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When still pregnant with my first child, being a triathlon world champion, I was already eager for him to learn to swim and love the water as soon as possible. We also had a pool at our house, which I knew added the risk of drowning. I immediately started researching swim instruction methods and some of the survival techniques described were highly criticized as causing trauma. A friend enrolled her 12-month-old son in a swim survival program in the USA and by the end of the 4-5 week course, her son screamed when he saw a pool from a distance. She had to enroll him with an alternative private swim instructor for her son to like the water again. I thought to myself, “Can a child be safe but also have a passion for water just like I did?

More than 90% of drownings occur in low and middle income countries. Drowning is the leading cause of accidental death in children ages 1-4 globally, including in the USA. This age group is at highest risk because they are ambulatory and curious, but don’t fully understand the risks of the world around them. For the last two decades, sadly, the number of these tragedies continues to rise. Death by drowning can be particularly heartbreaking for families and its effects reach beyond just the immediate grief. Drowning can affect the whole community: police, paramedics, doctors, nurses, it truly breaks people's hearts.

There is no one single solution to prevent drowning in this age group. The National Drowning Prevention Alliance has outlined five layers of protection: 1) Adult Supervision, 2) Barriers and Alarms, 3) Water Competency, 4) Personal Flotation Devices, and 5) Emergency Preparation. While most of these are straightforward, water competency (swim lessons) in young children can be more complex. Parents must decide when to start their kids in swim lessons and navigate the myriad claims of swim schools and teaching methods. The current recommendation from the American Academy of Pediatrics is that “all children should eventually learn to swim” and can enter formal swim lessons when they are “developmentally ready”. Some children aged 2-4 years are developmentally able to perform some swim strokes, but for most kids, this doesn’t occur until age 5 or 6. That leaves a vulnerable gap between birth and 4 years old where drowning risk is the highest and the skills to survive a fall into the water are necessary. Swim to survive programs are one of the niches that fill this gap.

The five layers of drowning prevention. (National Drowning Prevention Alliance)

Little kids float naturally because of their high body fat and surface area. There is nothing especially difficult about floating, it just requires them to “lay back, open arms and legs, and relax”.  While “easy”, any parent will tell you that asking your child to “relax” in a floating position can be a seemingly impossible task! Floating can be learned before they even learn to sit, between 3-9 months. Babies under 6 months of age will often actually relax in the floating position! Self-rescue skills, so called “float to live” courses, start around 9-10 months of age when they start to crawl or toddle on their own. Learning to roll from face down to face up while naturally floating can be life-saving for the unintentional fall into the water in this newly mobile group. Of course, we often provide our child with tools we hope they will never need, but could be the most important first skills they learn.

Three-month-old baby in the water adaptation and introduction to water course during the pandemic, 2022.

I have been teaching survival swimming to babies and toddlers for 20 years, since my children were born, which is why I naturally became an advocate for drowning prevention in my hometown, Guatemala City. We have four different courses depending on developmental age: a “water adaptation” and “introduction to water” course for babies as young as 4 to 9 months old. There is no exact timeline, and with lots of patience they eventually learn to balance themselves in the water while floating. After learning to float, if a child is developmentally ready (12-24 months old), they can learn the swim-float-swim sequence which will also be the foundation for eventually learning freestyle.

Toti teaching Luca, her first child, to float and swim in 2005.

Infant swim survival courses don’t have to be traumatic and don’t have to rely on just “throwing” them into the water and letting them “struggle” until they roll over to float. While that technique may work for some, I wanted to find a different way for my kids. It was important for me that in addition to being safe, I wanted my kids to develop a love for the water, so I thought about this “work and reward” system: 10-minute class and 10-minute play. 

"Work and reward” system: Left – work: 10 minutes class followed by right – reward: 10 minute play in the shallow end with water toys.

We have many success stories of learning to float and swim from happy parents and children and also some real survival stories too thanks to these self-rescue courses. One of the most memorable was Mia. By the age of 3, she had done conventional swim lessons as well as the “mommy and me” courses, but always swam with arm “floaties”, or direct contact with a parent or caregiver. She had no prior experience swimming unsupported. The family was vacationing and playing by the pool when the parents had the gut-wrenching terror of looking to the pool and seeing her “floaties”, but not Mia. After being pulled to the surface and receiving brief CPR, she was taken to a local clinic, then flown to the tertiary care center in Guatemala City. Fortunately, her submersion was brief and she was discharged 24 hours later, having survived with no neurologic morbidity. Mia’s parents, appropriately terrified of this ever happening again, immediately sought out swim lessons that emphasized survival. I met her just two weeks after her non-fatal drowning. Using a gentle teaching method, she was not afraid of being in the water and was able to float on her back and swim to the side within just three weeks.

Left: Mia, two minutes before her non-fatal drowning incident with the arm-floats still on. Right, Mia, a few weeks later independently swimming, floating, and practicing self-rescue skills.

My children are now 19 and 17, both now entering college. Fortunately, they both love the water and started lifeguarding at 16. On any given day, they can be found water skiing, wake boarding, surfing, kite surfing, paddle boarding, or SCUBA diving. I like to think that my early time in the water with them helped to set them on this path and that they can share their love of water safety with their friends and families of their own one day.

Toti and her sons: Luca, left and Liam, right, have always shared a special bond and love for swimming, water activities and water sports, 2011.

When it comes to finding the right course for your child, ask around. Look for skilled swimming coaches, ask for references, talk with the other parents, and former students. Trust your gut. Ask about the goals of that program. Is the goal for them to survive an unexpected fall into the water and float until help arrives? Or is the goal just comfort in the water until they can learn strokes for the swim team? No matter which swimming program you choose, start early! If you haven’t started yet (even as an adult), then it’s never too late to start. In addition to being fun, learning to swim can be a lifelong skill that reduces their chance of drowning and hopefully they can pass it on to their kids one day!




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