Water Safety and Drowning Prevention for Children

Healthcare providers caring for children are frequently asked about water safety practices during the summer months. Drowning prevention is one of the most important topics of discussion for anticipatory guidance in the pediatric population, especially for toddlers. It is important to be comfortable in bringing up this topic and providing resources for families.

The American Academy of Pediatrics (AAP) has multiple resources available through their website and various other online platforms affiliated with the organization.^1,2 Drowning is the leading cause of injury death in US children between 1-4 years of age and is a significant morbidity well into early adulthood.³ Some studies have indicated that the majority of preschool-aged children drown in swimming pools, and this has been linked to a lack of barriers to prevent unsupervised access to water.⁴ As children get older, they become more likely to drown in open water areas, whereas infants are more likely to drown at home. Medical conditions, notably epilepsy, autism, and cardiac arrhythmias, have also been shown to be contributing factors to incidence of drowning.⁵ The AAP Policy Statement, the “Prevention of Drowning,” provides education and recommendations for parents and caregivers on how to prevent drowning within their communities.

The AAP also offers a drowning prevention campaign/toolkit for parents and caregivers, including videos with sobering infographics such as morbidity statistics.⁶ The Centers for Disease Control and Prevention (CDC) also have epidemiologic data readily available such as the fact that 3960 fatal unintentional drownings occur daily in the US every year.⁷ That number nearly doubles when considering nonfatal drownings, which can result in long-term health consequences especially related to brain injuries. Not wearing life jackets also has a significant impact when considering drowning deaths. Life jackets prevent drowning, especially during boating and swimming accidents. In 2019, the US Coast Guard reported 613 boating-related deaths, 79% being drowning related. Of those drowning deaths, 86% did not wear life jackets.⁸

Healthychildren.org is another incredible website that provides useful information on various pediatric topics including drowning prevention. One of the most effective ways to reduce drownings in young children is to prevent unintended, unsupervised access to water. Some important steps include at least having a 4-foot-high fence surrounding all sides of a pool and removal of backyard water hazards, full supervision of children when they are around a body of water, emptying water containers (buckets, bathtubs, wading pools) after each use, and blocking unsupervised access to bathrooms.²

These steps are all directly associated with close supervision of children around water – and life jackets are important to use whenever possible. The AAP recommends swim lessons as an additional way to protect against drowning that can begin for many children as early as one year of age.⁹ Infant swim classes are currently not recommended by the AAP – although it is considered acceptable for families to enroll in parent-child water play classes for infants.

There are various online resources to provide education to families and caregivers about drowning prevention. During these summer months, anticipatory guidance should be given to anyone caring for children whenever possible. Depending on the age of the child or the sources of water, guidance can change, but supervision is something that is a constant regardless of the situation. Having these difficult conversations early-on can prevent mortality and make our children safer year-round.

Eevar Benjamin Rossavik, DO, is a chief pediatrics resident who will soon join his program’s faculty to be a pediatrics attending. He has a specific interest in allergy, asthma, and immunology.

Clinicians and experts interested in responding to this piece, or submitting their own articles to HCPLive, can contact the editorial team here.

Resources:

^{1. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/child_death_review/Pages/Water-Safety.aspx}

^{2. https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Water-Safety-And-Young-Children.aspx}

^{3. https://pediatrics.aappublications.org/content/94/2/137?ijkey=48abaf71ce0749bca0cdb88072e7fa3779651438&keytype2=tf_ipsecsha}

^{4. https://pediatrics.aappublications.org/content/108/1/85?ijkey=094f3918fdc227864aa10052c1ca371e62e63ebe&keytype2=tf_ipsecsha}

^{5. https://pediatrics.aappublications.org/content/143/5/e20190850#ref-8}

^{6. https://services.aap.org/en/news-room/campaigns-and-toolkits/drowning-prevention/}

^{7. https://www.cdc.gov/drowning/facts/index.html}

^{8. https://www.uscgboating.org/library/accident-statistics/Recreational-Boating-Statistics-2019.pdf}

^{9. https://www.healthychildren.org/English/safety-prevention/at-play/Pages/swim-lessons.aspx}