As pediatricians, one of our most important goals in caring for young children is educating parents on injury prevention. Of particular relevance as the warm spring and summer months approach is the topic of swimming safety and drowning prevention. Despite the development of swimming and survival programs for infants and toddlers, drowning is still a leading cause of death in American children. Moreover, for every child who dies from drowning, there are as many as one to four more children who are hospitalized for and suffer morbidity from a near-drowning event.
Although there are many anecdotal success stories of infants who avoided drowning by using survival techniques, there are no adequate studies available to suggest that children who are taught these methods are less likely to succumb in a drowning situation. However, there are many things we can do as parents and as a community to avoid such a tragic event. The most effective way to prevent drowning is to become aware of ALL of the hazards that might be posed to a young child in a particular environment and to make them as inaccessible as possible.
Pools are often the first places people think of when confronted with the subject of drowning, but there are countless others to consider. Such hazards might include a tub with only a few inches of water, a toilet with an open lid, or an uncovered bucket left outside. It only would take a few minutes for the unthinkable to occur with an unsupervised toddler. With regard to preventing pool drowning, a four-sided fence that completely surrounds the pool is the most effective way to insure infant and toddler safety.
According to the Consumer Product Safety Commission, the fence should be at least 4 feet high and climb-resistant. The vertical components should be less than 4 inches apart, and the bottom of the fence should be no greater than 4 inches from the ground. The gate should be self-latching and self-closing and should open away from the pool. Pool covers and pool alarms are also helpful, but have not been shown to be as effective as fences in preventing drowning.
When teaching young children to swim, it is important to realize that they are only capable of performing at a developmentally appropriate level. Although there are classes available to children as young as 6 months of age, the American Academy of Pediatrics advises that children are not truly ready to learn to swim until the age of 4. Some concerns have been raised that early swimming lessons can lead to hypothermia and water intoxication in infants due to prolonged exposure to and drinking of water.
Another concern involves the idea that chlorine in indoor pools becomes airborne and can cause asthma in these young toddlers. Regardless of the aforementioned hazards, the greatest concern is that these courses provide a false sense of security for parents. There is no substitute for CLOSE (within an arm’s reach) adult supervision when a child’s contact with ANY body of water is involved.
In the unfortunate event of a drowning, it is always helpful to be skilled in the practice of administering CPR. However, it is important to understand that children who require CPR outside of a hospital setting have a poor prognosis, and run the risk of having significant neurological impairment should they survive. This is why having a solid barrier between the child and the hazard is a necessity.