This Brain Surgeon & Mom Will NEVER Break This Rule {Contributor}

Contributor Julie Forbes is here today with something that tends to be controversial. And listen, I get it. We are all doing the best we can with what we have for our kids, right? The extended rear facing conversation can get heated and judgmental, and that is NOT what we’re after. Julie and I both struggled with whether or not to turn our children forward facing before age two. I actually did turn Kendall forward facing, and then turned him back around. We’re not here to preach to anyone, we’re just here to share some information with you.

I’m a rule follower, by nature.  Rules give me boundaries and guidelines.  So, when it comes to parenting, I do things by the book.  If the AAP says, “Back to Sleep,” my kids go to sleep on their back.  If the pediatrician tells me not to put any loose bedding in the baby’s crib, then a mattress and a fitted sheet is all they get.

But the one rule I always struggle with is keeping kids in a rear-facing car seat until they’re 2.  I try to justify it, like, “My kids are really tall.  There’s not room for their legs.”  Or, “The younger one can see that the older one is facing-forward, and she wants to see out too.”  And, “I’ve made it past a year (which was the old rule), that’s good enough, right?”

Right around the time that my second child was about 18 months, and I was trying to come up with any good reason to turn my daughter around, my friend, Lola Chambless wrote a post on Facebook that got my attention.  She said that while she’s never one to dole out parenting advice, she can’t keep quiet about the importance of keeping your children in rear-facing car seats for as long as possible.  

I figured if anyone would have some insight, it would be her.  You see, Lola is not just a friend, she’s a mom to two little girls, and a Neurosurgeon with Vanderbilt University Medical Center in Nashville, Tennessee.

Lola Chambless, M.D. and her two daughters

I had to ask her why this issue was so important to her.  And, just as I suspected, her story gave me goosebumps.  She said when she was in residency, she treated a family who had been in a fairly minor car accident.  The parents in the front were barely hurt.  The older child in the back suffered injuries, but would be fine.  But the one year old child, who was in a forward-facing car seat, died.

Lola Chambless, M.D., said, “I remember seeing those parents late in the night and talking to them about this injury and the fact that it was unsurvivable, thinking to myself how everyone in that car had been in a restraint.  These parents had their kid in an approved car seat that they thought was appropriate at that point.” (This was 10 years ago before the AAP updated its recommendations urging parents to keep their children in rear-facing car seats until at least the age of 2.)

She continued, “They were doing everything they thought they needed to do to keep their family safe.  They were in a car accident that was not incredibly severe, and their child had this horrific injury, and I just remember thinking… I wasn’t a parent at the time… but I remember thinking about the horrific guilt I would feel in that scenario, and the fact that these poor parents just didn’t know that there were things they could do to make that potentially safer.”

In the 10 years since Dr. Chambless had this experience (and others like it), the American Academy of Pediatrics has updated it’s recommendations on car seats, instructing parents to keep children rear-facing until the age of 2, or until they reach the maximum height and weight for their seat.   Dr. Chambless says the reason for it is simple.  “The rear-facing position is the safest position for anybody at any age.”

Have you ever noticed that flight attendants sit rear-facing?  It’s not a coincidence.  But while everyone in the car can’t be rear-facing, young children can be, and should be, for a long time.

“Until children are 4, they have significantly more laxity of the ligaments at the bottom of the skull, and the top of their spine and within the cervical spine, itself,” says Chambless.  This makes children more at risk of experiencing an Atlanto-occipital dislocation, which is doctor speak for an internal decapitation, which is deadly.

“The formation of the spine and the skull is very immature for long periods of time and that maturation process happens progressively and slowly.  So a child that’s 3 is more skeletally mature than a child that’s 2.  But really, up until the age of 4, there’s a much higher risk of spinal cord injury related to high speed car accidents.”

And that’s why in some parts of the world, like Scandanavian countries, parents keep their children in rear-facing car seats until the age of 4.  These practices have been studied, and the evidence is so convincing that Chambless plans to keep her youngest daughter rear-facing until she reaches the age of 4.

“To me, as a parent, there’s no possible thought in the world that is worse than losing a child.  And the idea of losing a child in a scenario that you could have prevented is just something I don’t know how I could survive.”

In this case, it does take a brain surgeon to figure out that the longer you keep your child rear-facing, the better (as annoying as it may be).