This document discusses rear-facing car seats and provides best practices for their use. It describes why children should travel rear-facing due to their anatomy, identifies two types of rear-facing seats, and outlines the 5 key steps for proper installation and use. Common errors are also reviewed, such as loose installation, incorrect direction, and improper harnessing, which can lead to injuries in an accident if not addressed. Caregivers are advised to keep children rear-facing as long as possible according to their car seat's limits.

1. National Child Passenger Safety Certification Training Program
National Child Passenger Safety Certification Training Program
Module 8
Children in Rear-Facing Car Seats
8-1

2. Module 8 Objectives
• Describe why children should travel rear-facing.
• Identify types of rear-facing car seats.
• Apply 5 steps for rear-facing car seat use.
• Explain best practices and caregiver choices
about rear-facing car seats.
• Identify rear-facing car seat errors and
consequences.
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3. Children’s Bodies Change as They Grow
8-3

4. Why Children Should Travel Rear-Facing
8-4

5. 2 Types of Rear-Facing Car Seats
Rear-facing-only
Convertible
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6. Rear-Facing-Only Car Seats
• Check car seat label for starting weight.
• In general, top of child’s head should be well
contained within shell and at least 1 inch from
top
of shell.
• Harness needs to be snug at or below child’s
shoulders.
• Caregivers should NEVER use rear-facing seat
above height or weight limits designated by
manufacturer.
8-6

7. Rear-Facing Convertible Car Seats
• Many new car seats are approved for rearfacing for up to 40+ pound children.
• Children commonly sit with legs crossed or
resting on back of vehicle seat – low injury
risk.
• Older children with poor head control and other
children with special needs may benefit from
staying rear-facing as long as possible.
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8. 5 Steps for Car Seat Use
1. Selection: Choose the right car seat.
2. Direction: Face the car seat the right way.
3. Location: Install the car seat in an appropriate
location in the vehicle.
4. Installation: Secure the car seat to vehicle in
the right way.
5. Harnessing: Place the child correctly in the car
seat.
8-8

9. Rear-Facing Car Seat Selection
• Select for the child’s height, weight,
development levels, AND that caregiver can use
correctly.
• Select with an adjustable harness height to offer
options for rapidly growing infant.
• Some have multiple positions for crotch straps
for better fit as child grows.
8-9

10. Rear-Facing Car Seat Direction
• Under age 1 ALWAYS ride rear-facing.
• Stay rear-facing AS LONG AS POSSIBLE – until
reaching the top height or weight limit.
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11. Rear-Facing Car Seat Location
• Not all seats are suitable for installing a car
seat. Check manufacturer instructions.
• Always ask, “Who rides in this vehicle? Where
will each person sit?”
• Turn off air bag if necessary to place child in the
front seat.
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12. Rear-Facing Car Seat Installation
• Rear-facing car seat spreads crash forces.
• Correct angle helps keep airway open.
• Know car seat recline angle.
• Use recline angle and adjustor.
• Adjust to accommodate the seat and vehicle
slope.
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13. Recline Angle
8-13

14. Seat Belt or Lower Anchors
• Car seats can be installed
with a seat belt or with
lower anchor attachments
– usually NOT both.
• While the systems are
different, they are equally
safe.
8-14

15. Install a Rear-Facing Car Seat
8-15

16. Common Rear-Facing Car Seat
Installation Errors
• Seat belt or lower anchor attachment that is too
loose or not locked
• Rear-facing-only car seat that is facing forward
• Seat belt or lower anchor attachments routed
incorrectly
• Incorrect recline angle especially for an infant
• Using 2 seat belts or using a seat belt and lower
anchor attachments together (must be allowed
by BOTH the vehicle and car seat manufacturer)
8-16

17. Common Rear-Facing Car Seat
Installation Errors (continued)
• Incorrect use of lower anchor connectors and
tethers
• Not using appropriate tether anchor or using a
tether when it should not be used (most
convertible car seats do not tether when rearfacing)
• Locking clip installed incorrectly
• Carrying handle not used in the approved
position for vehicle travel
8-17

18. Common Rear-Facing Car Seat
Harnessing Errors
• Harness not used and child just sitting in car
seat
• Harness straps that are too loose
• Retainer clip not at armpit level
• Harness routed through wrong slots
• Harness not doubled-back through buckle type
metal adjuster, if it requires double-back to
secure the harness
• Harness is twisted
8-18

19. Common Rear-Facing Car Seat
Harnessing Errors (continued)
• Harness not placed on child correctly
• Harness frayed or damaged
• M etal adjuster not flush with slot or out of
position
• Crotch strap adjusted too long
• Harness not at or below shoulder
• Crotch strap not through slot closest to child
• Harness incorrectly routed
8-19

20. AAP Recommendations for
Small & Premature Children
• Monitor all children
born before 37 weeks
before they leave
hospital for possible
breathing problems
or slowing of heart
rate when sitting in a
semi-reclined
position
• Physician determines
how children will ride
8-20

21. How to Fit Small & Prematurely Born
Infants in Car Seats
• Use a rear-facing car seat with small internal
harness dimensions.
• Use a car seat designed for the child’s low
weight.
• Center child in a car seat with rolled receiving
blankets and a crotch roll, if necessary.
8-21

22. How to Fit Children in Car Beds
• Secure child in car
bed with the internal
harness or bunting.
• Place child’s head
toward center of
vehicle – NOT next to
door.
• Use seat belt to
anchor car bed
lengthwise on vehicle
seat.
8-22

23. How to Fit Children with
Breathing Problems
• May require child to lie
flat or use a nonconventional car seat.
• Semi-reclined position of
car seat could make
breathing problems
worse.
• Children may need to
travel with secured
special medical
equipment.
8-23

24. Key Questions Related to
Rear-Facing Car Seats
• What are the age, height, and weight of the
child?
• Does the child have any special needs such as
being very small, premature, or other physical or
developmental needs?
• What does the car seat owner’s manual or label
say about the minimum and maximum heights
and weights for the child using this car seat?
• Is the car seat a rear-facing-only or convertible
type?
• Does the rear-facing-only car seat have a base?
Can it be installed without a base?
8-24

25. Key Questions Related to
Rear-Facing Car Seats (continued)
• Is the car seat facing the correct direction in the
vehicle?
• Is the car seat in an appropriate seating position
in the vehicle according to the vehicle and car
seat manufacturers?
• Is the car seat installed tightly?
• Is the car seat secured by a seat belt or with
lower anchor attachments?
• Is the car seat at the correct recline angle?
• Is the harness being used correctly?
8-25

26. Car Seat Errors & Consequences
8-26

27. Car Seat Errors & Consequences (continued)
8-27

28. Car Seat Errors & Consequences (continued)
8-28

29. Car Seat Errors & Consequences (continued)
8-29

30. Car Seat Errors & Consequences (continued)
8-30