Water Safety for Kids: Because Your Kid’s Life Is Worth All the Trouble!

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September 5, 2019

Drowning rarely looks like drowning. Images from last summer are still imprinted in my mind, and they’ll always remain so.

We were a group of moms, sitting idly on the sand (as much as being a mom and sitting idly go hand in hand), while our kids played in shallow water.

Suddenly, one of the older ones, a six-year-old who had just learnt how to swim, ventured out a little more.

The water was still shallow, and we could see him raising his hands in and out of the water. In our eyes, he was having fun with all the water splashing around him.

Suddenly, an adult who was swimming close by frantically swam towards the child and lifted him up.

For us, a couple of meters away, it looked as if the boy was playing. For someone swimming close by, it soon became obvious that the child was in distress.

Luckily, the other swimmer noticed the signs and acted immediately. He lifted the child up and brought him on the sand, exhausted, scared and coughing up water.

Needless to say, this episode served as an eye opener for all of us. Accidents can happen right under our noses; and just a few seconds can change an entire lifetime.

We’re surrounded by water, be it something as simple as a tub or paddling pool, or larger bodies of water such as pools, lakes, and the sea.

Yet, most of us are very much ill-informed when it comes to water safety. Horrendous statistics of injury and death from water-related accidents attest to this.

This guide will delve into the risks babies and children face in or near water, striving to arm you with the knowledge on the warning signs of a child in distress.

We’ll also present safety and prevention measures you should take both at home and outdoors, as well as what to do in case of an emergency.

Water Safety for Kids: The Ultimate Guide (Infographic)

Water Safety 101

The figures speak for themselves. In 2017 alone, drowning was behind the death of almost 1000 US children younger than 20 years of age. This means that drowning is a leading cause of injury-related death in children.

Water safety does not only relate to large open bodies of water, either. The family tub can also present a dangerous environment if a child is left unaccompanied. Just an inch of water can be a reason behind a death.

Being armed with the knowledge to prevent such tragedies is the first step for a healthier childhood, with minimized risk of injury. As emphasized by the American Academy of Pediatrics (AAP), a number of strategies are available to prevent tragedies.

Thankfully, drowning fatality rates have decreased steadily, however they still remain high. In children between the ages of 1 and 4, drowning is the leading cause of injury death.

Injuries and death from drowning go beyond the toddler years, though. For children and adolescents aged 5 to 19 years, drowning is the third most common cause of unintentional injury death.

Morbidity as a result of drowning is also a reality. In 2017 alone, an estimated 8700 children were taken to the emergency department for a drowning event.

25% of these children were transferred for further care. Most recovered fully with no effects, but severe long-term neurological deficits were seen in instances where the child spent more than 6 minutes submerged, resuscitation efforts were prolonged, and CPR was not initiated immediately.

Why and How Are Babies and Children at Risk When Being in Water?

Child drowning happens quickly. 77% of child victims of drowning had been missing from sight for 5 minutes or less.

In the time it takes to quickly answer a call, a child can drown. Drowning also happens silently – in the sense that there’s no yelling or splashing to alert you to it.

Babies and children do not perceive danger in the way that adults do. If reaching for a ball in the pool is what they want to do, they’ll go and grab it, even if they don’t know how to swim.

Water’s sparkly nature also attracts curious toddlers and kids towards it. It’s super easy for babies and children to fall in water, especially if there are no barriers to prevent this.

Survival from drowning very much depends on the speed at which the child’s face is brought to the surface and the breathing process restarted.

Each and every single second is precious in these situations, and counts in preventing death or brain damage – starting resuscitation in the water saves on precious time.

In its revised policy document, the AAP analyzed drowning statistics and listed the population most suspectable to drowning. Of these, toddlers top the list, followed by adolescents at a close second.

#1: Toddlers at Greatest Risk of Drowning

Between 2013 and 2017, the highest rate of drowning occurred among toddlers, with children between 12 to 36 months at the highest risk.

While most infants drown in bathtubs and buckets, the majority of pre-school aged children drown in swimming pools.

According to the US Consumer Product Safety Commission, 300 children under the age of 5 years die each year from drowning in swimming pools, the majority of them in pools at home.

Apart from this, more than 2000 children under 5 years of age are taken to hospital emergency rooms after submersion incidents.

The AAP recognizes that the reason behind this is the lack of obstructions to prevent unanticipated – and hence unsupervised – access to water.

Swimming pools, hot tubs and spas, bathtubs, natural bodies of water, and standing water in homes in the form of buckets, tubs, and toilets all present a risk to toddlers.

The Consumer Product Safety Commission (CPSC) found that 69% of children under the age of 5 years were not expected to be at or in the pool at the time of a drowning incident.

Toddlers are little balls of energy with capabilities that change on a daily basis, and a sense of adventure that knows no end.

As parents, we do our utmost to keep them away from harm and trouble, but there’s no telling how they would still end up in harm’s way. This makes setting up appropriate protective measures even more of a must (more on that below).

#2: Adolescents and the Risk of Drowning

Just like toddlers, adolescents are at a high risk of drowning, specifically because of characteristics common to their age.

