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New Car Seat Guidelines: Rear Facing Seats Until Two Years Old

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The American Academy of Pediatrics has changed its recommendations on car seat usage. The AAP’s new policy now recommends that children remain in rear-facing car seats until age two.  Here is a summary of the new recommendations:

This policy statement provides 4 evidence-based recommendations for best practices in the choice of a child restraint system to optimize safety in passenger vehicles for children from birth through adolescence: (1) rear-facing car safety seats for most infants up to 2 years of age; (2) forward-facing car safety seats for most children through 4 years of age; (3) belt-positioning booster seats for most children through 8 years of age; and (4) lap-and-shoulder seat belts for all who have outgrown booster seats. In addition, a fifth evidence-based recommendation is for all children younger than 13 years to ride in the rear seats of vehicles. It is important to note that every transition is associated with some decrease in protection; therefore, parents should be encouraged to delay these transitions for as long as possible.

And from Parenting.com:

Previously, the AAP advised parents to keep kids rear-facing as long as possible, up to the maximum limit of the car seat, and this has not changed. But it also cited one year and 20 pounds as the minimum for flipping the seat, which many parents and pediatricians interpreted as conventional wisdom on the best time to make the switch. The new policy clarifies the AAP’s recommendation, making age two the new guideline—a real game-changer for parents of toddlers.

Breastfeeding and Vitamin D

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MSNBC has a story that’s a reminder that Vitamin D is especially important for young children and infants. From the story:

…(B)reast milk — considered the best source of nutrition for babies — is low in vitamin D. The American Academy of Pediatrics (AAP) recommends all children, including infants, get 400 international units (IU) of vitamin D per day, an amount that is not possible to get from breast milk alone, experts say. And while people can also get vitamin D from sunlight, the AAP advises that infants younger than six months avoid exposure to direct sunlight due to skin cancer risk.

So what’s a mom to do?

The AAP recommends vitamin D supplements, in the form of drops, be given to breast-fed babies shortly after birth…Only about 5 percent to 13 percent of breast-fed babies received vitamin D supplements between 2005 and 2007, according to a study published in April in the journal Pediatrics. These low numbers might stem from the misperception that breast milk contains everything the baby needs, experts say.

So why is Vitamin D important? From the Mayo Clinic’s website:

The major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones. Recently, research also suggests vitamin D may provide protection from osteoporosis, hypertension (high blood pressure), cancer, and several autoimmune diseases.

Rickets and osteomalacia are classic vitamin D deficiency diseases. In children, vitamin D deficiency causes rickets, which results in skeletal deformities. In adults, vitamin D deficiency can lead to osteomalacia, which results in muscular weakness in addition to weak bones. Populations who may be at a high risk for vitamin D deficiencies include the elderly, obese individuals, exclusively breastfed infants, and those who have limited sun exposure. Also, individuals who have fat malabsorption syndromes (e.g., cystic fibrosis) or inflammatory bowel disease (e.g., Crohn’s disease) are at risk.

Here’s a link to the AAP recommendations.  As always, before you make any decision about a vitamin supplement, check with your pediatrician.