The leading cause of death IS …

Summer is here, the results are in, and a recent CDC study confirms that the leading cause of accidental death in children under 4, second overall only to birth defects, is … accidental drowning. And most of the time it’s entirely preventable.

Drownings occur in males four times more often than in females (those active, distractible little guys scoot past in a nanosecond) , and half of child drownings occur in swimming pools, often in plain sight of adults.

Some tips from the American Academy of Pediatrics:

–Safety gates and locks and swimming lessons are a must.

—All caregivers should learn CPR.

—Never leave a toy in or around a pool.

—Never leave a child alone in or near a pool.

—Make sure an adult is always within arm’s length.

—Children ages 1 to 4 years old should take swimming lessons. But remember that teaching children to swim does not guarantee their safety in the water.

—Teach children to never run, push, or jump on others around water.

—Teach them never to swim alone.

—Keep a phone by the pool, along with rescue equipment, such as a life preserver and a shepherd’s hook — a long pole with a hook at the end.

—Pools should be surrounded by a fence at least 4-feet high. Pool gates should self-close and self-latch at a height unreachable by small children.

—If you have an inflatable or plastic pool, empty it after each use and turn it upside down.

This is simple, straightforward prevention that’s easy to put in place. What’s missing is a description of what’s at stake — the overwhelming devastation when a small child finds his way into big water. It happens in the blink of an eye, often in the most watchful of families.

During my time in a Pediatric Intensive Care Unit in Orange County, California (home to many thousands of back yard swimming pools), I saw the wreckage more times than I can count. It always started the same way, with a call from the ER alerting us to an incoming ambulance or helicopter.

They’re always called near-drownings, because no matter how many minutes a kiddo is down there’s always an all-out attempt to bring them back. Many times you don’t know for sure how long it’s been. The magic number is Four Minutes, because after that the damage to the brain is considered devastating and irreversible, but it doesn’t matter; you still go for the save every time.

Kiddo arrives at the ER wet, limp, unconscious and pale. Pale means white. As white as your computer screen. No blood flow to the skin, because that little body is doing its best to keep blood supply to vital organs — the brain and the heart. Often there’s a paramedic perched atop the tiny form, actively performing CPR. It’s an eerie, disturbing vision that I still see in my sleep  sometimes.

Shortly after Kiddo arrives his parents come running through the sliding doors. Distraught and near-hysterical, it’s almost impossible to get through to them and explain their child’s condition. You talk slowly and repeat each piece of information. The happy, active toddler who was running around the yard (or party or water park) minutes ago is now lifeless, rapidly being consumed by the trauma team and their life-sustaining equipment.

If the resuscitation is successful, and Kiddo is stabilized, a breathing tube pushing each breath into soggy lungs and powerful drugs maintaining blood pressure that has dropped below a number compatible with survival, he will be sent to intensive care and the ‘watch’ will begin. Will he be one of the lucky ones who wakes up in the first 24-48 hours as if nothing has happened, or will he go day after day in a state of suspended animation without evidence of consciousness while his parents hope against hope that he’ll come back to them?

For some, a decision will be made whether or not to continue life on the vent. For others, spontaneous breathing will return and be cause for celebration, only to turn out to be the last natural activity that does. Ever. The truth is, there are some things worse than death.

This is the reality for more than 5,000 children in the US each year. 15 percent will die in the hospital. Another 20 percent will suffer severe, permanent neurological damage. Of all preschoolers who drown, 70 percent are in the care of one or both parents at the time of the drowning and 75 percent are missing from sight for five minutes or less.

Summer is here. Take another hard look at the list above. Protect your precious Kiddo.





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Ellen and Rachel are two old friends and “expert” mamas—one a pediatrician and one a family therapist—with fifty years of parenting experience between them.

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