The Swedish (rear facing) car seat approach
How does Sweden keep young children so safe in cars? How come fatalities and serious injuries are close to zero for young children? This is a common question among foreigners. Ask a Swedish parent and the answer will be a shrug, parents feel like they are doing nothing special. The answer to our safety record is a very simple and affordable approach which is very effective in keeping the little ones safe in cars.
Sweden started focusing on car seat safety in 1960's, decades before other countries. We realized early on that many children were dying in traffic and that almost all of these fatalities could easily be prevented by simple and affordable mesures regardless of country. In the 1960's we also discovered how amazingly safe rear facing was, something which has saved the lives of a large amount of children since then.
Child fatalities in traffic has decreased but is even in 2010 a common reason for children dying in modern countries. Traffic accidents in USA are for example the number one cause of death among young children. Thing about that for a minute. Traffic is the largest killer of children in the country, far more common than any desease, drowning, etc. Almost all of these fatalities are easily preventable with simple and affordable measures.
Our approach is extremely simple and can basically be divided into three simple stages:
1. Infant stage – birth to around 6 months:
Children sit rear facing, normally in an infant seat. These seats are affordable and easy to use. Some parents use seats such as DuoLogic from birth which also works nicely.
2. Age 6 months to 4 years (or longer):
Children sit rear facing in our Swedish seats which provide unbelievable protection. We keep our kids rear facing mainly for the great protection of head and neck. As doctors say, "we can fix arms and legs – we can't fix head and neck". At this stage all children have weak neck muscles and a fragile skeleton. Head of a child is also proportionally very large, around 25% of total weight for a 12 month old. This makes forward facing a bad choice before age 4.
Most of our seats have rear facing weight limits of 25 kg (55 lbs) and some use 18 kg (40 lbs). The Swedish rear facing seats can be used comfortably until age 4-6 years in all positions of the car. Seats are overall compact, there are rear facing options for families with small cars as well.
Contrary to popular belief there is no law regarding rear facing use in Sweden. We use it since it's a safe and easy solution.
How safe is rear facing? Our experiences, going back to 1965, show that it's almost impossible for a child in a rear facing Swedish seat to die or become seriously injured regardless of circumstances.
3. Age 4-10 years:
Children sit forward facing in high back boosters (rear facing longer than age 4 would be far safer and preferred). A high back booster is necessary for two reasons. First, to keep seat belt across chest of child. The high back booster keeps seat belt in the right place and can be adjusted a children grow. Second, to keep the lower part of the seat belt, the lap part, below a child's abdomen.
Children have round and underdeveloped hip bones, also called iliac crest, which means seat belt will slide up on abdomen in a collision unless a booster is used. This can cause terrible internal injuries. A booster will keep seat belt low on the hips where the tremendous forces in a collision can be absorbed.
We do have parents who only use a booster cushion for their children and some who only use seat belt. The Swedes are doing a great job in keeping their kids safe in cars but there is still plenty of room for improvement.
It's easy to talk about car seat safety and theoretical approaches. How well does the Swedish approach work? Unbelievably well!!. How do we know this? We follow our own advice and our fatality rate for children age 0-6 years in traffic accidents is basically zero each year.
How come other countries don't follow our approach? Or at least try harder in lowering the amount of fatalities and serious injuries among young children? The answer is that car seat safety is a low priority in other countries despite taking the lives and seriously injuring an enormous amount of children each year.
Coming up next, some things we do and other things we avoid to keep our children safe in cars. The answers are likely to surprise you.