The American Academy of Pediatrics (AAP) recently released updated guidelines for the prevention of drowning in children. Drowning is the leading cause of injury-related death in children, claiming the lives of 1,000 children in the United States in 2017. Toddlers and adolescent boys currently have the highest risk of death by drowning, compared to other age groups, with male children of all ages having a higher risk of drowning compared to female children over the age of one year. Greater risk for severe, long-term neurological damage can occur when drowning victims are submerged in water for longer than six minutes and/or when resuscitation efforts are prolonged or delayed (e.g., due to lack of early bystander-initiated cardiopulmonary resuscitation [CPR]). The good news is that childhood drowning rates have decreased steadily from 2.68 per 100,000 children in 1985 to 1.11 per 100,000 children in 2017. The guidelines released by the AAP urges pediatricians to educate parents and kids on water safety to continue decreasing the number of drowning deaths among children.
14 PARENT AND CAREGIVER RECOMMENDATIONS FOR THE PREVENTION OF DROWNING
1. Never leave young children unattended or in the care of another child when near any open standing water, including buckets and bathtubs.
2. Practice supervision and caution when bathing an infant while using a bath seat due to its ability to tip easily.
3. Use toilet locks to prevent small children from drowning in toilets.
4. Empty pails and buckets immediately after using.
5. In circumstances where infants and toddlers are in or around water, there should always be an adult within arm’s length. With older children, even in circumstances where a lifeguard is present, “water watcher” should be designated. A water watcher is an adult with swimming skills who devotes unwavering attention to swimming children and is able to perform a rescue and initiate CPR if required.
6. Owners of private pools should install fencing that is at least four feet tall, with a self-latching gate, that completely isolates the pool from the surrounding area; this is the most studied and most effective prevention strategy. Other gear, such as pool alarms and weight-bearing pool covers, should not be used as a substitute for fencing but can be used as supplemental protection.
7. It is recommended that all parents, caregivers, and pool owners learn CPR and keep United States (US) Coast Guard-approved rescue equipment near pools at all times.
8. Parents and caregivers should always have access to a phone when supervising children who are swimming.
9. Swim lessons have been shown to reduce the risk of drowning in children. The AAP explains that children can begin swimming lessons as early as one year of age, depending on emotional and physical maturity. However, the AAP does not recommend swimming lessons for children younger than one year of age due to their lack of physical development required to perform the complex movements of swimming, such as lifting the head to breathe. Children should learn the following basic swimming skills: entering the water, surfacing, turning around, propelling for at least 25 yards, floating or treading water, and exiting the water. Multiple lessons are necessary to practice and achieve these basic competency skills. Thorough lessons will provide what the AAP refers to as, “experiential training,” which includes swimming in clothes and life jackets, falling in, and self- rescue. In addition, children’s swimming lessons should stress the importance
of swimming only when an adult is present.
10. When a child visits a home with a pool, hot tub, or other similar source of open water, his or her parent or caregiver should assess the area to ensure proper barriers to water access are in place, such as gates with self-latching locks.
11. Children and adolescents should always wear US Coast Guard-approved life jackets when riding on a boat or other water craft. Adults should model safe water behavior around children by also wearing life jackets on water craft. Small children should always wear a life jacket when swimming. Due to risk of deflation, inflatable arm bands, also known as floaties or water wings, or other air-filled swimming aids, are not considered adequate substitutes for a life jacket.
12. Parents should exercise caution when permitting children to jump into pools or other open water. Encourage children to jump into water feet first and always remain aware of water depth to avoid injury.
13. In the winter months, parents and children should be aware that ice formation over a body of water might not be able to withstand the weight of a child. Children should be advised not to walk or ice skate on any frozen body of water that has not been approved for use by those trained to do so.
SOURCE: Adapted from Denny SA, Quan L, Gilchrist J, et al. AAP council on injury, violence, and poison prevention. Prevention of Drowning. Pediatrics. 2019;143(5):e20190850 NHR
RIP Current Safety
- A rip current is a relatively strong, narrow ocean current that flows outward from the beach.
- Before headingtothebeach,checklocalforecastsandripcurrent information.
- Donotfightagainstthecurrent—swimoutofthecurrentinadirection following the shoreline. When out of the current, swim at an angle away from the current toward shore.
- Thecurrentwillnotpullyouunder,onlyfurtherawayfromtheshore.If you cannot escape the current, float or tread water calmly while waving your arms to attract attention. See instructional graphic on next page.
- National Ocean Service. Rip current safety for kids. https://oceantoday.noaa.gov/ripcurrentsafety/.Accessed 30 May 2019.
- National Weather Service National Oceanic and Atmospheric Administration site. Rip current information. https://www.
weather.gov/mhx/RipCurrentsInfo. Accessed 30 May 2019. NHR
Summer Boating Safety: Sizing your Child’s Life Vest
Alife vest that is too large will ride up around a child’s face and fail to keep his head above water. If the vest is too small, it will not be able to keep the child afloat. To ensure a proper fit, first, make sure the vest specifications found on its label match the child’s size and weight. To test the vest size, properly fasten the vest on the child, then ask the child to hold his or her arms straight up over his or her head. Grasp the tops of the arm openings of the vest and gently pull up. There should not be any excess room above the arm openings, otherwise the jacket might ride
up over the child’s chin or face once in the water. The United States Coast Guard site lists several types of life vests that are suitable for recreational boating, but many are not suitable for nonswimmers or for those under the age of 16 years. Vests that are suitable for children have child-specific safety features and will be marked as such.
1. United States Coast Guard. How to choose the right life jacket. https://www.uscgboating.org/images/ howtochoosetherightlifejacket_brochure.pdf. Accessed 30 May 2019. NHR
A European study, recently published in the International Journal of Environment Research and Public Health, included 3,600 participants and found that adults who were less exposed to natural spaces during their childhood had lower scores in mental health tests compared to those with higher exposure.
SOURCE: Preuss M, Nieuwenhuijsen M, Márquez S, et al. Low childhood nature exposure is associated with worse mental health in adulthood. Int J Environ Res Public Health. 2019;16(10):1809.