infant swimming

Most human babies demonstrate an innate swimming or diving reflex from birth until the age of approximately six months, which are part of a wider range of primitive reflexes found in infants and babies, but not children, adolescents and adults. Other mammals also demonstrate this phenomenon (see mammalian diving reflex). This reflex involves apnea (loss of drive to breathe), slowed heart rate (reflex bradycardia), and reduced blood circulation to the extremities such as fingers and toes (peripheral vasoconstriction). During the diving reflex, the infant's heart rate decreases by an average of 20%. The glottis is spontaneously sealed off and the water entering the upper respiratory tract is diverted down the esophagus into the stomach.{{cite news|last1=Winston|first1=Robert|title=The Human Body|url=http://topdocumentaryfilms.com/human-body/|access-date=18 August 2014|publisher=BBC|date=1998}}

The diving response has been shown to have an oxygen-conserving effect, both during movement and at rest. Oxygen is saved for the heart and the brain, slowing the onset of serious hypoxic damage. The diving response can therefore be regarded as an important defence mechanism for the body.{{cite journal|last1=Alboni|first1=Paolo|last2=Alboni|first2=Marco|last3=Gianfranchi|first3=Lorella|title=Diving bradycardia: a mechanism of defence against hypoxic damage|journal=Journal of Cardiovascular Medicine|date=Feb 2011|volume=12|issue=6|pages=422–427|url=https://www.researchgate.net/publication/49845311|access-date=17 August 2014|doi=10.2459/jcm.0b013e328344bcdc|pmid=21330930|s2cid=21948366}}

Drowning is a leading cause of unintentional injury and death worldwide, and the highest rates are among children. Overall, drowning is the most common fatal injury among children aged 1–4 years in the USA,[http://webappa.cdc.gov/cgi-bin/broker.exe?_service=v8prod&_server=app-v-ehip-wisq.cdc.gov&_port=5081&_sessionid=tE987yjzN52&_program=wisqars.dd_details10.sas&_service=&type=U&prtfmt=STANDARD&age1=1&age2=4&agegp=1-4&deaths=1316&_debug=0&lcdfmt=lcd1ageðnicty=0&ranking=10&deathtle=Death Percentage chart of the causes of death by unintentional injury, ages 1–4 (all races, both sexes), in 2013.] Sample size: 1,316. Drowning: 29.9%, motor vehicle traffic accidents: 24.8%, suffocation: 12.2%, fire/burns: 9.8%, etc. National Center for Health Statistics (NCHS), National Vital Statistics System. and is the second highest cause of death altogether in that age range, after congenital defects.{{cite journal|last1=Laosee|first1=Orapin C.|last2=Gilchrist|first2=Julie|last3=Rudd|first3=Rose|title=Drowning - United States, 2005-2009|journal=Center for Disease Control: Morbidity and Mortality Weekly Report|date=May 18, 2012|volume=61|issue=19|pages=344–347|pmid=22592273 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6119a4.htm|access-date=18 August 2014}}{{cite web|title=Unintentional Drowning: Get the Facts|url=https://www.cdc.gov/homeandrecreationalsafety/water-safety/waterinjuries-factsheet.html|website=Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention|access-date=18 August 2014}}

A Centers for Disease Control and Prevention study in 2012 of United States data from 2005 to 2009 indicated that each year an average of 513 children aged 0–4 years were victims of fatal drowning and a further 3,057 of that age range were treated in U.S. hospital emergency departments for non-fatal drowning. Of all the age groups, children aged 0–4 years had the highest death rate and also non-fatal injury rate. In 2013, among children 1 to 4 years old who died from an unintentional injury, almost 30% died from drowning. These children most commonly drowned in swimming pools, often at their own homes.

File:Swimming Lesson.jpg]]

