The American Academy of Pediatrics is now recommending toddlers stay rear-facing in car seats until age 2.

The AAP reports:

Recent data shows why toddlers between 12 and 23 months who ride rear-facing in a car safety seat are more than FIVE times safer than those riding forward-facing in a seat.

The only problem with this is some car seats won't be able to safely hold a two-year-old rear-facing.  This is because the average weight of a 24 month old baby is 28 lbs (boys) and 26.5 lbs (girls) and some convertible car seats can't handle that.  Also bigger babies may weigh closer to 34 lbs. by their second birthday.

So, make sure you get a car seat that works rear-facing to at least 35 lbs.

Here is the full report:

New advice: Rear-facing car seats safer for children until they are 2
by Lori O'Keefe - Correspondent

Toddlers between the ages of 12 and 23 months who ride rear-facing in a car safety seat are more than five times safer than toddlers in that same age group who ride forward-facing in a car seat.

Overall, children under the age of 2 are 75% less likely to die or experience a serious injury when they ride in a rear-facing car seat, according to the first U.S. data to substantiate the benefits of toddlers riding rear-facing until they are almost 2 years old (Henary B, et al. Inj Prev. 2007;13:398-402).

There is a common myth that rear-facing toddlers whose feet reach the back of the vehicle seat are more likely to suffer injuries to the lower extremities in a car accident, according to a commentary co-written by Marilyn J. Bull, M.D., FAAP, AAP District V chair and one of the co-authors of the study. However, lower extremity injuries are rare with rear-facing seats, Dr. Bull wrote in the commentary (Bull MJ, Durbin DR. Pediatrics. 2008;121:619-620).

Rear-facing seats are more likely to support the back, neck, head and pelvis because the force of a crash is distributed evenly over the entire body. Forward-facing children are more likely to be injured because the force of the crash is concentrated on seat belt contact points, and younger children’s heads are disproportionately large for their small, weak necks, according to the study.

“I teach my medical students that parents worry about leg injuries but that it is far better to send children to orthopedic specialists to have lower extremities treated than to send them to neurological specialists to have cervical spine injuries treated,” said Dr. Bull. “I put it into the context of rehabilitation potential: fracture vs. paralysis.”

In Sweden, children ride in rear-facing seats until the age of 4, which has been proven to be 90% effective compared to children who ride unrestrained. However, car seats are engineered differently in Sweden to allow older toddlers to remain rear-facing longer.

“Since motor vehicle injuries are the leading cause of death in children, the Academy must do whatever it can to educate our members and the general public about the safest ways for children to ride in motor vehicles,” said AAP President David T. Tayloe Jr., M.D., FAAP. “We should make sure all of our members know to encourage parents to keep their children in rear-facing car seats as long as they do not exceed the size limits of the car seats.”

Dr. Bull noted that it takes less than 30 seconds to tell parents that children are five times safer riding rear-facing until their second birthday — a statistic that is likely to stick with parents.