As outlined by the AAP, this age group is known to overestimate skills, underestimate dangerous situations, engage in high-risk and impulsive behavior for the thrill of it, as well as substance use which makes the risk of drowning very much higher.

To put things into perspective, Safe Kids Worldwide reported in 2016 that the adolescent natural water fatal drowning rate was twice the rate of that for children younger than 5 years of age.

Unfortunately, yes, parenting and worry go hand in hand for a very long time.

Water Safety for Children with Medical Conditions

Some medical conditions make children more susceptible to injuries or death from drowning. Of these, epilepsy, autism, and cardiac arrhythmias present specific risks.

#1: Water Safety for Children with Epilepsy

Statistics show that children with epilepsy are at a greater risk of drowning in pools or bathtubs.

A study by Bell et al. entitled ‘Drowning in people with epilepsy: how great is the risk?’ concluded that the risk of drowning is raised 15- to 19- fold in people with epilepsy, and that it is imperative that parents and caregivers be informed of the risks so that deaths could be prevented.

If your child has epilepsy, it is all the more imperative to directly supervise them around water at all times.

The study also recommends that, whenever possible, children with epilepsy should shower instead of bathe, and only swim in locations where a lifeguard is present.

If your child’s epilepsy is poorly controlled, speak to the neurologist or pediatrician before attempting swimming.

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “The issue of swimming among patients with seizure disorders comes up during “camp physical season.”

Most camp forms have a specific question about whether or not a child has seizures, and if they are well controlled with medication.

Some camps are equipped to handle emergency situations during swimming activities, but most are not.

Camps that are specifically for children with special needs tend to have the proper staff available. Parents should inquire in advance about this when choosing a camp.”

#2: Water Safety for Children with Autism

A study entitled ‘Injury Mortality in Individuals with Autism’ concluded that individuals with autism are at a substantially heightened risk of dying from an injury, water-related included.

Of these, the most susceptible are children younger than 15 years of age, and those with a higher degree of intellectual disability.

Between January 2000 and May 2017, 23 fatal drownings of children with autism were reported. Of these, 73.9% were due to wandering near ponds, lakes or rivers.

Research specifically undertaken on the characteristics of drowning deaths in children with autism found that fatal drowning typically occurs in water bodies close to the child’s home. For this reason, intervention programs are needed to reduce the excess risk of drowning that children with autism face.

Direct supervision as well as restricting access to areas with bodies of water remains imperative in all circumstances. Enrolling your child for swim lessons that cater for children with autism is another preventive measure you can take.

The AAP recommends that parents of children with autism identify local hazards and work with their community to seek ways to reduce this danger. This is especially so in the case of children prone to wandering off.

The AAP has an article regarding autism and water safety (as well as when they wander off in other situations).

#3: Water Safety for Children with Heart Arrhythmia

The AAP notes that all the exertion resulting from swimming may trigger arrhythmia.

Although rare, ‘long QT syndrome, as well as Brugada syndrome and catecholaminergic polymorphic ventricular tachycardia, should be considered as a possible cause for unexplained submersion injuries among proficient swimmers in low-risk settings’.

What You Have to Be Careful of Around the House

A residential swimming pool is the first thing that comes to mind, and is regarded as a major danger to kids.

However, there are other water-related hazards scattered around the house that you have to be weary of as well. The AAP identifies the following:

#1: Infant Baths and Bath Tubs

Infant bath seats can easily tip over and, even if you fill the tub a mere inch, a child can still drown.

Infants and babies should never be left on their own in infant or regular baths.

#2: Pails and Buckets

It’s not the first time I left a bucket of water lying around, ready to wipe down the many spills that see us through the day.

However, a bucket or pail filled with water also presents its own hazards.

Crawling babies or wandering toddlers can easily use a bucket as a way to stand upright, presenting the possibility of toppling right into it.

Water should be emptied from buckets and pails immediately after use. On a personal level, this is why I opt for miraculous wet ones to address any form of spill, however creative.

#3: Toilets

This may sound strange: who in their right mind would try to put their head in a toilet (apart from a cat or two, that is)?

Truth is, babies and toddlers are still at the experiential stage, always on the lookout to see where their new capabilities can take them. So, a head in a toilet bowl can very much be very a dangerous reality.

#4: Safety in the Bathroom

Bathrooms are a risk area when it comes to infants and young children.

As a matter of fact, most child drownings when indoors at home occur in bathtubs, and half of these involve babies under one year of age.

The best possible way you can prevent such accidents from occurring is to lock bathrooms when not in use and only allow children inside when a competent adult is present and supervising.

The AAP also emphasizes that locked bathroom doors should provide the possibility of being opened from the outside by an adult, in case a child locks themselves in.

Healthy Children reminds parents and caregivers that children can drown in just a few inches of water. So, a young child should never be left alone in a bath, not even an empty one, as they can easily fill it up with water themselves.

If you need to leave the room, take your child with you, even if they’re still soaking wet. It’s better to wrap them up in a towel and tend to what came up, rather than risk making a dash for it.

When not in use, remove the bath tub drain plug.

Bath seats and rings, while very helpful in navigating a bath with a slippery infant, are not meant to prevent drowning. Whatever you do, do not rely on them, thinking your little one will be safe while you run to grab an outfit from the room next door.

