Rear-Facing Car Seats for Infants & Toddlers

The AAP recommends that all infants ride rear-facing starting with their first ride home from the hospital. All infants and toddlers should ride in a rear-facing seat, as long as possible, until they reach the highest weight or height allowed by their car safety seat manufacturer. Most convertible seats have limits that will allow children to ride rear facing for 2 years or more. When infants outgrow their rear-facing–only seat, a convertible seat installed rear facing is needed. 

All parents can benefit from getting installation help from a CPST to ensure that their seat is properly installed.

Types of Rear-Facing Seats:

Three types of rear-facing seats are available: rear-facing–only, convertible, and 3-in-1. When children reach the highest weight or length allowed by the manufacturer of their rear-facing–only seat, they should continue to ride rear-facing in a convertible or 3-in-1 seat.

Rear-facing–only seats

• Are used for infants up to 22 to 35 pounds, depending on the model.
  

• Are small and have carrying handles.

• Usually, come with a base that can be left in the car.The seat clicks into and out of the base so you don't have to install it each time you use it. Parents can buy more than one base for additional vehicles.

• Should be used only for travel (not sleeping, feeding, or any other use outside the vehicle).
  

Convertible seats (used rear facing)

• Can be used rear facing and, later, "converted" to forward facing for older children when they outgrow either the weight limit or the length limit, for rear facing. This means the seat can be used longer by your child.
  

• They are bulkier than infant seats, however, and they do not come with carrying handles or separate bases and are designed to stay in the car.
  

• Many have higher limits in rear-facing weight (up to 40–50 pounds) and height than rear-facing–only seats, which make them ideal for bigger babies and toddlers.
  

• Have a 5-point harness that attaches at the shoulders, at the hips, and between the legs.
  

• Should be used only for travel (not sleeping, feeding, or any other use outside the vehicle).
  

3-in-1 seats (used rear facing)

• Can be used rear facing, forward facing, or as a belt-positioning booster. This means the seat may be used longer by your child as your child grows.
  

• Are often bigger in size, so it is important to check that they fit in the vehicle while rear facing.
  

• Do not have the convenience of a carrying handle or separate base; however, they may have higher limits in rear-facing weight (up to 40–50 pounds) and height than rear-facing–only seats, which make them ideal for bigger babies and toddlers.
  

Installation Tips for Rear-Facing Seats:

Always read the vehicle owner's manual and the car seat manual before installing the seat.

What do I do if my baby slouches down or to the side in the car seat?

• You can try placing a tightly rolled receiving blanket on both sides of your infant. Many manufacturers allow the use of a tightly rolled small diaper or cloth between the crotch strap and your infant if necessary to prevent slouching. Do not place padding under or behind your infant or use any sort of car seat insert unless it came with the seat or was made by the manufacturer for use with that specific seat.

Why should I dress my baby in thinner layers of clothing before strapping him or her into a car seat?

• Bulky clothing, including winter coats and snowsuits, can compress in a crash and leave the straps too loose to restrain your child, leading to increased risk of injury. Ideally, dress your baby in thinner layers and wrap a coat or blanket around your baby over the buckled harness straps if needed. See Winter Car Seat Safety Tips from the AAP. 

Do preemies need a special car seat?

• A car seat should be approved for a baby's weight. Very small babies who can sit safely in a semi-reclined position usually fit better in rear-facing–only seats. Preterm infants should be tested while still in the hospital to make sure they can sit safely in a semi-reclined position. Babies who need to lie flat during travel should ride in a car bed that meets Federal Motor Vehicle Safety Standard 213. They should be tested while in the hospital to make sure they can lie safely in the car bed.
  

Additional Information from HealthyChildren.org:

• Heading Out With Baby​
  

• Shopping for Car Seats: Tips for Parents
  

• Car Seats: Product Listing ​
  

^{Figure 1 from Bull MJ, Engle WA; American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention, Committee on Fetus and Newborn. Safe transportation of preterm and low birth weight infants at hospital discharge. Pediatrics. 2009;123(5);1424–1429.​​​}