It’s just another typical day at the pool, until you see your 8-year-old son struggling in the water.
Without hesitating, you dive in, grab your son and pull him out of the water. You breathe a sigh of relief because he immediately coughs up water and is not experiencing any trouble breathing. He says those words every parent wants to hear: “Mom, I’m fine.”
After dinner and later that night, he rubs his eyes and says he’s sleepy. It’s almost bed time, so you think nothing of it. Before you turn in for the night, you check on him, and then panic sets in. He is having severe breathing difficulties.
This is the reality of what’s known as secondary drowning: It’s silent and may appear hours later.
“What makes secondary drowning quite scary is that a child may look well for 48 hours before its onset,” says Rupali Drewek, MD, a pediatric pulmonologist and director of the Sleep Disorders Center at Phoenix Children Hospital.
What happens during secondary drowning?
“When a small amount of pool water enters the lungs, it disrupts a substance called surfactant,” Drewek explains. “Surfactant prevents the lungs from collapsing. When the surfactant is disrupted, small airways collapse and airflow is restricted. Fluid leaks from the lung and fills the lung’s alveoli,” which are critical to the exchange of gases between bronchioles and pulmonary capillaries.
If this condition goes undetected or undiagnosed, it is fatal. Although these types of incidents are rare, parents need to pay attention when they witness their child in a near-drowning event. The signs of secondary drowning include fatigue, behavioral changes, cough and chest tightness and or shortness of breath.
“These symptoms can show up minutes or up to two days after the water first gets into the child’s lungs,” Drewek says. “It’s important to remain vigilant for 48 hours after a child has had a near-drowning event.”
Seek medical help immediately if symptoms are present. “There is no specific treatment for secondary drowning, but supportive care in a medical facility offers the best chance for survival,” Drewek says. Early detection improves the chances of a positive outcome.
“Drowning is one of the three leading causes of accidental death in children,” Drewek says.
Prevention is key. The American Academy of Pediatrics recommends swimming lessons for kids 4 or older, but acknowledges some studies show benefits to teaching kids earlier. Parents can start lessons with infants as young as 6 months at many local swim schools.
Drewek urges parents to “always remain within an arm’s length of a child” around water, “even during bath time.”