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Car accidents are the leading cause of death for kids older than three in the U.S. But many children are at greater risk of death or injury from a car accident because they’re not using the proper safety restraint.

To keep kids safe, the American Academy of Pediatrics updated its child passenger safety guidelines in 2011 with these recommendations:

• Children should stay in rear-facing car seats at least until the age of two.
• Children should then be in forward-facing car seats for as long as possible (until they reach the maximum height and weight limit listed by the car seat manufacturer).
• Booster seats should be used until an adult seat belt fits properly (usually when the child is about 57” in height).
• Children should ride in the back seat of the car until age 13.

However, a new study led by Dr. Michelle Macy from the University of Michigan, found that few children remain rear-facing after age 1, fewer than 2% use a booster seat after age 7, and many over age six sit in the front seat (press release available at UofMHealth.org).

Dr. Macy also worked with the National Poll on Children’s Health on a recent car seat safety Poll. In that Poll, we found only 13% of children remained in rear-facing car seat until the age of two and one in three children were turned to face forward before the age one. (See the full report: Parents turning car seats to face forward too early).

Car seat recommendations are intended to reduce child injury and death related to car crashes. Although the guidelines were updated in 2011, this research shows that many parents haven’t made the appropriate changes yet.

Are your children using the proper child passenger safety restraints? For more information on which car seat is right your children, visit HealthyChildren.org.