When a child goes under in a bathtub or pool, is pulled out and starts crying, relief is natural. But if water may have been breathed in, breathing problems can appear later, so an evaluation is sometimes needed. This article covers rescue first aid, when to go to the hospital and prevention.
Why It Happens
The Centers for Disease Control and Prevention (CDC) reports that drowning is the leading cause of death for children ages 1 to 4. Among children aged 1-4, drownings happen most often in swimming pools, and the drowning rate for ages 1-4 in 2022 was 28% higher than in 2019. Children often slip under silently rather than splashing and calling out, so a nearby adult may not notice. When water reaches the lungs, it interferes with oxygen exchange.
How It Differs by Age and Stage
Infants can drown in a bathtub or bucket, toddlers most often in home pools, and older children more often in natural water such as lakes and oceans. Non-fatal drownings treated in emergency departments are reported to be far more common than drowning deaths. Terms like “dry drowning” and “secondary drowning” are not recognized medical diagnoses; what matters is whether a child has cough, trouble breathing or unusual sleepiness after being under water.
What to Do at Home
Call 911 and check whether the child is breathing. AAP and American Heart Association guidance says a person pulled from the water without normal breathing or responsiveness should be presumed to be in cardiac arrest, and trained rescuers should give CPR with breaths and compressions. If you cannot give breaths, chest compressions alone are better than nothing until help arrives. A conscious child can be kept more upright to reduce vomiting; remove wet clothes and keep the child warm. Anyone who needed any level of resuscitation should be taken to a hospital for evaluation and monitoring. For prevention, the CDC recommends four-sided fencing at least 4 feet high with self-closing, self-latching gates, which is reported to lower risk by 83% compared with three-sided fencing. Swimming lessons reduce risk, but children who have had lessons still need close, constant supervision.
Common Misunderstandings
Many assume that a child who cries or talks is fine, yet breathing symptoms can show up later. Some try to make the child vomit up water, which is not recommended. Others believe floaties or a life jacket mean an adult can look away. And many expect drowning to be loud, when it is often quiet.
When to Seek Care
Go to the emergency room right away if, after being under water, the child has trouble breathing, a persistent cough, blue lips, vomiting, drowsiness or limpness. If the child was unresponsive or needed rescue breaths or compressions, an emergency evaluation is needed even if symptoms settle. After a very brief dunk with immediate normal breathing, call the pediatrician or a nurse line to ask about monitoring. This information is based on U.S. sources; if you live elsewhere, check with a local pediatrician. This information isn’t a diagnostic tool and doesn’t replace advice from a medical professional.