Traditionally, swimming lessons started at age four years or later, as children under four were not considered developmentally ready.{{cite journal|last1=American Academy of Pediatrics, Committee on Sports Medicine and Fitness and Committee on Injury, Violence, and Poison Prevention.|title=Swimming Programs for Infants and Toddlers|journal=Pediatrics|date=2000|volume=105|issue=4 pt 1|pages=868–870|url=http://pediatrics.aappublications.org/content/105/4/868.abstract?ijkey=40ab7a8a013fdd8e7f9cdc5ce52be659c47df433&keytype2=tf_ipsecsha|access-date=18 August 2014|doi=10.1542/peds.105.4.868|doi-access=}} However, swimming lessons for infants have become more common. The Australian Swimming Coaches and Teachers Association recommends that infants can start a formal program of swimming lessons at four months of age and many accredited swimming schools offer classes for very young children, especially towards the beginning of the swimming season in October.{{cite web|title=Swim Australia FAQs|url=http://www.swimaustralia.org.au/parents|access-date=21 September 2014|archive-url=https://web.archive.org/web/20141016195123/http://www.swimaustralia.org.au/parents|archive-date=16 October 2014|url-status=dead}} In the US, the YMCA{{cite web|title=Parent/Child Swim Lessons (Ages 6-36 months)|url=http://www.ymcanyc.org/association/classes/parent-child-swim-lessons-6-36-months|website=New York's YMCA|access-date=18 August 2014}} and American Red Cross offer swim classes.{{cite web|title=Swimming Classes and Water Safety|url=http://www.redcross.org/take-a-class/program-highlights/swimming|website=American Red Cross|access-date=18 August 2014}} A baby has to be able to hold his or her head up (usually at 3 to 4 months) to be ready for swimming lessons.{{cite news|last1=Pratt|first1=Sarah|title=Infant Swimming Classes|url=http://www.parenting.com/article/infant-swimming-classes|access-date=18 August 2014|work=Parenting}}

Children can be taught, through a series of "prompts and procedures," to float on their backs to breathe, and then to flip over and swim toward a wall or other safe area. Children are essentially taught to swim, flip over and float, then flip over and swim again. Thus, the method is called "swim, float, swim."{{cite journal|last1=Chief Judge Babcock|title=Findings of Fact: Harvey Barnett, Inc. v. Shidler|journal=Court Listener|date=April 16, 2001|volume=143 F. Supp. 2d|pages=1247|url=https://www.courtlistener.com/cod/ds1H/harvey-barnett-inc-v-shidler/|access-date=18 August 2014|url-status=dead|archive-url=https://archive.today/20140818010102/https://www.courtlistener.com/cod/ds1H/harvey-barnett-inc-v-shidler/|archive-date=18 August 2014}}{{cite journal|last1=Court of Appeals for the Tenth Circuit|title=Harvey Barnett, Inc. v. Shidler|journal=Court Listener|date=Aug 15, 2006|url=https://www.courtlistener.com/ca10/RWk/harvey-barnett-inc-v-shidler/|access-date=18 August 2014|url-status=dead|archive-url=https://archive.today/20140818010101/https://www.courtlistener.com/ca10/RWk/harvey-barnett-inc-v-shidler/|archive-date=18 August 2014}}

File:Infant swimming lessons 001.jpg|Water babies infant swimming lessons in State College, PA 1984

File:Infant swimming lessons 002.jpg|Water babies infant swimming lessons in State College, PA 1984

File:Infant swimming lessons 003.jpg|Water babies infant swimming lessons in State College, PA 1984

File:Infant swimming lessons 004.jpg|Water babies infant swimming lessons in State College, PA 1984

File:Infant swimming lessons 005.jpg|Water babies infant swimming lessons in State College, PA 1984

In a 2009 retrospective case-control study that involved significant potential sources of bias, participation in formal swimming lessons was associated with an 88% reduction in the risk of drowning in 1- to 4-year-old children, although the authors of the study found the conclusion imprecise.{{cite journal|last1=Brenner|first1=RA|last2=Taneja|first2=GS|last3=Haynie|first3=DL|last4=Trumble|first4=AC|last5=Qian|first5=C|last6=Klinger|first6=RM|last7=Klebanoff|first7=MA|title=Association between swimming lessons and drowning in childhood: a case-control study.|journal=Archives of Pediatrics & Adolescent Medicine|date=Mar 2009|volume=163|issue=3|pages=203–10|pmid=19255386|doi=10.1001/archpediatrics.2008.563|pmc=4151293}}{{cite journal|last1=Moreno|first1=MA|last2=Furtner|first2=F|last3=Rivara|first3=FP|title=Water safety and swimming lessons for children.|journal=Archives of Pediatrics & Adolescent Medicine|date=Mar 2009|volume=163|issue=3|pages=288|pmid=19255402|doi=10.1001/archpediatrics.2008.572|doi-access=}} Another study showed that infant swimming lessons may improve motor skills, but the number of study subjects was too low to be conclusive.{{cite journal|last1=Dias|first1=JA|last2=Manoel Ede|first2=J|last3=Dias|first3=RB|last4=Okazaki|first4=VH|title=Pilot study on infant swimming classes and early motor development.|journal=Perceptual and Motor Skills|date=Dec 2013|volume=117|issue=3|pages=950–5|pmid=24665810|doi=10.2466/10.25.PMS.117x30z2|s2cid=28391494}}