Prepare everything you’ll need for the bath and afterwards close by before you begin, so that you’ll have no reason to leave before bath time is over.

Healthy Children also reminds parents to lock away electric appliances such as razors and hairdryers to prevent electrical injuries if the appliance falls or is pulled into the water. Never leave such appliances plugged in when not in use!

As for toilet bowls, the AAP suggests the installation of safety latches or locks on all toilet seat lids. Locking the door behind you after using the bathroom is an added safety measure.

#5: Backyard Water Hazards

Wells and irrigation or drainage ditches, as well as bird baths, fountains and ponds all present serious hazards that many tend to overlook.

Once your little one starts to crawl, study your yard and see which features of it can easily become a hazard for a curious and energetic child.

The AAP remind parents and caregivers to also be careful around post holes left open in the process of building fences, decks or flagpoles.

As for bird baths, fountains and ponds, the AAP suggests holding off a little before installing these landscape features. If you already have them in your yard, set structures that limit access to them and supervise your little one attentively when out playing.

#6: Access to Hazardous Areas

Swimming pools, ponds, wading pools, or open water close to home all present very serious hazards to kids.

Ensure that you have gates and locks in place to prevent unsupervised wandering, and restrict access to areas which can leave your little one in a dangerous situation.

Most child drownings are reported to have happened in places the child was familiar with. Statistics show that 65% of pool incidents happened in a pool owned by the child’s family; 33% occurred in a pool owned by relatives or friends.

#7: Drowning Risks in Winter

Colder seasons present specific drowning risks. Weak or thawing ice can spell disaster if walked or played upon.

Arm your little ones with knowledge on the dangers of walking, playing, skating or riding on thin or thawing ice.

What You Have to Be Careful of Outside the House

Swimming in places other than a pool presents specific challenges and requires more skill, especially when currents come into play.

Even children who are already good swimmers need to be careful when swimming in open bodies of water.

Supervision close to rivers, lakes or beaches must be constant, regardless if the plan is to swim or to simply play close to the water.

Lakes or ponds may also hide jagged rocks and other hazardous items that could easily entangle an arm or leg and send your little one into distress. Wildlife specific to the area, such as snakes or alligators, can also present an added risk.

Water parks also present safety hazards related to drowning. Only going on rides appropriate for your child’s age is one step towards safety.

Boating on a calm, shallow, backwater or pond is one thing, while boating in open water another entirely. Still, both environments present specific challenges.

Boating is fun, but it should also include constant supervision and the adoption of all safety and precautionary measures.

Being out in the water with children holds great responsibility. While wearing a life jacket does reduce the risks of drowning, reports of children drowning while boating and wearing a life vest are still a reality, too.

Just to give you an idea about how serious of an issue this is, twenty-two children under thirteen died while boating. More than half of these died from drowning.

Holidays present a unique risk. For starters, both you and your little ones are not accustomed to your surroundings and the hazards which may be lurking.

There is also the relaxation factor which, while most needed by us parents or caregivers, can limit that attentiveness which usually takes over at home.

This is especially the case when holidaying with friends. Having more hands to pitch in and care for the little ones can prove detrimental rather than offer added safety.

This is why the AAP emphasizes the importance of designating a ‘watcher’. Accidents have happened when one adult thinks another is supervising the kids.

What Are the Signs That a Child Is Drowning?

Keep an eye out for any of the following signs that might indicate your child (or anyone else’s for that matter) is drowning:

#1: Head Low in the Water

A drowning child’s head will lie low in the water with the mouth at or below the water level.

A child’s head may also be tilted back, with the mouth open and the eyes looking glassy or empty, wide open, or completely and tightly shut.

#2: Gasping for Air

A drowning child rarely calls out for help because all their energy is focused on trying to breathe at this point, and not using it up on anything else.

#3: Bobbing up and Down

There will be no loud splashing around. A drowning child will bob in and out of water, rising above the water only to sink below it again. Their body will be in an almost-vertical position.

#4: Arms at the Sides

In the movies, drowning people are depicted waving their hands up in the air. In reality though, doing this requires a lot of energy.

Drowning children usually have their arms spread out to their sides in efforts to keep their head out of water.

#5: Floating Face Down

Floating face down is the last sign, and it means that the child has fallen unconscious.

This stage is critical, and pulling the little one out of the water as quickly as possible can make a huge difference in terms of recovery, permanent disability, or death.

How to Prevent Your Baby or Child from Drowning

Babies, toddlers, and older children are naturally drawn to water. In most cases, simply talking about the danger of water to them and explaining everything in a clear way doesn’t really make that great of an impact.

Older children might understand the reasoning behind not being allowed to swim alone, or going close to the water, but toddlers and babies spend their days exploring all the new things they can do.

If that involves trying to drink out of the toilet bowl, they’ll have no qualms about doing so.

With this in mind, creating physical barriers to stop your little ones from getting near water, practicing safety measures, and arming yourself with knowledge on what to do if they end up in distress can mean all the difference between life and death.

Experts recommend that parents setup multiple layers of protection, since no single measure on its own will suffice in preventing deaths and injuries.

