Swimming lessons lower drowning risk in toddlers

The wisdom of enrolling toddlers and preschoolers in formal swimming lessons has been debated vehemently over the years. Some people believe even babies should be taught to swim to help protect against drowning. Others say swimming lessons too early in life could decrease a child's fear of water and give parents a false sense of security, thus increasing a toddler's risk of drowning. However, until now, there was no scientific data on the protective effects of swimming lessons in children ages 1 to 4.

A long-awaited study published today concludes that swimming lessons for children ages 1 to 4 lowers the risk of drowning. The study, conducted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, looked at the association between drowning and swimming lessons in children ages 1 to 19 in six states. Interviews were conducted with the families of 88 children who drowned between 2003 and 2005 and with the families of 213 control children who were the same age, gender and lived in the same county as those who drowned.

The study, published in the Archives of Pediatric and Adolescent Medicine, found that among the 61 children ages 1-4 who drowned, 3% had ever taken formal swimming lessons. In contrast, 26% of the children in the control group  had taken swimming lessons. Parent interviews also suggested that children who drowned were less skilled swimmers. Only 5% of them were able to float on their back for 10 seconds compared to 18% of the children in the control group. "From our calculations, we are confident that swimming lessons do not increase drowning risk in this age group and likely have a protective effect," Dr. Ruth A. Brenner, the lead author of the study, said in a news release.

Among children ages 5 to 19, 27% of those who drowned had taken swimming lessons compared to 53% of the control group. This also suggests swimming lessons for older children are protective, but the difference between the two groups was not statistically significant.

Drowning is the second most common cause of death in people ages 0 to 14 in the United States. Although  the American Academy of Pediatrics has refrained from recommending for or against swimming lessons in younger children, the new study may provide grounds for favoring lessons for toddlers. Future studies should be done to clarify the protection afforded to older children who take swimming lessons,  Dr. Frederick P. Rivara, a University of Washington pediatrician, said in an editorial accompanying the study.

"Other interventions to prevent drowning are also important, such as pool fencing, use of personal flotation devices, and supervised swim areas. Swimming lessons should not replace these other strategies nor should they substitute for adult supervision and vigilance. However, formal swimming lessons offer an opportunity to make a real difference in communities around the globe to prevent the sound of happy children splashing in the water from turning into the wail of an ambulance siren or the sound of a parent crying in grief."

-- Shari Roan

Photo:  Mel Melcon / Los Angeles Times

Comments

[Harvey Barnett, Ph.D.]

As a behavioral scientist working for the last 43 years to prevent drowning deaths and near-drowning scenarios that involve infants and young children, it is encouraging to see that the ground breaking study recently published in the Archives of Pediatric and Adolescent Medicine was introduced with an editorial comment titled, ”Drowning Prevention, the time is now.” Sadly, the strategy used for the last several decades consisting of supervision, pool fences and CPR has done little to reduce the growing number of children under age 5 in the United States who drown or nearly drown every year. That strategy has also done little to reduce the $3.4 billion spent every year for the medical care associated with near drowning survivors under 5 years of age.

Dr. Brenner’s work in the area of drowning prevention has consistently led to policy change and rethinking by medical and aquatic safety organizations. Her technical report, “Prevention of Drowning in Infants, Children, and Adolescents” published in Pediatrics in 2003 preceded the AAP policy Statement for Drowning Prevention. This new case study, “Association Between Swimming Lessons and Childhood Drowning” published in the Archives of Pediatric and Adolescent Medicine, 2009, should serve as the starting point for the vital studies that must follow if we are to solve the problem of pediatric drowning. To move this initial study forward, we must have a concentrated effort that includes work from several disciplines.

A more inclusive definition of drowning and its more immediate and accurate reporting would be of great benefit. The last year for data on morbidity and mortality from the CDC is 2005.

We must have operational definitions for the various types of aquatic instruction infants and young children are exposed to in the United States and how those various approaches contribute to the noted reduction in drowning risk supported by Dr. Brenner’s study. Those six approaches, with different goals and objectives, are as follows:

1. Structured play
2. Water adjustment classes
3. Swimming readiness
4. “Swimming with devices”
5. Survival swimming
6. Modified adult swimming stroke

Regardless of whichever particular approach further research shows contributes most to the reduction of the risk of drowning, care giver and parent education must be a primary effort. Lessons for infants in the water whether formal or not must include comprehensive and effective adult education. The programs should aim to make the baby safer in the water and the family safer around it. In that, our research has shown segmented supervision, permanent pool fences with gates that are spring loaded and fitted with tamper-proof alarms and the engineering of the aquatic exposures and environment to complement the survival swimming instruction for the young children has worked without mishap for over 175,000 families since 1966.

We look forward to contributing to the growing body of research that Dr. Brenner’s study has imitated such that we can all look to a day where not more child drowns.

Harvey Barnett, Ph.D.
Founder, Infant swimming Resource LLC

[Maggie Brown]

Preventing the accidental death in children under 5 is my passion. I wholeheartedly agree targeting the parent and caregiver is essential to prevent drownings as well as deaths due to auto accidents, the #1 Killer, and other PREVENTABLE causes of accidental death in children under 5. I continue to find resources aimed at schools, specifically school age children and teachers, when most of these fatalities involve children under 5! We have to reach out to new parents and caregivers of small children and I specifically am pushing the elimination of "group accountability" of the child while adding multiple layers of protection. I too look forward to the day when these tragedies are no more... Maggie Brown Founder, Alive Past 5, LLC.

[Greg Friedman, Founder SwimSafeUSA, ThinkWaterSafety.com]

Fantastic research and article. Professional Swimming Instructors and Swim School operators have been teaching survival swimming and water safety skills to children as young as 18 months for decades. Professionals in the learn-to-swim business have witnessed and understood the value of swimming lessons first hand. Children who learn to swim and participate in Swim Classes develop a healthy and fundamental respect for the water. SwimSafeUSA and the Dolphin Swim School promotes drowning prevention in all communites. Attention parents: ThinkWaterSafety and remember: BLOCK+GUARD+TEACH=ZERO DROWNINGS. BLOCK access to the pool. GUARD/Watch children in or around the water at ALL times. TEACH-teach your child suvival swimming and self-rescue skills. Children who take swimming lessons and learn SwimSafe are more secure and careful around the water.