in contrast to forward-facing seats, rear-facing seats provide full alignment of the head, neck, and spine, so that crash forces are dispersed over these areas rather than centered on one site.

The message for healthcare professionals, the authors say, is that they should recommend rear-facing car seats for children under 4 years of age. To fully address the issue, however, seat manufacturers and retailers need to "increase the availability of rear-facing car seats for children over 20 pounds."