Nemour’s Hospital has a nice article about barrier measures to prevent drowning.

Other than that, here are some general steps you can take to ensure added safety for your child when around water:

#1: Learn CPR

Knowing how to perform cardiopulmonary resuscitation (CPR) greatly reduces the risk of drowning.

Acting fast once a drowning accident does occur makes a world of difference in terms of eventual recovery.

Knowledge of CPR should ideally be a must for all parents and caregivers.

#2: Direct Supervision

It really goes without saying, but never leave a child unsupervised close to any water.

It’s easy to get distracted – be it if you’re conversing with a friend, answering a call, or having a bite to eat. Unfortunately, accidents happen with adults close by, too.

Drownings also happen under adult supervision: in 2000, 88% of children were under some form of supervision when they drowned, with 46% of them in the care of a parent at the time of the incident.

The Mayoclinic suggests to designate a ‘watcher’ and take turns watching the kids. Accidents can happen when one adult thinks another is being attentive to the kids, without deciding this together prior.

If your little one is still under four years of age, then you should always be at arm’s length, even if they know how to swim. Air-filled or foam toys should not be relied on for complete safety. Nothing replaces adult supervision!

For children who are still starting to learn how to swim, the best supervision is ‘touch supervision’ where you are within arm’s reach of your little one.

If their little head submerges, you’re close enough to immediately lift them up and keep them out of harm’s way.

#3: Swim Lessons

Teaching your little one to swim early on has the potential of greatly decreasing the risk of drowning.

A study looking into the association between swimming lessons and drowning in childhood found that formal swimming lessons reduced the risk of drowning by 88% in children aged 1 to 4 years.

So, children over one year of age will benefit from swimming lessons.

Still, and as highlighted by the Mayoclinic, swimming lessons are no substitute for adult supervision. The AAP goes further in saying that swim lessons and swim skills on their own do not prevent drowning entirely.

Wider water competency is a must, and we’ll be talking more about that below.

When Is It Best for My Child to Start Swimming Lessons?

There is no one correct answer to this question. As we’ve seen above, learning how to swim greatly reduces the risk of drowning, however it is one factor among plenty of others required for total safety around water.

The AAP notes that a decision to start swimming lessons is a very individualized and personal one.

A variety of factors, including comfort with being in water, the child’s health, emotional maturity, and physical and cognitive limitations must be taken into consideration before taking the plunge.

Babies under one year of age are, according to the AAP, developmentally unable to learn complex swimming movements.

Yes, they do show reflexive swimming movement under the water, but they cannot raise their heads to breathe. Breathing, a necessary aspect of swimming, is a complex movement for babies under one year of age.

There is currently no evidence that shows that swimming lessons for babies under one year of age are beneficial.

#4: Water Competency

Water competency goes beyond simply knowing how to swim. It involves the ability to anticipate, avoid and survive common drowning situations, something that younger children fail to possess.

As highlighted by the AAP, water competency includes:

  • Water-safety awareness.
  • Basic swim skills, including knowledge and awareness of hazards, own limitations, and how to wear a life jacket.
  • The ability to recognize and respond to a person in trouble, including calling for help and performing safe rescue and CPR.

As can be seen, this is a doable list for adults, but is often quite a challenge for younger children to nail down.

#5: Water Safety When out Boating

Children, and also adolescents, are required to wear US Coast Guard-approved life jackets whenever they are in or on a boat, or any other kind of watercraft for that matter.

As an adult, you should also be wearing a life jacket yourself. Not only does this assist you in case of an emergency, but you’ll also be presenting a good example to your little ones.

Plus, if they’re giving you trouble wearing a life jacket, seeing you wear one yourself could give them all the more reason to “copy” you. We have to take advantage of this psychological stuff, right?

It should be made very clear that air filled swimming aides such as inflatable arm bands, neck rings or floaties are not adequate substitutes for a good life jacket.

The majority of boating accidents occur because of alcohol, and when children are on board, they’re usually the ones taking the brunt of it. So, when out boating, be sure to appoint a designated driver who won’t drink!

Also, in case of bad weather, return to shore. Your safety and that of everyone else’s is way more important than risking it all for a bit of fun.

#6: Water Safety at the Beach

There’s great fun to be had on a day at the beach or by the lake. Ensuring utmost safety at all times makes the day a memorable one, and for all the right reasons.

When choosing a place to swim, opt for one with lifeguards close by and with clear designated areas for swimming. Areas not designated for swimming might not be safe due to currents or, possibly, boat traffic.

Regardless of how talented your little swimmer is, consider the weather, tide-levels, waves, and water currents before going in for a dip.

Currents, while not always visible, can be deadly. As emphasized by Kids’ Health, do not allow babies and children to swim in large waves or undertows.

Inform your little ones as well as other adults present on what to do if caught in a rip current. The AAP provides the following instructions:

  • First things first, remain calm, or else you won’t be of much help.
  • Either swim out of the rip current parallel to the shore, or tread water until safely out of the current and able to return to shore. If you can’t do either, signal for help.
  • Never swim against the current.

Babies and children should wear a lifejacket even when playing on the sand close to the water. Remember that it only takes a blink of an eye for a toddler to dash into the water!

