Sink or swim: A pediatrician’s perspective

I was 16 years old, standing in the locker room stacking kickboards, as any swim team coach does after practice, when I heard screaming coming from the pool area. I bounded out of the locker room to see a woman with an infant in her arms, screaming and pointing towards the pool. There was a child in the water, bobbing over the water, then under, then deeper below.

I jumped in and pulled the toddler from the pool. Luckily he was crying, because at that point in my life I had never done CPR on a real child, but I knew a crying child was a breathing child. The toddler seemed terrified, but he was alive. He ran towards his mom, who thanked me profusely, but I barely heard a word. He could have died.

Years later, I realized that my experience of a “near drowning” event is not uncommon. In fact, drowning is one of the leading causes of death in children. As a physician I have heard terrifying stories of “I just turned my back to pick up my other child,” or “I was only gone for a minute,” or “I thought the lifeguard was watching.” These frightening stories come from caring, loving, well-meaning, wonderful parents. And just when you think, “It won’t happen to me,” it does.

Did you know …

  • Most infant drownings occur in bathtubs and buckets?
  • Most toddler drownings (ages 1-4) occur in swimming pools?
  • Most children older than five are most likely to down in rivers and lakes?

Let’s talk about preventing drowning events in the first place. Here are some safety points to consider:

  • Know that all bodies of water pose a risk for drowning (oceans, lakes, rivers, small or large pools, hot tubs, baths, buckets, etc.)
  • Maintain “touch supervision”—keep infants and toddlers within an arm’s reach in and near the water
  • Supervise children without distraction (e.g., no talking on the phone, socializing, tending to household chores or consuming alcohol)
  • Don’t allow your child to use inflatable toys or floats in place of a life jacket
  • Ensure your child always wears a life jacket when swimming or riding in a boat
  • Fence off backyard swimming pools (including large, inflatable, above-ground pools) completely with at least a 4-foot high fence that separates the pool from the house
  • If your pool has a cover, remove it completely before swimming
  • Keep toys away from bodies of water when not in use
  • Empty blow-up pools after use
  • Consider learning CPR and what to do in the event of a swim emergency (click here for more info)

New evidence shows that children ages 1 to 4 may be less likely to drown if they have had formal swimming instruction, and those over 4 are definitely less likely to drown. Before age 4, the American Academy of Pediatrics (AAP) recommends that parents should decide whether to enroll an individual child in swim lessons based on the child’s frequency of exposure to water, emotional development, physical abilities, and certain health conditions related to pool water infections and pool chemicals.

The AAP does not recommend formal water safety programs for children younger than 1 year old as a form of “safety training.” This is because safety training does not result in a significant increase in the poolside safety skills of young children.

My plea to you, from my then-terrified, 16-year-old swim-coach self to my now-even-more-terrified, pediatrician self, is that you hold tight to your babies. Keep your babies safe. Recognize that water, although fun, can be very dangerous. For more information, please visit the resources below.

HealthyChildren.org: Drowning

HealthChildren.org: Water Safety and Young Children

HealthyChildren.org: Swimming Pool Safety

Kindal Dankovich, MD, is a third-year Pediatrics resident at Children’s Hospital of Greenville Health System.

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