When the weather heats up, you probably spend a lot of time cooling off with your kids at the pool, beach or lake. And while swimming is a great way to stay active and play together, remember that water can be dangerous, even for little ones who've learned how to swim.
That's why it's so important to keep close watch on your little guppy whenever she jumps in. Meaning you should always keep your eyes on her and stay within arm's reach.
Although the thought of a baby or toddler drowning isn't one any parent wants to have, it's imperative to be informed. Knowing what to look for and what to do in a case of an emergency can help save a child's life.
What is drowning?
Drowning is defined by the World Health Organization (WHO) and other medical groups as respiratory impairment (i.e. being unable to breathe) as a result of being underwater.[1]
Though the term "drowning" has traditionally only been used to refer to fatal events in the water, WHO's definition includes both fatal drowning and nonfatal drowning.
An average of 3,957 Americans die from drowning each year, with children ages 1 to 4 at the highest risk. In fact, drowning is one of the leading causes of unintentional deaths among children ages 1 to 14, second only to car crashes.
While home swimming pools are the most common site for toddler and preschooler incidents, babies are most likely to drown in a bathtub, toilet or bucket of water — which is why it's critical to childproof your home and never leave your child unattended in the bath or bathroom.
Signs of drowning
You've seen it many times on TV: A drowning person splashes, waves her hands frantically and yells out for help — right? Not quite. In real life, drowning is usually silent and quick, often happening within minutes or even as little as 30 seconds.
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A drowning child usually can't call out. Instead of flailing her arms, she might use them to try to push up on the water's surface, which can look like normal playing. (Babies and younger toddlers might not move their arms much or at all.)
Here are some signs your child is in distress in the water:[2]
- Head low in the water with the mouth at or below water level. (Very young babies may keep their heads down or not move their heads at all.)
- Head tilted back with mouth open
- Glassy or empty-looking eyes
- Eyes wide open or shut tightly
- Hair hanging over forehead or eyes
- Body in a near-vertical position, with little or no leg movement
- Attempting to swim but making little or no forward progress
- Gasping or hyperventilating
- Near (or at) the bottom of the water
- Attempting to roll over onto her back
If you see any of these signs, remove your child from the water immediately.
What should I do if my child has a drowning scare?
First things first: Get your little one out of the water as soon as possible. What you should do next depends on whether your child is conscious.
If your child is unconscious
In the event that your little one is breathing but is unconscious, have someone call 911, or call yourself if you're alone. (If you're unsure whether she's breathing, quickly put your face near her nose and mouth to see if you feel air — or look to see if her chest is rising and falling.)
If your child isn't breathing, have someone call 911 while you or someone else performs infant CPR (for babies up to age 1) or child CPR (for kids ages 1 to 8). If she's inhaled water, start with rescue breaths. Chest compressions can also help push some of the water out, but rescue breaths should be the priority. The 911 operator can also give you instructions on what to do if no one knows CPR.
Follow all directions and continue giving CPR until your child starts breathing or emergency personnel arrive and take over.
If your child is conscious
If your child is awake, coughing and sputtering, and seems afraid after she's pulled out of the water, that's a good sign — it means she's breathing and will likely be okay. Help her calm down and watch for the symptoms listed below, which would arise within a few minutes to hours (not show up a day or more later).
Symptoms to watch for after a nonfatal drowning
Anytime your child has a drowning scare, you should get her evaluated by a doctor as soon as possible. Remember, if she loses consciousness or has trouble breathing, call 911 or get her to the emergency room right away, even if she comes to or starts breathing again before help arrives or you get her to the hospital.
In fact, if you notice any of these symptoms — or your child's behavior seems off in any way — the American College of Emergency Physicians advises taking your child to your local emergency department ASAP:
- Persistent coughing
- Labored breathing
- Chest pain
- Extreme fatigue or exhaustion
- Vomiting
- Irritability or mood changes
- Difficulty talking
- Confusion or disorientation
- Bluish skin color
- Foam at mouth or nose
- Worsening symptoms
What is secondary drowning?
The American Academy of Pediatrics (AAP) and other major medical organizations do not use the phrase "secondary drowning" because it's not a medically accepted term, but you may have heard about cases in media reports or from other parents. So what's the real story?
Secondary drowning (sometimes called delayed drowning) can refer to incidents where children or adults suffer subsequent, worsening symptoms after struggling to stay afloat in the water for a period of time.
The AAP does not use the phrase, however, because it's not a true diagnosis. Symptoms that may occur after drowning can stem from several different causes, such as pulmonary edema (a build-up of fluids in the lungs) or a head injury.
The term can also cause unnecessary alarm. Children do not unexpectedly die a day or more later without warning after a drowning scare. Still, it's important to watch for the symptoms listed above in the hours afterwards in case any complications develop.
What is dry drowning?
"Dry drowning" is another phrase often seen in headlines but not accepted by medical experts like the AAP. It's sometimes used as a synonym for secondary drowning, although other times they can each refer to different outcomes after drowning scares.
Dry drowning is not a true medical diagnosis — several different conditions can cause complications (also known as submersion injuries) after a drowning scare, including including hypothermia, lung inflammation and/or pulmonary edema, as is the case with secondary drowning.
The term dry drowning has various definitions but can refer to what occurs when water is inhaled or aspirated into the lungs via the mouth or nose.
That closes off your windpipe (known as laryngospasm, which is the body’s way of protecting you against drowning and preventing water from getting into the lungs), making it difficult to breathe.
Regardless, as a parent, you should monitor your little one for several hours after your child has experienced a struggle in the water. You'll most likely see warning signs right away or soon afterwards.
A good rule of thumb: If your child inhaled a little water after a cannonball or pool game, she's likely okay. If she struggled underwater and has coughing and breathing difficulties (more than when a drink of water goes down "the wrong pipe"), call 911 or your pediatrician right away or take your little one to the nearest ER or urgent care.
Pool and swimming safety tips to follow
Being prepared and following standard water safety rules significantly reduce your child’s risk of drowning.[3] Parents can:
Fence in your pool
If you have a pool, secure it with a self-locking, self-latching gate that's at least 4 to 5 feet high and a four-sided fence.
Remove any furniture or objects that a child may be able to use to climb over the gate or into the pool and toys that may tempt them to enter the water unsupervised. Follow any other local laws regarding pools.
Stay close
Always keep your little one no more than arm's length away in the water, learn CPR and have a phone nearby. If you're going to be busy or distracted, assign a dedicated "water watcher" to stay close to your child and keep eyes on her.
Get the right gear
Have (and use!) safety equipment like life jackets and vests that fit your baby or toddler snugly rather than flotation devices like arm floaties and rings, which may provide a false sense of security.
Keep in mind that you should never rely on life vests to help your baby or tot swim if you're not nearby.
Sign up for swim classes
It's also a good idea to enroll everyone in your home in an age-appropriate swimming class. The AAP recommends lessons for kids 1 and older who are ready, with a pediatrician's approval. In fact, new evidence shows that children ages 1 to 4 may be less likely to drown if they've had formal swimming instruction.
Remember, though, that learning to swim doesn't mean your child will know what to do if she gets into trouble. The best way to prevent drowning is to always closely supervise your little one in or near the water.
By taking the proper precautions, swimming with your child can be a fun, safe activity for both of you.
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