#7: Safety at Lakes and Ponds

Babies and children should never be left in or near lakes or ponds without supervision.

These bodies of water are shallow close to shore, but they get deep very quickly.

Apart from this, check for potentially dangerous wildlife and make sure that you and your child wear foot protection such as aqua socks or water shoes.

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “This reminded me of the child that was pulled into the water at Disney World… just awful!

In case you don’t know about that incident, you can read about it here.”

#8: Safe Fun at Water Parks

Water parks are great fun, and there’s nothing like the deep sleep that follows after a full day out playing in the water.

However, knowing what to look for in a water park you take your kids to, as well as being prepared for any accidents there, is vital.

When choosing a water park, go for one that uses qualified lifeguards.

Take note and follow all signage – each ride or slide is best for a specific age, height, weight and health requirements.

Babies and younger children shouldn’t play next to older ones. Older kids tend to play rougher, not mentioning all the splashing that can easily feel like a tsunami for little swimmers.

As noted by KidsHealth, instruct older children to follow the rules and use the slides as they were meant to be used – feet first, and face up.

Wearing a life jacket also reduces the risk factor of water parks.

The AAP has an article that not only discusses swim safety, but ways to reduce risk of contracting infections at water parks. Check it out here.

#9: Limiting Risk at Community Pools

When swimming at community pools, make sure you follow all signage and instruct your little one to do the same.

Stay close to lifeguards and ensure that the area your child is playing in is appropriate for their age. Older children playing rough or diving close to younger children presents a hazard.

Also, always supervise your little one, even if lifeguards are present.

#10: Keeping Pools at Home Safe

4-sided fencing at least 4 feet tall with self-closing and self-latching gates has been found to effectively prevent more than 50% of swimming pool drownings of young children.

Research by Thompson and Rivara found that isolation fencing that encloses just the pool is more effective than perimeter fencing that basically still allows access to the pool area from the house.

So, pool fencing is a tested drowning prevention strategy.

The US Consumer Product Safety Commission has published Guidelines for Safety Barriers for Residential Pools to prevent child drownings.

The document contains all you need to know for setting up fencing that meets all safety requirements, and it can be accessed here.

You can also have a look at the following AAP link that give lots of details on fencing, pool covers, pool alarms and other safety measures you have to put in place.

#10 (A): A Word on Drain Covers

Many accidents have been reported of children being sucked towards pool drains and the outcomes having been very unfortunate.

Appropriate pool and drain covers should be installed to prevent the risk of entrapment and eventual drowning from drain suction.

In 2002, Virginia Graeme Baker was a victim of the powerful draining suction of a hot tub. In the wake of her death, the Virginia Graeme Baker Pool and Spa Safety Act was passed.

This Act outlines the requirements for safe drain covers and vacuum release systems to reduce the chances of injury or death.

Before you purchase drain covers and draining systems, be sure to check that they comply with all safety requirements.

#10 (B): A Word on Pool Covers

Healthy Children warns about the danger of some pool covers.

Floating solar or winter covers are not meant to be used as safety covers. These can actually increase the risk of drowning, as it’s easy for babies and children to simply walk over them, unaware that they can easily slip underneath and end up drowning while hidden from view.

Pool covers should cover the entire pool securely enough that no child can slip through, and it should be ensured that no water collects on top.

Healthy Children recommends power-operated covers as being both safe and easy to use.

#10 (C): A Word on Above Ground Pools

Surface pools are a great option if digging and preparing the foundations for a residential pool is not really a possibility for you at this time.

However, just like other water-related things, they pose specific risks to children.

To avoid death or injury surrounding above ground pools, make sure that ladders are not easily accessible by toddlers and children.

Above ground pools also require appropriate fencing to provide an extra barrier for adventurous children.

Last but certainly not least, and as you should do with regular pools, do not leave toys in the water when not in use.

The Haddon Matrix for Drowning-Prevention Strategies

The AAP policy document on the prevention of drowning includes within it a plethora of measures to be taken to ensure water safety at all times.

The table below is handy to have, if you’re trying to ensure that your little ones are safe from the dangers of water at all times.

It outlines what you need to do to ensure utmost safety, what to do in case a drowning incident is taking place right in front of you, as well as all the steps you should take after the drowning has occurred.

If I were you, this is one table I most certainly wouldn’t mind having stuck to the fridge (or wherever else you would keep being reminded of everything on it).

Before the event Personal Equipment Physical Environment
Supervision of children and poor swimmers should be close, constant, and attentive. Tip: designate a ”watcher” and take turns in this role. Install 4-sided fencing and isolate the pool from the rest of the house and yard. Swim where lifeguards are present.
Clear handoff supervision responsibilities. Install self-closing and latching gates that are hard for kids to open. Follow warning signage.
Develop complete water competency: water safety knowledge, basic swim skills, ability to recognize and respond to a situation. Wear life jackets. Swim at designated swim sites.
Evaluate preexisting health conditions (and act in accordance with professional advice given). Install compliant pool drains. Do not leave toys in pool when not in use, to reduce the level of temptation for children to enter.
Know how to shop and fit a life jacket. Install door locks. Empty water buckets and wading pools.
Stay away from substance use. Enclose open bodies of water.
Know the specific water hazards and conditions. Promote life jacket-loaner programs.
Swim at designated swim site. Be a role model as an adult and wear a life jacket.
Learn CPR. Make rescue devices available at swim sites.
Take a boater education course. Close phone access to call for help in case of need.
Ensure that watercraft is functional.
Event Use water survival skills. Rescue device availability.
After the event Perform early bystander CPR. AED.
Respond. Rescue equipment.

