Children Under Age 4 Are at Highest Risk For Drowning

Swimming lessons and parents' vigilance are crucial for preventing drowning injuries and death among young kids.

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It’s almost summertime, and that means water sports and long afternoons spent by the pool. Water safety becomes increasingly important this time of year, especially for very young children. Drowning is the leading cause of injury death in children ages 1 to 4, according to a Centers for Disease Control and Prevention (CDC) report released Thursday.

In the last decade, drowning rates in the U.S. have declined. But that’s not reason to let down your guard, particularly if you’re a parent of a little kid. Children between the ages of 1 to 4 have the highest rates of both fatal and non-fatal drowning, according to the report, with 50% of fatal incidents occurring in swimming pools.

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The CDC analyzed death certificate data from the National Vital Statistics System and injury data from the National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP) for the years 2005 to 2009. Their findings show that each year, an average of 3,880 people died due to drowning and an estimated 5,789 people were treated in U.S. hospital emergency departments for non-fatal drowning.

“Hospital treatment is really high, but unlike other injuries in which hospital care can make a big difference, hospital care doesn’t tend to alter outcomes [for drowning cases],” says study author Dr. Julie Gilchrist, a pediatrician and medical epidemiologist with the Division of Unintentional Injury Prevention in the National Center for Injury Prevention and Control. “A lot of victims survive but are left with consequences like delayed brain functions and disabilities.”

Among the report’s findings:

  • Drowning resulted in more deaths among 1- to 4-year olds than any other cause except birth defects.
  • Incidents in bathtubs accounted for approximately 10% of fatal and non-fatal drownings and were most common among children ages 4 and younger.
  • Males account for approximately 80% of fatal drowning victims. The researchers speculate it’s due to men overestimating their swimming abilities.
  •  The drowning rate among blacks is 9% higher than that of the overall population. Among those ages 5 to 14, the drowning rate is 116% higher than the overall population.

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Since swimming pools are a high-risk location for young kids, the research team recommends early formal swimming lessons and learning basic water survival skills like the ability to right oneself after falling into water and how to tread water and float. “When kids are supposed to be in the water, the best prevention is parents’ eyes on their children the entire time and kids’ own swimming skills,” says Gilchrist. “Some parents do not realize how quickly and quietly drowning can occur. You cannot just keep an ear out. Lifeguards are there for emergencies, but parents need to be the first line of defense.”

Some argue that initiating swimming lessons early can increase young kids’ drowning risk. However, a study in Bangladesh found teaching basic water safety survival skills in kids ages 4 and under significantly reduced drowning rates. Other U.S. and China studies found similar results for formal swimming lessons.

“When you get into drowning rates for adolescents and adults, other things can contribute like alcohol use and risky behavior, but for children, it really is a lack of swimming skills,” says Dr. Gilchrist. “We need basic swimming skills in all children.”

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Here are some drowning prevention tips for kids from the CDC:

  • Learn life-saving skills.  Everyone should know the basics of swimming (floating, moving through the water) and cardiopulmonary resuscitation (CPR).
  • Fence it off. Install a four–sided isolation fence, with self–closing and self–latching gates, around backyard swimming pools. Pool fences should completely separate the house and play area from the pool. Gilchrist recommends extra precautions for any nearby body of water including backyard ponds.
  • Make life jackets a “must.” Kids should wear life jackets in and and near all natural bodies of water even if they know how to swim. Weak swimmers should also wear life jackets around pools.
  • Be on the lookout. When kids are in or near water — including bathtubs — they should be closely supervised at all times. Adults watching kids near water should avoid all distracting activities.

The study was published in the CDC’s Morbidity & Morality Weekly Report.