Checkup Newsroom

Is Your Baby Ready For Swim Lessons?

Fri, 25 May 2018 08:36:42 -0500

“I would love to know the opinions of some of the [Cook Children’s] physicians on the new trend of starting babies in swimming lessons as early as 6 months. It seems to be gaining popularity, but I have not heard any doctors weigh in on whether they think that it is too young or not.”

When a reader wrote in with this question, we asked Nicole Wineriter, M.D., in Keller for her thoughts on this topic. Dr. Wineriter’s children started swim lessons when they were older infants, around 1 year old, and now her 5 year old can swim laps the length of the pool in three different stokes.

“I can’t say enough great praises about swim lessons,” Dr. Wineriter said. “My 2 year old can swim 10 seconds under water for about 10 feet, grab the side of the pool and climb out. I’m a huge fan of swim lessons, if started at the appropriate time for each child.”

Private companies and public organizations, such as the YMCA, begin swim lessons as early as 6 months of age. The American Academy of Pediatrics (AAP) updated its policy statement and recommendations in 2010 regarding swim lessons for children under the age of 4 years old.

“The evidence no longer supports an advisory against early aquatic experience and swimming lessons for children of any specific age,” the AAP wrote. “However, the current evidence is insufficient to support a recommendation that all 1- to 4-year-old children receive swimming lessons. It must be stressed that even advanced swimming skills will not always prevent drowning and that swimming lessons must be considered only within the context of multilayered protection with effective pool barriers and constant, capable supervision.”

A study by the USA Swimming Foundation and conducted by the University of Memphis found that 70 percent of African American children and nearly 60 percent of Hispanic children have low or no swim ability, putting them at a risk for drowning. African- American children drown at a rate nearly three times higher than Caucasian children.

Participation in formal swimming lessons can reduce the risk of drowning by 88 percent among children aged 1 to 4 years old, according to Pediatrics and Adolescent Medicine.

“Parents should check with their pediatrician to find out if their child might be developmentally ready for swim lessons,” Dr. Wineriter suggests. “It is important that parents not feel secure that their child is safe in water or safe from drowning after children have participated in swim lessons. Adequate ‘touch supervision’ is still recommended, meaning an adult should be within an arm’s length at all times.”

Swimming skills should be just one aspect of an overall drowning prevention strategy, in addition to effective barriers (for example pool fences), appropriate adult supervision and CPR training.

Parents are cautioned not to use air-filled swimming aids (such as inflatable arm bands/”floaties”) in place of Personal Flotation Devices (PFDs- life jackets). These aids can deflate and are not designed to keep swimmers safe.

The AAP also comments regarding the baby survival swim lessons that are often seen: “In recent years, water-survival skills programs designed for infants younger than 12 months have become popular both in the United States and internationally. Many movies of tiny infants who have been taught to swim underwater, float fully clothed on their backs, and even cry out for help have emerged on the Internet. Although there are anecdotal reports of infants who have “saved themselves,” no scientific study has clearly demonstrated the safety and efficacy of training programs for such young infants."

Of note, these types of lessons are less commonly found and generally aren't taught when babies start swim lessons at 6-12 months old.

Click here to find swim lessons in your area.

Get to know Nicole Wineriter, M.D.

Nicole Wineriter, M.D., is a Cook Children's pediatrician located in Keller, Texas. New and exisiting Cook Children's Keller pediatrician office patients can make an appointment by clicking here or by calling 817-592-8253. Dr. Wineriter earned her medical degree and completed her residency in pediatrics at the University of Texas Southwestern Medical School in Dallas, Texas. She is board certified, a fellow of the American Academy of Pediatrics, a member of the Texas Medical Association and Safe Kids.

Is your child's car seat safe?

Sun, 31 Aug 2014 15:51:02 -0500

As a mom and a pediatrician, I want what is best for my children and my patients. I want to keep my kids and my patients as safe as possible. One way to do this is to follow the recommendations and best practices regarding child passenger safety. Motor vehicle crashes are the leading cause of death for kids 14 and under. In the Tarrant County area, 92 percent of car seats/booster seats are not used or installed correctly. That means that only 8 out of 100 families in the area are properly using their car seats or booster seats. Let’s face it, car seats can be complicated!

If you are having even the slightest trouble, questions or concerns regarding your child’s safety in the car, certified child passenger safety technicians are able to help or even double check your work.

For those of you in the Tarrant County area, you can call Safe Kids Tarrant County, led by Cook Children’s, at 682-885-2634. Also visit this site for a quick car seat checklist with the top 5 things to do to check your seat.

1. When can my child change from rear-facing to forward-facing?

The American Academy of Pediatrics (AAP) recommends children ride rear-facing until at least 2 years old or until they reach the maximum height and weight for their seat. Keeping children in a rear-facing position better protects their heads, necks, and backs. Seats will indicate on the side labels what the rear-facing weight/height limit is and you can also check the manual of the seat. Parents often worry about the safety of a child’s legs when the child is growing taller and is still rear-facing. Studies show that a child’s legs are actually injured less often when a child is rear-facing. Both of my children were in the 90+ percentiles for height at age 2 and both remained rear-facing past 2 years old.

2. When can my child use a booster seat instead of a harness forward-facing seat?

The AAP recommends children ride in car seats with a harness until at least 4 years old, however they should continue to use a 5-point harness up to the highest weight or height allowed by the manufacturer of the seat. Moving from a 5-point harness to a booster seat is a step down in safety, so a child should remain in the harness seat as long as possible.

3. When does my child no longer need to use a booster seat?

Texas law requires children to remain in booster seats until at least age 8, unless the child reaches a height of 4 feet, 9 inches before age 8 (which is extremely uncommon).

Recommendations state a child should remain in a booster seat until at least age 8 or until the seat belt fits correctly. Most children are 9 years or older before they reach 4 feet, 9 inches, which is when the seat belt will usually fit them correctly without the booster seat. You can use the “Safety Belt Fit Test” to help you determine if your child is ready to use the seat belt alone without a booster seat:

Have your child sit all the way back on the vehicle seat. Do the knees bend at the front edge of the seat? If no, then your child should stay in a booster seat. If yes, then go to No. 2.
Buckle the seat belt. Does the lap belt lie on the upper legs or hips (not the stomach)? If no, then your child should stay in a booster seat. If yes, then go to No. 3.
Does the shoulder belt rest on the shoulder or outer collar bone (not the neck)? [Note- Never put the shoulder belt under a child’s arm or behind a child’s back.] If no, then your child should stay in a booster seat. If yes, then go to No. 4.
Can your child maintain the correct seating position for as long as you are in the car without slouching or moving positions causing the belt to move improperly to the neck or stomach? If no, then your child should stay in a booster seat. If yes, and you answered yes to all 4 questions, then your child is ready to use a seat belt without a booster seat.

4. When can my child sit in the front seat?

Children should not ride in the front seat until age 13. The safest place for a child in the car (or any person for that matter) is the back seat, particularly since the most common crash is a frontal crash. Air bags deploy with such force that they can cause severe head and neck injuries to a child.

5. Do car seats and booster seats expire?

Yes, all car seats and booster seats expire. Usually they last about six years, but be sure to check for an expiration date on the seat label.

For more information:

About the author

Nicole Wineriter, M.D., is a Cook Children's pediatrician at the Heritage Trace Clinic. She is a Fellow with the American Academy of Pediatrics and a member of Safe Kids Tarrant County, led by Cook Children's, and a certified child passenger safety technician.