Source: American Academy of Pediatrics Policy Statement: Prevention of Drowning by Sarah A. Denny, Linda Quan, Julie Gilchrist, Tracy McCallin, Rohit Shenoi, Shabana Yusuf, Banjamin Hoffman, Jeffrey Weiss, Council on Injury Violence, and Poison Prevention

The Importance of CPR – and Knowing How to Do It Well

Immediate CPR can save your child’s life, so it’s crucial that you know what to do in situations where performing this might mean all the difference between a child’s death and survival.

As noted by the AAP, ‘immediate resuscitation at the submersion site, even before the arrival of emergency medical services personnel, is the most effective means to improve outcomes in the event of a drowning incident’.

So, as you can see, time is of the essence.

The initiation of CPR must be prompt, focusing on airway and rescue breathing before applying compressions.

Advanced cardiac life support prior to arrival in hospital has also been found to impact survival and general prognosis.

Even if your little one appears alert after receiving rescue breaths, a trip to the ER is still a must. Any child who drowns and requires resuscitation, even if only rescue breaths, has to be taken to emergency for evaluation and monitoring.

Nemour’s Hospital also has a detailed page about CPR, which we encourage you to check out.

Prepare Your Child Whenever They’re Close to Water

You cannot really control what infants decide to do when presented with an opportunity, but you can do your best to put measures in place that keep them out of harm’s way, and you can certainly do a lot in teaching them about their own safety and well-being.

Sharing the importance of safe water practices early on will see your little one kitted with knowledge to avoid risky situations.

Toddlers in particular should be taught about water safety, regardless if they’re taking swimming classes or not. With toddlers behind the highest number of drowning accidents, teaching water safety is absolutely crucial.

The Texas Swim Academy recommends these tips for teaching toddlers about safety around water:

#1: Ask Permission

Toddlers should be taught that they must ask permission before going into a pool or playing in water.

To really nail this home, explain the dangers involved with being close to or in water on their own.

#2: Roll-Back-To-Float

Teach your toddler the maneuver they should be doing if they accidentally fall into the pool or any other body of water.

#3: Swim Classes

Swim lessons geared towards toddlers include activities and skills that emphasize safety and confidence in water. The roll-back-to-float technique is also taught in such classes

#4: Use Fun Activities

Making use of fun activities to teach your little munchkin valuable water safety lessons will make the learning process enjoyable for all.

Click here for some activity ideas you can easily carry out, ones that are great for toddlers.

How to Monitor a Child in Water

When a baby or child is playing in or near water, they require constant and undivided adult supervision.

Follow these steps for safe water play, each and every time.

  1. Ensure that your little one is wearing an appropriate life jacket and one which tips them on their back if in trouble.
  2. Infants should be held at all times – it doesn’t take much for them to lower their head and swallow water. Ensure that all airways are above the water level at all times.
  3. Designate a ‘watcher’ who will be actively responsible to supervise the child(ren). If you’re out with a group of children, designate more than one ‘watcher’ and clarify who is responsible for whom.
  4. Swim within reach (at arm’s length) of toddlers and young children.
  5. Accompany children playing in the sand.
  6. Do not leave children swimming alone in family pools, regardless of their depth.

Should We Invest in an Infant Life Jacket?

Yes, of course you should!

All children should wear a life jacket or personal flotation device any time they’re out swimming. Babies and toddlers up to 5 years old should wear a life jacket while in or near water, including while playing at the beach.

Many drownings occur in instances where the child would not have been expected to be in water. Wearing a life jacket ensures that if they do fall in, or curiosity gets the better of them, they’ll still be safe in water.

Life jackets are still required beyond the early years as well. Even if your little one knows how to swim well, they still need to wear a life jacket.

When boating too, life jackets are a must. If something happens and you end up overboard, a life jacket not only helps your little one float, but also offers a layer of protection and keeps your child warm as you await rescue.

When shopping for a life jacket, make sure that the model you go for meets safety standards, and that it’s appropriately-sized for your child. (Have a look at this article from the U.S. Coast Guard that gives further details on what parents should look for in a life jacket).

Life jackets shouldn’t be bought on the premise that your little one will grow into it – instead, choose one based on your child’s current weight as it is right now.

A bright life jacket is easier to spot in water, so keep in mind that the more colorful and the brighter it is, the better.

Life jackets with a large collar that supports your munchkin’s head, together with a grab strap and reflective tape and a whistle for emergencies offer more protection.

So does a safety strap that fastens between the legs – this will keep the jacket in place and prevent it from lifting up with water pressure.

To be extra sure, make sure that you test the jacket out in a controllable environment before first use. Only by testing it can you know that it really works well for your child.

