risk for excessive stretching or transection of the spinal cord in a head-on collision because of their relatively large heads, as well as anatomical differences in the cervical spine.
While the American Academy of Pediatrics recommends that children be placed in a rear-facing car seat until they are at least a year old and weigh at least 20 pounds, a 2002 statement added that, for optimal protection,children should remain rear facing until reaching the maximum weight for the car safety seat, and as long as the top of the head is below the top of the seat back. "Manufacturers should be encouraged to develop car safety seats that accommodate children rear facing to 4 years of age (45 pounds)," the statement concluded.