Make a Splash With Your Kids Over the Fourth

From the WebMD Archives

July 3, 2000 -- This holiday weekend, thousands of American families will escape the summer swelter and head to pools, lakes, and oceans for an interlude of watery fun.

But to make sure the mood stays carefree, experts say that before packing the beach bag, parents should take a moment to think about water safety. Most water-related deaths and injuries among children can be prevented, they say, and the bottom line is adult supervision.

"Toddlers and children love to play in water, but don't understand the dangers of drowning," says Heather Paul, PhD, executive director of the National SAFE KIDS Campaign. "And it can happen in just a matter of seconds."

Drowning is the leading cause of death in children under age 4, and happens most often in residential pools during the months of May through August, according to SAFE KIDS. Last year, there were nearly 1,000 child drownings.

Near-drownings can be almost as disastrous. "Lack of oxygen causes irreversible brain damage after four to six minutes of submersion," says David Fagin, MD, the medical director of emergency services for Children's Healthcare of Atlanta at Scottish Rite Hospital. "And almost 20% of near-drowning survivors have permanent neurological disability."

Among its prevention tips, SAFE KIDS recommends that pools be fenced on all four sides and that a telephone be at poolside at all times. Water-safety instruction for children is also advised, although some say swimming lessons can give parents a false sense of security.

"A recent study showed that kids under the age of 4 need more swimming instruction and are limited by their physical capacity," says pediatric sports medicine specialist Eric Small, MD. "So lessons for infants and toddlers don't necessarily translate to rapid mastery." Small is a member of an American Academy of Pediatrics (AAP) injury prevention committee and an instructor at Mount Sinai School of Medicine in New York.

Nor do they decrease the risk of drowning. "Aquatic readiness programs help toddlers adjust to the water, but don't include strokes or proper breathing," says Arnie Collins, a spokesperson for the YMCA of the USA. "They're not intended to drown-proof children, because only an adult can prevent a drowning."

For these reasons, the AAP recommends swimming lessons as kids approach their fifth birthday. To prevent drowning, it also urges adults to remain within an arm's reach at all times, providing what the YMCA calls "touch supervision."

"YMCA swimming lessons and Splash classes are a great way for school-age kids to learn about water safety, but constant supervision is still the bottom line," says national aquatic director Laura Slane.

Last August, one family learned this lesson the hard way. Upon returning from work to her Avenue, Md., home, Janet Murphy found her 2-year-old son, Alex, at the bottom of the family's above-ground pool. Her 17-year-old son, Michael, was babysitting, but got distracted for a moment while washing his car. But the story has a happy ending: Janet performed CPR, and Alex survived.

Because diving is one of the most dangerous water activities, SAFE KIDS advises against diving in above-ground pools and in depths less than five feet. Teaching children to dive with their hands in front of their faces is also recommended, as is swimming toward the surface immediately after diving. But even these precautions couldn't prevent a recent accident in Atlanta.

"My son fell through the diving board railing and fractured his skull," says Lucy Daniel, mother of 3-year old Davis. "Even though there wasn't any swelling or bleeding, he had seizures for an hour and needed a breathing tube," she adds.

"Davis was back in the pool just 10 days later, but now he wears swim shoes with heavy traction." Understandably, Daniel urges age limitations on diving board use.

Similarly, doctors advise that young children be prohibited from using the personal watercraft known by names such as Jet Ski, Sea-Doo, or Waverunner. Because deaths and injuries related to these devices are increasing in children and adolescents, the AAP recommends a minimum operating age of 16 and mandatory use of flotation devices.

"Most of these incidents involve collisions with other vessels, docks, or tree stumps," says Marilyn Bull, MD, chair of the AAP injury prevention committee and professor of pediatrics at the Indiana University School of Medicine. "And three studies cite inexperience, inattention, excessive speed, and recklessness as factors that lead to accidents."

One trauma surgeon applauds these prevention efforts. "In Florida, we see too many of these accidents," says David Shatz, MD, an associate professor of surgery at the University of Miami School of Medicine. "Lacerations account for most of the injuries, followed by fractures and head trauma.

"Given the high speed of personal watercraft, it's amazing that protective gear isn't required," he says.

Bull says it's not yet clear what kind of helmet gives the most protection to personal watercraft riders. "Some professional riders wear helmets, but more research is needed to determine which type of helmet provides the best protection," she says. In the meantime, the Personal Watercraft Industry Association recommends wearing a wetsuit, gloves, protective eyewear, and footwear.

Water safety regulations are also expanding in many areas. In 32 states, children are required to wear flotation devices when they are on watercraft or near open bodies of water. Arizona, California, and Oregon also require fencing around residential pools.