[Skip to Navigation]
Sign In
Advice for Patients
March 2, 2009

Water Safety and Swimming Lessons for Children

Arch Pediatr Adolesc Med. 2009;163(3):288. doi:10.1001/archpediatrics.2008.572

Drowning is the second leading cause of unintentional injury death for children and adolescents. The American Academy of Pediatrics encourages parents to teach their children to swim by 5 years of age to reduce these risks.

Risk factors for drowning

Children younger than 1 year are most at risk for drowning in bathtubs, buckets, or toilets. Children aged 1 to 4 years are most at risk for drowning in swimming pools. Older children and teenagers are most at risk in natural water settings such as lakes, rivers, or the ocean.

Each year many boating accidents lead to drowning; most people who drown are not wearing life jackets.

Alcohol use is involved in up to half of teenage and adult deaths associated with water recreation.

Children with seizure disorders have a much higher risk of drowning; the bathtub is the site of highest drowning risk.

What can i do to protect my child?

Assign a responsible adult to watch young children while in the bath, as well as all children who are playing or swimming in or around water. Supervising adults should not be involved in any other distracting activity during this time (such as telephone conversations or reading) and should not drink alcohol. Supervision for children younger than 5 years should include being within arm's length reach (“touch supervision”) at all times.

In the time it might take for paramedics to arrive, your CPR skills could make a difference.

Do not rely on floatation devices such as water wings, noodles, or other foam or air-filled toys in place of life jackets.

  • Install a 4-sided isolation pool fence with a self-locking gate that completely separates the house and play area of the yard from the pool area.

  • Remove toys from the pool and surrounding area immediately after use.

  • For hot tubs and whirlpools, use a rigid lockable cover or fence on all 4 sides, as you would for a swimming pool.

Though swimming lessons cannot be the only method of drowning prevention, especially in children younger than 5 years, a current study in this month's Archives found that swimming lessons may help protect against drowning in the 1- to 4-year age group.

Swimming lessons for infants and toddlers

Aquatic programs for young children are popular; an estimated 5 to 10 million infants and preschool children participate in formal water instruction programs in the United States. Infant and preschool programs have been developed by organizations such as the American Red Cross and the YMCA. Most programs focus on water adjustment and swimming readiness skills and may also include water safety instruction for parents. All aquatic programs should include information on the cognitive and motor limitations of infants and toddlers, the risks of water, the strategies for prevention of drowning, and the role of adults in supervising children in and around water at all times.

For more information

American Academy of Pediatrics http://aappolicy.aappublications.org/cgi/content/full/pediatrics;105/4/868http://www.aap.org/healthtopics/watersafety.cfm

Centers for Disease Control and Prevention www.cdc.gov/ncipc/factsheets/drown.htm

Inform yourself

To find this and other Advice for Patients articles, go to the Advice for Patients link on the Archives of Pediatrics and Adolescent Medicine Web site at http://archpedi.ama-assn.org/.

Box Section Ref ID

The Advice for Patients feature is a public service of Archives of Pediatrics and Adolescent Medicine. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child's medical condition, Archives of Pediatrics and Adolescent Medicine suggests that you consult your child's physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Sources: Centers for Disease Control and Prevention and American Academy of Pediatrics