Can a child be water safe?

In South Africa, a large percentage of h omes has swimming pools. Drowning risk is a very real reality. The thought instils fear in any parent. It is a valid fear though. In the US, drowning was the second leading cause of unintentional injury death among children between 1 and 19 years old. That is a scary statistic. Fortunately, most victims (90 – 95%) of nonfatal drowning do well, but severe long-term neurological deficits are seen with extended submersion times and lack of early by-stander initiated CPR.

So, the first practical application here is – do a CPR course both for infants, toddlers and children to ensure if such an event had to occur that you are able to respond immediately and prevent long term injury and brain damage.

Parents wonder how they can prevent drowning from occurring?

Groups such as the National Drowning Prevention Alliance have proposed the concept of multiple “barriers” between water environments and prospective drowning victims, particularly young children, ages 1-5 years. The multiple barriers proposal arose from the recognition that NO SINGLE VARIABLE explains the majority of drowning experiences. The need for multiple barriers to water results from the fact that although we can identify a number of factors that could contribute to drowning incidences (e.g., lack or momentary loss of adult supervision, excessive ease of access to water such as inadequate fencing around backyard pools or no childproof locks on windows or doors), NONE OF THEM ALONE is sufficient to prevent drowning.

Swimming lessons or so-called ‘water safety’ programmes alone are not adequate, or a reason for you to be complacent with your little one around water sources. There can be no doubt that knowing how to swim can be a powerful deterrent to drowning but the recognition of the complexity of drowning factors is an important realization.

Consider the diagram below:

Individual characteristics at the peak angle of the triangle illustrate the personal qualities that any human brings to aquatic endeavours. These include a person’s/child’s size, body segment relative proportions, their force production capabilities, their body composition, the state of their nervous system including consciousness, and a host of other relevant abilities/disabilities. There are massive differences in gross motor skills when comparing a 1 year old to a 3 year old for example.

The bottom right angle of the triangle represents the conditions of the aquatic environment including the type of facility or lack of facility, the water depth, the water and air temperature and relative humidity etc.

Finally, the bottom left angle of the triangle in represents the factors associated with the task(s) being performed in the water, including the swimmer’s goal, presence of any equipment (e.g., goggles, nose plug, kickboard, hand paddles, wet suit, or even clothing), and any relevant external expectations or rules (e.g., competitive stroke rules, pool rules).

Importantly, each of the three factors in this model of swimming or drowning prevention are “connected” or “linked” by the sides of the triangle, representing the so-called “constraints” or relationships among the factors. According to Newell’s model, it is the interaction among these relationships from which emerge swimming behaviours or conversely, drowning behaviour.

Regardless of how well we arbitrarily say the child “can swim,” it is this complex set of interacting constraints that shapes different sets of probabilities toward swimming and/or drowning.

Larger amounts of body fat create an enabling constraint with the aquatic environment to likewise support floating, if not swimming as well. . In contrast, wearing clothing or footwear as well as having very low body fat both serve as disabling constraints to the act of efficiently traveling through the water (a.k.a., swimming) when they interact with the density of the water environment and create additional drag and reduced buoyancy. Falling into warm water (in which swimming lessons are typically performed) vs. cold water will have a different reaction on overall physiology and ability.

A baby who can happily float on their backs in the water, get up from a step in the pool or submerge with a smile, won’t necessarily be able to react in the same way in different conditions. Keep in mind that the likelihood of transferring their skills from one simple situation to another uncontrolled one, has never been conclusively demonstrated with any scientific evidence.

In summary, perform a CPR course in order to respond quickly in an emergency situation and integrate as many ‘barriers’ as possible to prevent drowning:

• Supervision

• A net over the pool

• A fence around the pool

• Lockable doors inter-leading to the pool area

• Baby swimming/Water Safety/Water Awareness Programmes

Do not rely on a single barrier and do not assume because your baby can comfortably perform certain aquatic skills that they are completely “drownproofed”...

References:

Langendorfer, S., 2011. Considering Drowning, Drowning Prevention, and Learning to Swim. International Journal of Aquatic Research and Education, Vol 3. No. 3, 1-9.

Brenner, R., 2003. Prevention of Drowning in Infants, Children, and Adolescents. AMERICAN ACADEMY OF PEDIATRICS, 113, 440 - 445.

Weiss, J., 2010. Technical Report—Prevention of Drowning. AMERICAN ACADEMY OF PEDIATRICS, 126, 253- 263.

Photograph: http://aquasplashtots.co.uk/