Kids should sit in rear-facing car seats as long as they fit, or until age two, pediatricians urged Monday.
After that, they should ride in booster seats up to age eight or if they're still too small to fit correctly in seat belts.
"The best possible thing you can do is keep your child rear-facing as long as possible," said Dr. Benjamin Hoffman of the American Academy of Pediatrics, which issued the policy statement. "We hope we will be able to convince parents to keep their children rear-facing longer."
The new recommendations update a 2002 statement, which had advised parents to follow car seat manufacturer limits, but also mentioned one year and 20 pounds as a minimum.
That led to some confusion among some parents, who would use the one-year cut-off as a milestone for when to make their child ride forward-facing, Hoffman told Reuters Health.
"The message, while it's been consistent, has not been as clear as it could have been for parents," he added.
According to the new statement, published in the journal Pediatrics, 1,500 kids under 16 die every year in car crashes in the U.S.
Child safety seats have been shown to cut the risk of death by 28% compared with seatbelts, and they also reduce non-fatal injuries.
That's because they distribute the energy of a collision over a bigger area, instead of concentrating it on the points where the seatbelt touches the body -- the shoulders, the belly and the hips.
Hoffman said he usually compares the situation to the difference between pushing on your cheek with one finger versus the entire palm: One hurts, the other doesn't.
Specifically, the AAP recommends:
* Infants should ride in rear-facing car safety seats until age two or until they reach the height and weight limits specified by the manufacturer.
* After that, they should ride in forward-facing car seats with a harness until age four or until they have outgrown the seat.
* Then they should be switched to a belt-positioning booster seat until they can use the seatbelt alone (typically between eight and 12 years, or when they've reached 4 feet 9 inches).
* Kids who are big enough to use the seatbelt alone should sit in the rear of the car until age 13.