There may be a link between infant swimming and rhinovirus-induced wheezing illnesses.{{cite journal|last1=Schuez-Havupalo|first1=L|last2=Karppinen|first2=S|last3=Toivonen|first3=L|last4=Kaljonen|first4=A|last5=Jartti|first5=T|last6=Waris|first6=M|last7=Peltola|first7=V|title=Association between infant swimming and rhinovirus-induced wheezing|journal=Acta Paediatrica|date=Jul 7, 2014|pmid=25041066|doi=10.1111/apa.12736|volume=103|issue=11|pages=1153–1158|s2cid=20295117}}

Others have indicated concerns that the lessons might be traumatic, that the parents will have a false sense of security and not supervise young children adequately around pools, or that the infant could experience hypothermia, suffer from water intoxication after swallowing water, or develop gastrointestinal or skin infections.{{cite news|last1=Weeks|first1=Carly|title=Water Safety: Can a six-month-old save himself from drowning?|url=https://www.theglobeandmail.com/life/parenting/can-a-six-month-old-save-himself-from-drowning/article535433/|access-date=18 August 2014|work=The Globe and Mail|date=July 13, 2009}}{{cite news|title=US babies learn 'self-rescue' from drowning|url=http://lifestyle.inquirer.net/6615/us-babies-learn-self-rescue-from-drowning|access-date=18 August 2014|agency=France-Presse|date=July 23, 2011}}

In 2010, the American Academy of Pediatrics reversed its previous position in which it had disapproved of lessons before age 4, indicating that the evidence no longer supported an advisory against early swimming lessons. However, the AAP stated that it found the evidence at that time insufficient to support a recommendation that all 1- to 4-year-old children receive swimming lessons. The AAP further stated that in spite of the popularity of swimming lessons for infants under 12 months of age and anecdotal evidence of infants having saved themselves, no scientific study had clearly demonstrated the safety and efficacy of training programs for infants that young. The AAP indicated its position that the possible benefit of early swimming instruction must be weighed against the potential risks (e.g., hypothermia, hyponatremia, infectious illness, and lung damage from pool chemicals).{{cite journal|last1=American Academy of Pediatrics Committee on Injury, Violence, and Poison|first1=Prevention|title=Prevention of drowning.|journal=Pediatrics|date=Jul 2010|volume=126|issue=1|pages=178–85|doi= 10.1542/peds.2010-1264|pmid=20498166|url=http://pediatrics.aappublications.org/content/126/1/178.full?sid=9a507f3d-700b-4f25-bc27-c88a8312832c|access-date=18 August 2014|doi-access=}}

The U.S. Centers for Disease Control and Prevention recommends swimming lessons for children from 1–4, along with other precautionary measures to prevent drowning.{{cite web|title=Drowning Happens Quickly– Learn How to Reduce Your Risk|url=https://www.cdc.gov/features/drowningprevention/index.html#two|website=Centers for Disease Control and Prevention|access-date=18 August 2014}}

The Canadian Pediatric Society takes a middle-of-the-road approach. While it does not advise against swimming lessons for infants and toddlers, it advises that they can not be considered a reliable prevention for drowning, and that lessons for children less than 4 years should focus on building confidence in the water and teaching parents and children water safety skills. They also recommend, for all children less than 4 years, constant arms-length supervision for toddlers near any body of water (including bathtubs) and that infants be held at all times.{{cite journal|last1=Hong Nguyen|first1=B|title=Swimming lessons for infants and toddlers|journal=Paediatrics and Child Health|date=2003|volume=8|issue=2|pages=113–4|doi=10.1093/pch/8.2.113|pmid=20019931|pmc=2791436}}

{{Reflist|30em}}

• {{YouTube|id=fbSCSHzXkrI |title=The Diving Reflex - Infant Babies Swimming Underwater}}
• {{YouTube|id=QJ7XE9VyB10 |title=Infant Swimming Resource: Teaching Progression}}
• {{YouTube|id=v0mUPr68x2U |title=Infant Swim Self-Rescue}}

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Swimming

Category:Youth swimming