With that being said, life jackets are not meant to replace direct adult supervision. The former doesn’t cancel the latter! At the end of the day, supervision is (and will remain) the holy grail when it comes to water safety for kids.

Stuff You Should Get to Ensure Water Safety

Supervision remains the most important aspect of ensuring your little one’s safety around water.

However, accidents also happen when you’re not even expecting your child to be close to water in the first place. For this reason, preventing accidents through proper preparation lowers the risk factor.

Experts at safety.com compiled a list of items that are a must when it comes to water safety and kids:

#1: Pool Fence

A fence surrounding the entire pool area greatly reduces the risk factors involved.

The barrier should be at least four feet high, with each entrance featuring an alarm and self-closing, self-latching, and child proof locks.

The space between each slat should not exceed 4 inches, and the space between the floor and barrier should not exceed four inches either.

#2: Child Safety Gate Lock and Latch

What’s a barrier with an easy to open door? Toddlers and young kids find their own creative ways of testing set barriers.

Opting for a child safety lock that prevents tampering is a sure way of ensuring added safety.

#3: Child Life Vests

Children should always wear a life vest when near or in water.

Life vests should be U.S. Coast Guard-approved, fit snugly (not too tight and not too loose), and appropriate for your little one’s weight.

A crotch strap and grab handle are two features that are also great to have.

#4: Safety Float Lines

Safety float lines are good for restricting areas outside a swimming zone, but they cannot be relied on as a lifesaver for a child in trouble while swimming.

While you can use a line to mark a deep end of a residential pool, for instance, kids can easily find a way to bypass it.

#5: Buoy (Rescue Life Ring)

A buoy is a must-have when a child is close to any body of water. Be it a residential pool, a lake close to home or anything else along those lines, a buoy can be the main reason behind a life saved.

While babies and toddlers can’t really hold on to a buoy on their own if in distress, an adult can use it as support while assisting a younger child.

The buoy you opt for should be US Coast Guard-approved and ideally weatherproof to withstand all conditions.

#6: Pool Safety Net

A pool net is designed to restrict children from entering the pool. It usually comes with anchors for it to hold in place and a reeling system for easy removal and storage.

Always test its safety for assuredness – if a child’s weight sends the net under water, then it’s not safe at all.

Opting for a UV-protected net will give you more use out of it.

#7: Pool Alarm

Pool alarms can be installed to any door leading to the pool, or doors leading outdoors where you know other water hazards are present.

An alarm releases sound to alert you that a door has been opened, and you can take care of the rest from there.

#8: Child Immersion Pool and Water Alarm Kit

Wearable alarms are also a way of ensuring your child’s safety. These come in the form of a wristband which your child can wear.

An alarm sounds when the wristband comes into contact with water. It comes with a base that can be plugged in the house, and to which other wristbands can be connected.

The downside of this is that crafty kids will soon get the hang of removing the wristband and might get into trouble when you think they’re safe, but aren’t wearing one to alert you when they’re next to (or in) water.

#9: In-Ground Pool Alarm

An in-ground pool alarm is another great option to consider, and one which is less prone to being tampered with.

An alarm sounds once the device senses movement over it, alerting you of the situation.

Help! Drowning Emergency! What Should I Do?

Drowning is an extremely scary thought. Even the thought of a child face down in water sends shivers down my spine, and I’m sure you feel the same way too.

Knowing what to do when a child goes missing, or when accidents happen, is imperative. When it comes to drowning, each and every second that passes counts, and acting in a timely manner can very well save a life.

If a child is missing, check the pool or any body of water first. If they’re not there, check any parked cars.

If you do find a child in water, you’ll need to act as fast as possible. As emphasized by KidsHealth, survival depends on a quick rescue!

Re-initiating breathing as fast as possible is imperative for a complete recovery.

Scenario #1: If You Find a Baby or Child in Water

  1. Get the child out while loudly calling for help.
  2. Check to ensure the child’s air passages are clear.
  3. If the child is not breathing, and if you are trained to do so, start CPR straight away. Follow instructions given to you through the 911 call.

Scenario #2: If You’ve Pulled a Child out of Water and Suspect a Neck Injury

Then follow these instructions after you’ve managed 1 to 3 above:

  • Keep the child on their back.
  • Brace the neck and shoulders with your hands and forearms so that the neck does not move before emergency help arrives.
  • Keep the child still and comfort them while speaking in a calm tone.

Scenario #3: If You’re Swimming with Your Child and Both of You End in Distress

If you’re holding your child in water and feel that you’re being swept away by currents or into a vortex preventing you from holding your child properly:

  1. Try to get the child to float on their back. Don’t try to hold them , as you’ll both end up exhausted. It’s important to save your strength in situations like this.
  2. Make sure you’re both floating and let the current take you rather than swim against it.
  3. If you’re a trained swimmer, place the child on your back with them holding your neck, and swim a very long breaststroke with a long slow glide until you’re out of the current.

Scenario #4: If You’re in High Sea and See a Child in Distress

  1. If there are lifeguards present, immediately call out one – they’re trained to save lives.
  2. If no lifeguards are present, send someone to get help first, and only then get in the water.
  3. Check for your safety too – only try to save the child if they are within reach and the water does not go higher than your waist.
  4. Once you reach the child, try to calm them down and have them float on their back.
  5. Slowly swim to shore.

