HJBR Jul/Aug 2019

48 JUL / AUG 2019 I  Healthcare Journal of BATON ROUGE column PEDIATRIC Rear-facing until two… It’s the Law According to Louisiana Senate Bill 76, the following changes will be made to child passenger restraint laws: Achild under two years of age will be re- strained in a rear-facing car seat. A child who is at least two years of age AND has outgrown the height or weight limit for the rear-facing car seat shall ride in a forward-facing car seat with internal restraints (i.e. harness). A child who is four years of age AND has outgrown the forward-facing car seat shall ride in a belt positioning booster seat. Chil- dren must remain in a booster until at least nine years of age. Children under 13 years of age must be in the backseat when one is available. To have a law that requires children to remain rear-facing until at least two years of age is a huge victory in my opinion, as I often have to try and convince parents that turning the car seat around at the first birthday is a bad idea. Think about the science here; if you have an infant or toddler at home, take a minute to look at their head in proportion to their body. In infants, the head accounts for upwards of 25 percent of their body weight. Compare that to adults, where our head is only about 6 percent of our body weight. In a front- end collision, can you imagine putting 25 percent of your body weight as a rapid forward force onto your delicate spine? Second, the conversion of the cartilage in the infant spinal canal to hardened bone is a process that is not completed until late childhood. In a head-on collision, the spi- nal canal might be able to stretch up to two inches because of the cartilage that is still present in the developing spine, but the spinal cord is not as flexible. In severe cas- es, sudden shearing forces can cause inter- nal severing of the spinal cord, which can cause paralysis or even death. The concept of increased safety for Let’s face it...to get a new law in place takes a long time. Since 2011, the American Academy of Pediatrics (AAP) and every major car safety organization has recommended that children remain in a rear-facing car seat until at least two years of age. However, when you look at motor vehicle laws, only 11 states until this time have changed their laws to reflect this recommendation. Come August 2019, Louisiana will join the ranks of California, Connecticut, New Jersey, Oklahoma, Or- egon, Pennsylvania, Rhode Island, New York, Nebraska, Vir- ginia, and South Carolina with updated laws for children in car seats.