Time to brush up on water safety

Now is a good time to review strategies to prevent drowning deaths in young children, especially in the two age groups where those deaths spike, toddlers and adolescents. Drowning is the leading preventable cause of death in children from 1 to 4, and then again in adolescents, especially boys, where it's the second-most-common cause of preventable deaths from 15 to 19, after car accidents.

The start of summer, especially after this strange lockdown year, makes for a good moment to review water safety.

Parents who have lost children to drowning and experts across the country call for a layered approach to water safety, including fences around pools; close, constant and capable adult supervision; swimming lessons; CPR training for parents and caregivers; and Coast-Guard-approved life vests.

The Centers for Disease Control and Prevention has not yet released national data on drowning rates for 2020, but there were concerns last summer that they might be higher than usual in several states. Nicole Hughes, who lost a child to drowning, pointed to the many families who bought pools during the COVID-19 pandemic, but also to the additional stresses on parents who were trying to work from home and to supervise older children who were learning remotely.

"Toddlers are slipping out unnoticed, reaching the pool more than ever now," Hughes said. She has heard stories, she said, about children who drowned the first time they ever climbed out of their cribs, or while families were unloading groceries.

"It is during the non-swim time when everybody's loading the car to start the vacation trip," she said. "When everybody's watching the kid, then nobody's watching," said Hughes, whose son escaped from a room that contained 12 adults, six of whom were physicians. "Without realizing it, subconsciously you're letting your guard down when there's a bunch of people around."

The essential messages haven't changed; parents need to be aware of the danger, and they need to understand that this can happen in any family; that small children can move very quickly, and that most home drownings — 70% — occur outside of "swim time." So the layers of protection for toddlers and small children include that supervision, but also four-sided fences around pools, deadbolts on any door that leads to the water, latches placed up high so only an adult can reach.

"So few people are aware that drowning is a big-kid problem too," said Dana Gage, whose son, Connor, drowned in a Texas lake at age 15. She is a member of Families United to Prevent Drowning, which shares many family stories. "When an older person drowns, it's typically in open water, and typically there's a lot of victim blaming."

People look for an explanation that involves reckless behavior, or intoxication, she said. Parents need to understand the importance of continuing to model safe behavior as their children get older. "Wear life vests, just as you don't get into a car without a seat belt," she said. "Just because your child knows how to swim does not mean your child is drown-proof."

Hughes said she worries that parents encourage children to believe that water is fun. And she said it is not enough to simply warn them about the risks. Some "swim classes" for kids may rely on flotation devices, or on having children swim from one adult to another — which won't necessarily help if no adult is there, Hughes said. And those lessons may convey only the message that water is fun, she said, without the attendant warning that it can also be deadly.

In an e-mail, she wrote, "When parents are trying to find a swim provider, especially for the age group most at risk (1 to 4), the most important question they should ask the swim instructor is: 'Will these lessons teach my child how to get to the surface and get oxygen independently?' "

Dr. Benjamin Hoffman, one of the authors of the American Academy of Pediatrics policy statement on drowning prevention, said he worries about the proliferation of backyard pools over the past year, when many community pools were closed because of COVID-19 — and about all the children who missed what would have been a year of swimming lessons last summer.