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New report identifies kids most at risk of drowning: What parents should know

In a review of the latest research, the American Academy of Pediatrics finds drowning is the leading cause of unintentional death in children ages 1 to 4.

Most drownings of American children occur in pools and spas, but when it comes to the youngest kids, those under age 2, drowning is most likely to happen in bathtubs and large buckets, a new report finds.

Another alarming statistic from the report: About 75% of all children and teens who die from drowning are male. Teenage boys are 10 times more likely to drown than girls.

In a review of the latest research on drowning, the American Academy of Pediatrics finds that it is the leading cause of unintentional injury-related death in American children ages 1 to 4 and it’s the third leading cause of unintentional injury-related death in those from 5 to 19, according to the report published in Pediatrics.

“The reason drowning is the leading cause of death in children aged 1 to 4 is that they are impulsive; they’re not really good at following rules; they are built to explore the world; and water is really fascinating,” said report co-author Dr. Ben Hoffman, chair of the American Academy of Pediatrics Council on Injury, Violence and Poison Prevention and a professor of pediatrics at Oregon Health and Science University. “With the briefest lapse of supervision they can get into the water.”

When it comes to the littlest kids, parents or caregivers may leave them alone in the bath for a very short period of time, perhaps to answer the door or the phone, Hoffman said. “Twenty or 30 seconds alone can be enough to lead to absolute tragedy,” he added. “The message there is you should never ever, ever, ever leave an infant in any water alone.”

How to prevent drownings:

The main message from the report is that prevention must be multilayered. “There isn’t one single thing parents can do to drown proof their children," Hoffman said. “Supervision is absolutely essential but it’s not going to be enough. One thing we do know is that children who have had some training in water safety are less likely to drown than those who have not.”

Families need to have a water safety plan, which will be based on their kids and on what kind of exposure the kids have to water. “Families with a backyard pool will be different from ones that don’t have one,” Hoffman said. “Families with a lake house will be different from those who don’t have one.”

Also recommended are the use of life jackets, four-sided fences with self-latching gates surrounding pools and emptying of all containers of water (like a bathtub) immediately after use.

Findings from the report include:

  • In 2018, 900 children and teens under age 20 died from drowning and 7,200 were seen at a hospital emergency department for a drowning event, with 35% either hospitalized or transferred for further care.
  • Approximately 15% to 30% of caregivers have reported leaving children younger than 2 years unsupervised in the bath for a period ranging from a minute to slightly over five minutes.
  • Children under age 5 who drown each year often have unexpected, unsupervised access to water, such as in a residential pool.
  • Drowning rates are higher in Black children and American Indian/Alaska Native children age 19 and younger. In swimming pools, Black children ages 5 to 19 were 5.5 times more likely to drown than white children of the same age.
  • Seventy percent of drowning deaths for children age 15 and younger occur from May through August. One report found that approximately half of drownings occurred between 4:00 p.m. and 6:00 p.m.

The new report “has made some very sensible and thoughtful recommendations on preventing drowning,” said Dr. Guohua Li, Finster Professor of Epidemiology and Anesthesiology and founder and director of the Center for Injury Science and Prevention at Columbia University’s Mailman School of Public Health. In fact, Li said, “the report could serve as a basis upon which the United States could develop a national water safety and drowning prevention plan.”

While the U.S. has lowered the rate of drownings by about 11% in the last two decades, “Australia has managed a 39% reduction in drowning death rates because they have a robust water safety action plan,” Li said.

“Drowning is completely preventable,” he added. “When it occurs there are only two really critical factors that determine outcome: No. 1: How soon can you remove the child from the water? And No. 2: How quickly can proper CPR be performed.”