Parent and child holding hands at a pool Summer is finally here! We don’t know about you, but we’re more than ready to ramp up the trips to the pool and beach to stay cool while we enjoy the season. However, with all that fun comes an increased risk of drowning. Unintentional drowning is the leading cause of death for young children age 1 to 4 and the second leading cause of death for children age 5 to 14.

In 2020, 932 children age 0 to 19 — or 18 per week — lost their lives while bathing, swimming, or playing in or around water. (CDC, National Center for Health Statistics, Underlying Cause of Death, 1999–2020.) Nearly two-thirds of those deaths occurred between May and August. Thousands more children will be treated at hospitals for near-drowning accidents. For every single death, another five children visit an emergency department because of a non-fatal drowning incident.

We spoke with Gina Duchossois, MS, an injury-prevention expert with the Injury Prevention Program at Children's Hospital of Philadelphia (CHOP) and Chair of Safe Kids Southeastern Pennsylvania Coalition, to find out what parents should know about preventing drowning accidents and what steps they can take to keep their kids safe.

The hidden hazards of open water

Safety experts have focused drowning-prevention efforts on swimming pools and, for younger children, bathtubs and smaller containers of water. Those are big risks, and parents should never leave children unattended when they are in or near any water, even for a minute. But the risks to children and teenagers in open water haven’t received as much attention.

“A big eye-opener is that almost half of fatal drownings among children in 2020 occurred in open water,” says Duchossois, “in ponds, canals, lakes, rivers and the ocean. Also, the risks of open-water drowning go up in the teenage years, especially among boys.”

Reasons for the increase vary and include the following:

  • The water can be murky or cloudy. That means a swimmer of any age can’t see rocks, logs, underwater plants or sudden drop-offs.
  • Distances and depths are hard to gauge. In open water it can be hard to tell how far you are from the shore or how deep the water will be with the next step.
  • Currents and tides make open water unpredictable. Rivers can sweep a child downstream, and ocean currents can carry them along the shore or out to sea. And tides change the water terrain. What began a gentle slope in shallow water in the morning may become a sudden drop to deep water in the afternoon.
  • Weather and seasonal changes can have a big effect on water conditions. Heavy rains and seasonal flooding can create powerful currents, even in ponds and rivers where none existed in the dry season.
  • Cold water can shock a person when entering the water. The shock can cause panic and can affect a child’s ability to swim. This is particularly true when a child falls into water accidentally from a dock or boat.

Signs of drowning in water

  • A child can’t yell for help. If an adult calls to a child or asks them if they are OK, and the child gives no answer or looks at the adult with a blank stare, this may indicate the child is struggling and needs assistance.
  • The child’s head is back and low in the water with the mouth at water level.
  • The child is not using their legs. The child is vertical in the water, often bobbing up and down.
  • The child appears to be climbing an invisible ladder or pressing down on the water to raise their head.

Possible dangers after rescue

  • After a water rescue, if a child has minimal symptoms — for example, the kind of sputtering and coughing one might experience after liquid “goes down the wrong pipe” at the dinner table — that child should be fine but should still be observed by an attentive caretaker.
  • After a water rescue, if a child has an excessive or prolonged cough, exhibits fast or hard breathing, or is not breathing normally or “acting right,” the caretaker should seek immediate medical attention for the child.

Water safety tips

Drowning occurs quickly and quietly, so parents can’t assume they will be alerted by yells or splashes. In real life, there is very little splashing, waving or screaming. It’s critical to pay close attention and to prepare your child with basic water safety skills. Follow these safety tips.

  • Watch children when they are in or near the water, without distraction. Go in the water with young children and inexperienced swimmers and keep them within arm’s reach.
  • Always swim with a partner. Whenever teens swim without you, they should always swim with someone else, tell you who that person is and identify where they will be swimming. The same goes for adults!
  • Be clear which adult is watching. If several adults are present, take turns as the “water watcher” and always know who that person is. Change watchers every 15 minutes so you stay alert and focused.
  • Install fences around home pools. A pool fence should surround all sides of the pool, be at least 4 feet tall and include self-closing and self-latching gates.
  • Install safety devices for pools such as barriers, covers and alarms.
  • Empty kids’ pools after each use. Store them upside down so they don’t collect water.
  • Make sure kids learn how to swim and develop these five basic water-survival skills:
    • Step or jump into water over their head and return to the surface.
    • Turn around in the water and orient to safety.
    • Float or tread water.
    • Combine breathing with forward movement in the water.
    • Exit the water.
  • Enroll your children in swimming lessons. Swimming is not only fun, it’s a lifesaving skill.
  • Teach children how swimming in open water is different from swimming in a pool. Explain about murky water, uneven surfaces, sudden drop-offs and currents (especially undertow and rip tides if you are swimming in the ocean).
  • Have children wear U.S. Coast Guard-approved life jackets at all times when they are in or around open water. Make sure the life jackets are appropriate for the child’s age and weight and fit securely. Floats, such as tubes, air mattresses or “floaties,” are toys and are not substitutes for a life jacket.
  • Use recreation areas designated for swimming. These have been checked for hazards and often have lifeguards.
  • Learn basic water rescue skills and CPR. The quick application of CPR could save a life. CHOP offers a training video along with links to other helpful CPR resources.

Gina P. Duchossois, MS, is an injury prevention expert with the Injury Prevention Program at Children’s Hospital of Philadelphia and Chair of Safe Kids Southeastern Pennsylvania.

Contributed by: Gina P. Duchossois, MS

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