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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Drs Winston and Durbin¹ have given the medical community an excellent overview of the importance of proper restraint of children in motor vehicles. This is a complex issue, however, and some points need further clarification.

It is important to face very young children rearward, not because of weak neck musculature, but because of incomplete ossification of their vertebrae and their lax connecting ligaments. In a severe crash, forward motion of the head when the shoulders are held back can generate enough force on the neck to pull these flexible elements apart, leaving the spinal cord as the last link.² Even minor stretching of the spinal cord can result in rupture and paralysis, while complete spinal cord separation and death can also occur.³ Readiness to face forward cannot be determined from physical examination, but too often health care professionals give parents poor advice based on inappropriate criteria of . . . [Full Text of this Article]