June 4, 2004

The kids are giggling away as they splash each other, practice holding their breath, and bob in and out of the water in a game of Marco Polo, while you take a lap, get a little sun, or chat nearby with some fellow parents over a cool drink. Everything seems OK - perfectly safe. But the fact is that most drowning accidents happen right under the noses of adults who think children are being adequately supervised.

According to a recent study by the National SAFE KIDS Campaign, nearly 90% of drowning deaths in children between the ages of 1 and 14 happened under the supervision of another person, usually a family member. (The study defined supervision as "being in the care of another individual, not necessarily in their direct line of sight.")

The second leading cause of unintentional injury-related death (after car accidents) for children 14 and younger, drowning claims the lives of more than 900 kids in the United States every year. Little ones ages 4 and under account for 80% of home drownings, most often in swimming pools and bathtubs (the drowning rate for children ages 4 and under is two to three times greater than other age group).

Although even the most skilled child swimmer can drown, the SAFE KIDS study found that 55% of parents think it's OK to let a child swim unsupervised in some circumstances. And many parents who say they do supervise their children when swimming say they're doing other things as well: talking to others (38%), reading (18%), eating (17%), and talking on the phone (11%).

SAFE KIDS' study also discovered that parents aren't:

• properly fencing pools - Sixty-one percent of parents who own a pool or spa said they don't have the recommended four-sided isolation fencing that completely separates the pool area from the house and the rest of the property; and 43% said they have no self-closing or self-latching gate.
• requiring kids to use Coast Guard-approved personal flotation devices, or PFDs - Many tweens - ages 8 to 12 - said they never wear a life jacket when riding on a personal watercraft (50%) participating in water sports (37%), or on a boat (16%). And one in five parents mistakenly think air-filled water wings can protect their child from drowning.
• teaching children how to swim - Almost 75% of drowning victims studied by SAFE KIDS didn't know how to swim. And 37% of parents surveyed said their children have never taken swimming lessons, even though most parents said they know that kids should have their first lesson with a certified instructor by age 8.

Although it might seem like drowning occurs only when children are left unattended, the majority of kids who drowned in swimming pools were last seen in the home, had been in the care of one or both parents, and were out of sight for less than 5 minutes, according to SAFE KIDS.

And if you think you'd recognize when your child is drowning by the sounds and motions of distress he or she would make, think again. Drowning often happens quickly and quietly - there's little noise to alert parents that the child is in danger. Every second can mean the difference between life and death - loss of consciousness happens within 2 minutes after the child goes under and irreversible brain damage occurs 4 to 6 minutes after submersion, in most cases.

Young children are especially vulnerable - they can drown in as little as 1 inch of water. That means drowning can happen where you'd least expect it - the sink, the toilet bowl, fountains, buckets, pet bowls, birdbaths, wading pools, or small bodies of standing water around your home, such as ditches filled with rainwater.

Drowning Prevention

Close supervision whenever a child is near any water is key to preventing tragedy. Never leave a child - especially an infant or young child - unattended around water, whether it's a pool or lake, or a bathtub or small kiddie pool.

It's also a good idea for parents and any person supervising children around water to learn how to swim. If your child is older than 4 years, have him or her learn to swim, too (check the local recreation center or YMCA for classes taught by qualified instructors). Don't assume, however, that your child won't drown just because he or she knows how to swim. Children should always be supervised they're in the water, no matter how skilled they may seem. Parents and caregivers should also learn CPR so they'll be prepared to handle a potential drowning.

Invest in proper-fitting, Coast Guard-approved flotation devices (life vests) and use them whenever a child is near water. Check the weight and size recommendations on the label, then have your child try it on to make sure it fits snugly. For children younger than 5, choose a vest with a strap between the legs and head support - the collar will keep the child's head up and the face out of the water.

Here are some other tips to help keep your child safe around water:

At the Pool

• If you have a pool in your backyard, install fencing at least 5 feet high on all sides of the pool, as well as a self-closing and self-latching gate with a lock that's out of a child's reach.
• Inflatable flotation devices such as vests, water wings, rafts and tubes can give a false sense of security in the pool and are not effective in protecting a child from drowning. Never use these as a substitute for constant adult supervision.
• Dump out all water from a wading pool when you're finished using it.
• Remove any ladders from an above-ground pool.

• If you leave your child with a babysitter, make sure he or she knows your rules for the pool.

At the Beach

• Teach your child to always swim when and where a lifeguard is on duty. Don't swim close to piers or pilings because sudden water movements may cause your child to collide with them.
• Unlike the calm waters of a swimming pool, the beach has special dangers like currents and tides. Check with the lifeguard when you arrive to find out about the water conditions.
• Don't allow your child to swim in large waves or undertows, and tell your child to never stand with his or her back to the water because a sudden wave can easily knock your child over.
• Teach your child to swim parallel to the shore or tread water and call for a lifeguard's help if he or she caught in a rip current or undertow.

At the Lake or Pond

• Don't let your child swim without adult supervision - lakes or ponds may be shallow near the bank and then increase in depth sharply as the child moves further out into the water.
• Watch out for weeds and grass that could entangle your child's legs or arms.
• Most boating accidents, particularly among teenagers, are related to alcohol. When you and your family are boating, assign a designated driver who won't drink. Be sure your teen knows about the dangers of alcohol, on and off the water.

In the Bathtub/Bathroom

• Never leave a baby unattended in the bath. If you must answer the telephone or door, don't rely on an older sibling to watch the baby; wrap your baby in a towel and bring him or her with you.
• Stand guard over a bathtub that's filling with water.
• Don't use a bathtub seat with suction cups. The seat can overturn and flip a baby headfirst into the water.
• Install a toilet-lid locking device or keep bathroom doors closed.
• Never leave a small child unattended near a bucket filled with any amount of water or other liquid.

Above all, supervise your child in and around water at all times. Don't assume that your child can't drown just because he or she took swimming lessons or is using a flotation device such as an inner tube, inflatable raft, or water wings. If you're at a social outing with other adults and families, it's especially easy to become distracted, so designate an adult who will be responsible for watching the children. Make sure an otherwise happy day in the water doesn't become a tragic memory.

Reviewed by: Mary L. Gavin, MD
Date reviewed: June 2004