We were on the waitlist for swim lessons for over a year. Once off the list, F went in for the first lesson (pictured here) jumped in, did a great job, and then refused to ever go back in again. We went every week, twice a week, sat on the pool deck, and watched his peers swim. We waited. We watched. He often tantrumed. Parents stared. Friends commiserated. My mom tried to tell me what to do.
But then for the last class, last week, auspiciously F jumped back in again and gave it a go. Nothing is ever quite what I expect to be. When it comes to swimming lessons, at least in my world, everyone has an opinion and maybe a plan.
Yesterday, the AAP published a revised policy statement about the prevention of drowning. Most noteworthy, they have lifted the recommendation against swim lessons before the age of 4 for most children. With a cautious brush stroke, the AAP has painted the picture that swimming lessons are okay after age 1, depending on physical, emotional and developmental maturity. For most children, it is okay to start lessons after age 1. Really, it’s up to you if you feel your toddler is ready to take the plunge.
Some background: pediatricians have previously advised that swimming lessons did not protect against drowning in toddlerhood. The AAP went so far as to discourage swim lessons before age 4. Basically, research and insights from drowning experts found that swim lessons may give parents and toddlers a “false sense of security” around water. There was also no evidence proving swim lessons early in life made for earlier proficiency in swimming. And prior to 2009, there was no data to say that lessons decreased the likelihood of drowning. Doctors felt that if toddlers were out of arm’s reach, or their parents were distracted while their child was near any water, a toddler could easily fall into a pool, march into a lake, or slip out of arms reach and the unthinkable could occur. A drowning.
There are two groups of people that drown the most: toddlers and male teenagers. In teenagers, alcohol plays a big role. In 2006, 1100 children drown in the United States. So this is serious and not just someone else’s problem to deal with.
There is no disputing that an infant or toddler can have a drowning event in a mere seconds. This is still and will always be the case. However, how I council about swimming lessons all changed when a thorough and nicely done study published last year found that formal swimming lessons between ages 1-4 years of age conferred a 88% reduction of risk from drowning. This is not true for informal lessons (the kind you and I could teach). So we still need to pay the trained pros to instruct our children. I wrote about the study in a blog post about infant swimming back in February. With proper supervision, swimming (when your child agrees to enter the water!) can be a sincere delight.
The AAP has changed its recommendation and endorsed swimming for most toddlers partly because of the above study and also due to a Chinese study that revealed similar drowning protection.
Things To Consider For Infant and Toddler Swimmers
- Never leave your toddler or child even for a moment without supervision when in or around pools, spas, beach fronts, irrigation ditches and any open standing water.
- Whenever swimming, your infant or toddler should always be an arm’s length away. A supervising adult, with swimming skills, should provide “touch supervision.” That means you have to get in the pool with them. Really and truly. Don the suit…
- Be cautious about blow up or big inflatable pools because those often don’t have fences and protection around them to protect children from entering. And children may lean over and fall into them unintentionally.
- Lots of pediatricians support infant and toddler swimming. But they support being very careful. Most pediatricians have had to care for a drowning victim. It’s awful.
- Potential dangers include body (arms and legs) entrapment or hair entanglement in drains of pools and spas. Be aware of the risk and encourage friends or pool owners to install drain covers to protect against this. Safe Kids USA is a good place to go for help.
- Remember that swimming lessons do not provide “drown-proofing” for children at any age.
- Parents, caregivers and pool owners should learn CPR.
My rule of thumb: never trust infant or toddler swimming lessons as protective against drowning. And never trust that if you sign up and pay for swim lessons that your child will get into the water. Armed with those two pieces of knowledge, you should all have a splendid summer.
Atta Boy, F! Atta Girl, WSS!
Dr. Swanson, I just found your blog and am thoroughly enjoying it! Both my kids are your patients but rarely see you because they don’t get sick much (knock on wood). We’ve really enjoyed your reassuring manner and great advice in the exam room and I’m glad to find it on the Internet, too.
Regarding swimming, both my kids took swim lessons prior to turning 1. We didn’t do it to “drown-proof” them; to this day, we don’t take our eyes off our youngest, who is 9, when she swims laps at the Y. We did it because both of them enjoyed the water and seemed to really benefit from the exercise they got in the water. Plus, it was a great way for them to burn energy by going to an indoor pool on a rainy day.
I’m curious to find out if the AAP has any official stance on the health benefits (or harm) of having young children do swim lessons. Right now their statement seems to be made solely on the basis of water safety, which I appreciate, but it would be nice to hear the health opinions on this as well.
Wendy Sue Swanson, MD says
Health benefits are discussed but the AAP works to provide guidelines for safety and protection of all children. Physical excercise (especially bc of the high rates of obesity in US) remain a priority but when they talk about water, they will usually frame it as a safety issue. If you read my earlier blog re: swimming, I addressed just your point—that it is an enjoyable way to exercise and swimming really is a lifetime sport. I loved swimming with my boys when infants and now as they are toddlers. It’s a hoot!
So, it sounds like you have all benefited from the early swimming and you’ve done a great job prioritizing safety. Trust your instincts on both—you’re doing it right!
It5’s great to see more evidence in favor of younger swim toddler lessons. Now I at least have something to tell people who will look at me funny when I tell them my baby is swimming.