The American Academy of Pediatrics Updates Guidance on Water Safety and Drowning Prevention

Summer season unfortunately always comes with reports of drowning accidents in pools and at the beach. This season is starting no differently as this past week marked a bad beginning to the beach season in Long Beach, New York. Two young men drowned on Wednesday in the rip-tided infested surf. Also on Wednesday, a man sitting on a lounge chair on the beach was run over by a Long Beach Police sports utility vehicle that reportedly was responding to an ocean-swimmer in distress. Its operator stated that he did not see the man before he hit him and injured his spine.

Drowning continues to be the second leading cause of death for children ages 1 to 19, claiming the lives of roughly 1,100 children in 2006. Toddlers and teenaged boys are at greatest risk. The good news is that drowning rates have fallen steadily from 2.68 per 100,000 in 1985 to 1.32 per 100,000 in 2006. Concerns about the prevalence of drowning led the American Academy of Pediatrics (AAP) to release this week guidance on swimming lessons and highlight new drowning risks. The updated policy also outlines the danger of body entrapment and hair entanglement in a pool or spa drain. Special drain covers and other devices that release the pressure in a drain can prevent such incidents.

The AAP warns of the dangers of large, inexpensive, portable and inflatable pools. A pool that has soft sides is very easy for a child to lean over and fall headfirst into the water. Large, inflatable above-ground pools are considered portable, and thus these pools often are exempt from local building codes requiring pool fencing. A fence that completely surrounds the pool can cut drowning risk in half. In the new policy, the AAP modifies its previous recommendations concerning swimming lessons for toddlers.

The new policy reinforces its existing recommendation that most children age 4 and older should learn to swim. In the past, the AAP advised against swimming lessons for children ages 1 to 3 because there was little evidence that lessons prevented drowning or resulted in better swim skills and there was a concern that parents would become less vigilant about supervising a child who had learned some swimming skills.

However, new evidence shows that children ages 1 to 4 may be less likely to drown if they have had formal swimming instruction. Thus AAP is now recommending that parents should decide whether to enroll an individual child in swim lessons based on the child’s frequency of exposure to water, emotional development, physical abilities, and certain health concerns related to pool water infections and pool chemicals. AAP is not recommending mandatory swim lessons for all children ages 1 to 4 at this time. The AAP does not recommend formal water safety programs for children younger than 1 year of age.

AAP Drowning Prevention and Children’s Water Safety Advice for Parents:

  1. Never even for a moment leave small children alone or in the care of another young child while in bathtubs, pools, spas or wading pools, or near irrigation ditches or standing water. Bath seats cannot substitute for adult supervision. Empty water from buckets and other containers immediately after use. To prevent drowning in toilets, young children should not be left alone in the bathroom.
  2. Closely supervise children in and around water. With infants, toddlers and weak swimmers, an adult should be within an arm’s length. With older children and better swimmers, an adult should be focused on the child and not distracted by other activities.
  3. If children are in out-of-home child care, ask about exposure to water and the ratio of adults to children.
  4. If you have a pool, install a four-sided fence that is at least 4 feet high to limit access to the pool. The fence should be hard to climb (not chain-link) and have a self-latching, self-closing gate. Families may consider pool alarms and rigid pool covers as additional layers of protection, but neither can take the place of a fence.
  5. Children need to learn to swim. AAP supports swimming lessons for most children 4 years and older. Classes may reduce the risk of drowning in younger children as well, but because children develop at different rates, not all children will be ready to swim at the same age.
  6. Parents, caregivers and pool owners should learn CPR.
  7. Do not use air-filled swimming aids (such as inflatable arm bands) in place of life jackets. They can deflate and are not designed to keep swimmers safe.
  8. All children should wear a life jacket when riding in a boat. Small children and nonswimmers should also wear one at the water’s edge, such as on a river bank or pier.
  9. Parents should know the depth of the water and any underwater hazards before allowing children to jump in. The first time you enter the water, jump feet first; don’t dive.
  10. When choosing an open body of water for children to swim in, select a site with lifeguards. Swimmers should know what to do in case of rip currents (swim parallel to the shore until out of the current, then swim back to the shore).
  11. Counsel teenagers about the increased risk of drowning when alcohol is involved.

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