Dragging someone out of the water, even a child, is very difficult in a high sea.

This is why you have to ensure that back up help is there or arriving – otherwise, it’s very easy for both of you to end up in distress.

After all, the first step in first aid is to analyze danger, both for you and for the person you are assisting.

Who Do I Call in Case of a Drowning Accident?

If there are lifeguards close by, signal them. After all, this is what they’re trusted with.

The priority should be to first get the baby or child out of water.

Immediately call 911.

If you are not the child’s parent or caregiver, seek them out.

Where Can I Learn First Aid and CPR?

Knowing what to do when faced with a drowning emergency can save a life. As a parent or caregiver, a First Aid course that also covers CPR is a must.

Unfortunately, not all first aid courses were created equal, and there are a number of – at best – shady options available that promise you a First Aid certification quicker than the time it takes you to say ‘First Aid’.

As noted by the National Safety Council (NSC), many providers do not offer the comprehensive training needed to meet the OSHA First Aid Standard CFR 1910.151.

So, when shopping for a course, check that what’s being provided is in line with this standard.

Opting for a course focusing on pediatric first aid will arm you with the knowledge and training required to respond well in any situation.

The Pediatric First Aid Course run by the NSC teaches participants how to take action in a medical emergency and provide basic life support, how to treat bleeding and care for wounds, treat shock, burns, poisoning and sudden illness, respond in cold and heat emergencies, as well as ensure the safety of children with disabilities.

The course includes training in CPR and AED, and the course description may be viewed here.

The Training Services branch of the American Red Cross runs specific pediatric first aid courses as well as a course focused on swimming and water safety. If you’re interested, you can check available classes in your area via this link. All training and certificates are OSHA and Government-compliant.

Local classes are held at locations convenient to all, and times which take into consideration parents’ and caregivers’ busy schedules.

The course includes hands-on training delivered by experienced instructors, and you’ll also get a full certificate to show at the end of it.

Combined online-classroom sessions as well as completely online options are also available for added flexibility.

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “Parents may be able to take classes at their local hospitals or at the office of their pediatrician, too.

For example, my practice offers parent and babysitter CPR courses on a quarterly basis that are open to parents and adolescents.”

A Note About Dry Drowning

For any of you reading this who might be worried about a supposed phenomenon called dry drowning, please read the following story from our contributor pediatrician Dr. Leah Alexander:

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “I had a notification in my intraoffice inbox that one of my patients went to an urgent care 2 days ago for ‘dry drowning’, as well as an emergency room notification.

It was regarding a 7 year old who I had seen 3 weeks ago for swimmer’s ear. During that visit, his father mentioned that he was taking swimming lessons.

Today, I called the parents to find out exactly what had occurred. The mother said that she and her were swimming at a friend’s pool throughout that afternoon.

They had an uneventful time in the pool but my patient complained of chest pain and nausea a half an hour after his time in the pool, vomiting once.

Because this mother had heard reports about dry drowning on social media, she was concerned about her son. Unfortunately, the doctor at the urgent care center further perpetuated this belief by recommending that my patient be seen in an emergency room despite no history of distress, water inhalation, or resuscitation.

The mother, even more worried at this point, took him to the nearest emergency room. This time, the emergency room doctor properly explained that there is no such phenomenon as ‘dry drowning’ and that her son was in no way at risk for respiratory compromise or death.

I told the mother that I agreed with the information she received from the emergency room physician, and further reassured her that her son would be just fine.”

Wrapping it Up

If there’s one thing you should take away from this article, it’s that drowning is entirely preventable. However, many children are unfortunately still dying because of this.

Accidents happen when you least expect them to. Drowning does not only occur when kitted for the beach and swimming. As we’ve seen in this article, places like pools, lakes, ponds, the ocean, bath tubs and fountains all present specific risks to babies and children.

Close and direct supervision when close to water is imperative, and so are safety measures for reducing the risk of residential pools, bathrooms, and bodies of water close to home.

When outside the house with your little one(s), sometimes being present in unfamiliar environments, taking note of specific risks that surround you can help you better supervise your kids and keep them away from harm.

If an accident does occur for whatever reason, taking the baby or child out of the water, calling 911, and re-initiating breathing are priorities. The earlier the child starts to breathe again, the less of an impact this accident will have on them.

Great times are to be had swimming, playing near water, and bathing, so definitely don’t deprive your kid from all of this just so you keep them safe! Instead, allow them to have all the fun in the world while following precautionary measures to ensure that memories made are remembered for all the right (and happy) reasons.

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Medically Reviewed By: Leah Alexander, M.D., F.A.A.P.

Medically Reviewed By: Leah Alexander, M.D., F.A.A.P.

Leah Alexander, M.D. FAAP began practicing pediatrics at Elizabeth Pediatric Group of New Jersey in 2000. She has been an independently contracted pediatrician with Medical Doctors Associates at Pediatricare Associates of New Jersey since 2005. After graduating from Kalamazoo College and Michigan State University College of Human Medicine, she completed her pediatric residency at Overlook and Morristown Memorial Hospitals. She is board certified in General Pediatrics.

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