Drowning: What parents need to know before taking their child swimming

What people recognize as traditional drowning is a leading cause of unintentional death worldwide, according to the Centers for Disease Control and Prevention (CDC).

Drowning, which the World Congress on Drowning defines as “a process resulting in primary respiratory impairment from submersion/immersion in a liquid medium,” is the number-one killer of children aged 1 to 14 years old in the United States.

An estimated 80 percent of them are preventable.

Parents may be unaware that swimming dangers don’t necessarily end once the child leaves the pool. Panicked parents may have read online about how “dry drowning” can impact a person’s health hours after a swim.

If someone looks for the term on the CDC's website, however, chances are that their search will come up short.

That is largely due to the fact that terms such as dry, secondary and delayed drowning are frowned upon by medical professionals.

“Unfortunately, [these terms have] gotten out there, but it’s sensationalizing it and I think it’s making it harder for parents to understand what to look for,” said Dr. Shoba Srikantan, a pediatric critical care attending at the Arnold Palmer Hospital for Children.

“We’re making it harder for them, and they’re getting more paranoid,” she said.

Authors of the Handbook on Drowning called for the abandonment of such terms, including “near drowning” and “wet versus dry drowning.”

“Sometimes secondary drowning is referred to as delayed drowning, where symptoms don’t occur right away, but these are not really great terms,” said Dr. Richard Lichenstein, professor of pediatrics at the University of Maryland School of Medicine and pediatric emergency doctor at the University of Maryland Children’s Hospital.

“Ultimately, they’re all forms of drowning,” he said.

The CDC reports that for every child who drowns, another five will be treated in the emergency room for non-fatal submersion injuries.

“Five times more, you’re going to see a child come to the ER who is going to walk out in a few hours, just because they briefly struggled under the water and maybe required CPR for a minute,” said Srikantan.

Srikantan said that either drowning or non-fatal drowning are the preferred terms.

“[For instance,] if a kid just learned to swim and briefly struggled underneath the water, but you pulled them out, they started coughing and didn’t need CPR, that’s non-fatal drowning,” she said.

In a 3-year-old child, as little as an ounce of water can cause problems, said Dr. Sanjay Mehta, board-certified pediatrician and division chief of CentraState Medical Center's Pediatric Emergency Department.

Mehta's family once had a worrying experience while vacationing.

As his young daughter splashed around in the pool, Mehta went to retrieve the toy that had floated away from her.

“I turned around [briefly] and two or three seconds afterwards, I thought, ‘I’m not hearing any noise from her,’” he said.

In the blink of an eye, Mehta spotted his child submerged beneath the water.

“When I picked her up, she was beet red, coughing quite violently, and she actually threw up,” he said.

His daughter seemed fine after a few minutes.

“But I was cognizant of the fact that I could’ve used that as a false sense of security and knew I should watch her for several hours, which is exactly what I did,” he said.

“This type of event does happen a lot, and we’ve just got to make sure we watch out for further complications,” Mehta said.

Doctors agree that death from this type of event is rare.

Symptoms that parents should recognize after their child has experienced a submersion event include coughing; appearing to struggle with breathing; vomiting; lethargy; change in color of their face; and an altered mood.

They typically occur within the first four to six hours, said Srikantan.

“Usually, they just need to be observed in the ER; they might need a little oxygen and then they’re fine,” she said.

Prevention is key in avoiding any type of submersion event, doctors said.

In addition to teaching children as young as 4 years old to swim, doctors recommend that children wear life vests and parents practice “touch supervision,” which means always ensuring the child is within an arm’s reach.

Doctors also recommended that pool owners install appropriate fencing to keep unsupervised children away from the water.

“They should be at least 4 feet high with a gate that self-latches and is out of [a child's reach],” Mehta said.

“It’s also important to have someone who’s a dedicated water watcher, [such as] a lifeguard,” he said.

Doctors also advised parents to remain vigilant and not to use swimming lessons as a false sense of security.

“We have to make sure to keep an eye on the child," said Mehta. "Generally, they will let us know that something is not right."

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