Drowning results in more deaths among children ages 1 to 4 than any other cause except birth defects, according to the Centers for Disease Control and Prevention (CDC). Most of those drownings occur in home swimming pools.

"There are far too many water-related injuries and deaths, which is tragic, considering most can be prevented," says Ashanti Woods, MD, FAAP, attending pediatrician at Mercy Medical Center, Family Health Centers of Baltimore.

Woods and the American Academy of Pediatrics (AAP) offer the following pool safety guidelines:

  • Take turns supervising children in the water. "At least one pair of eyes needs to be on children in the water at all times, and the adult in charge should not be distracted by cell phones, socializing, drinking alcohol, or tending to household chores. Awareness is the best way to keep them safe," says Woods. "Most problems occur when adults assume someone else is watching the pool." Even a water-related accident that isn’t fatal—called a near drowning—can be serious: “Lack of oxygen to the brain can cause mild to severe developmental delays. Being submerged in the water for just a few minutes can cause permanent neurological [nervous system-related] damage."
  • While you’re on duty, watch kids’ faces. Children in distress may not realize they are in trouble, Woods points out. "Young children won’t call out for help or splash wildly to get your attention. They just sink. Drowning can be a quiet event," says the pediatrician.
  • Make sure children wear proper flotation devices. However, Woods doesn’t recommend water wings designed to fit around each arm separately: "They aren’t safe because the body’s weight is not evenly distributed, and there is a tendency for the swimmer to tip over. Traditional safety vests are more secure."
  • If you own a pool, become certified in CPR (cardiolpmonary resuscitation). "Everyone using the pool should at least be familiar with CPR. If you can’t take a course, watch the American Heart Association’s hands only CPR video online," Woods advises. (Watch it here).
  • Have children learn to swim. The AAP believes all children should learn to swim; but a child’s development greatly affects readiness. After the age of 1 is generally the best time to start lessons.

Here are some additional pool safety rules from Natalie Lane, MD, medical director of the Emergency Department of the Children’s Hospital of Georgia and the Georgia Regents University in Augusta:

A: Abide by the Rules

  • Don’t allow children to play or swim near pool drains, pipes and other openings.
  • When swimming is over and everyone is out of the pool for the day, remove toys and floats from pool area—they could attract children to the water.

B: Be Prepared

  • Have an emergency action plan with your children, and rehearse each family member’s role.
  • Make sure there’s a phone at the poolside in case of emergencies.

C: Childproof Your Pool

  • Install a self-latching and self-closing fence around the pool area. Fences should be at least 4 feet high.
  • Place a safety cover over the water area when the pool is not in use.
  • Keep rescue equipment, like a shepherd’s hook or lifesaving ring, poolside.
  • Install a pool alarm to alert you when children are near the water.
  • Have a qualified professional inspect drain suction fittings and covers on a regular basis to ensure they meet current safety standards.

In Case of Emergency

If a child is in trouble, here’s what to do:

  1. Remove the child from the water as quickly as possible.
  2. Administer back pats to dislodge water and clear the child’s airway.
  3. Call 9-1-1 or, better yet, have someone else do it while you start CPR (cardiopulmonary resuscitation).

"Blue skin is bad and signals a lack of oxygen," notes Woods. "Start CPR immediately and continue until help arrives." There have been cases where children have come back after several minutes of CPR chest compressions. "Even if the victim isn’t breathing, CPR continues to circulate the blood so that the organs receive some oxygen, and that is a good thing."

In spite of the dangers, Woods and his wife love entertaining other families poolside, and it can be a great source of summer fun: "When you take the proper precautions and closely supervise young swimmers, there’s no better way to spend a summer day."

The complete ABC’s of pool safety can be viewed here.

Ashanti Woods, MD, FAAP, reviewed this article.

Sources

Ashanti Woods, MD, FAAP. Interview on July 13, 2015.

"Unintentional Drowning: Get the Facts." The Centers for Disease Control and Prevention. Last reviewed May 15, 2014.

"A Parent’s Guide to Water Safety." The American Academy of Pediatrics. Updated May 11, 2015.

"Sun and Water Safety Tips." The American Academy of Pediatrics. Accessed July 19, 2015.

"Swimming Pool Safety." The American Academy of Pediatrics and Healthychildren.org. Updated May 11, 2015.

Parrish, Denise. "Know Your ABCs of Pool Safety." Georgia Regents University and Health Systems News. June 15, 2015.