It's one of the simplest and purest joys of summertime for children: the kiddie pool. But a new study finds that danger can lurk in those gentle waters when caregivers let down their guards.
During the warmer months, on average, one child drowns every five days in a portable above-ground pool -- including those small inflatable pools filled only with a few inches of water, as well as larger portable pools that can hold as much as four feet of water, according to the study published today in the journal Pediatrics.
"Because portable pools are generally small, inexpensive and easy to use, parents often do not think about the potential dangers these pools present," said Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Ohio, senior author of the study.
The study looked at the circumstances around 209 drowning deaths in portable pools by children under 12, from 2001 through 2009, as compiled by the Consumer Product Safety Commission (CPSC). The majority of the deaths were children under five. And many of those can be attributed to brief lapses in supervision, while others resulted when children found ways around barriers meant to keep them safe.
Keeping children safe around pools of any size means preventing access to the water by unsupervised children, as well as constant supervision when children are in and around the water, the study says.
It takes only a couple of minutes and as little as two inches of water for a child to drown, experts say.
And for young children, Smith said, an adult presence is not enough to keep children safe. "For the really young kids, toddlers and infants, touch supervision is necessary," in which an adult is just two feet away from any child in the pool, whether in the pool or on the edge, he said.
"We know that the best parent in the world can't supervise their child 100 percent of the time," Smith said. "We need to come up with additional ways to prevent injuries to children."
Andrea Gielen, who studies injuries as the director of the Johns Hopkins Center for Injury Research and Policy, said, "Parents don't know that injuries are the leading cause of death for kids in the United States," a large percentage of which are preventable.
The key to prevention of drowning deaths in portable pools is, in large part, the authors of the study said, awareness. With summer officially under way, it's a good time for parents to tune in to other warm weather dangers to keep their children safe this summer.
SUN: Cover your children in broad spectrum sunblock before going outdoors, applying it before putting clothing on. And remember to re-apply every two hours, and after going in water or sweating. The FDA will begin regulating sunblock next year. In the meantime, consumers should choose sunblock containing zinc oxide or avobenzone, according to Dr. Ari Brown, a pediatrician based in Austin, Texas, and co-author of "Baby 411" and "Toddler 411" guides.
Heat stroke is another danger on hot and humid days, particularly in the beginning of summer, before the body has had a chance to adapt to the warmer climes.
"We lose most of our body heat from evaporation," Smith said. "If you are out doing strenuous activity, you need to take frequent breaks and drink a lot of water. Heat-related illness is very serious and can come on quickly."
Look out for headaches as a danger sign, and as the heat stroke gets more severe, symptoms could include muscle cramps and confusion. Heat stroke can lead to coma and even death.
It may be prudent to look for indoor fun or shade play for your children during the hottest time of day, doctors say.
WHEELS: Many families pull bikes and scooters out of the garage when the mercury heats up, but whatever time of year, helmets are essential to saving lives.
"Any time a child is on wheels on a hard surface, they need to have a helmet," Smith said. He cautions parents not to overlook skateboards, self-propelled scooters, in-line skates and bicycles. Helmets reduce the risk of serious head injuries by up to 85 percent, experts say.
Smith recommends parents make sure the helmets they purchase have the Consumer Product Safety Commission seal.
Helmets should sit level on the head, above the eyebrow line and straps need to be secure, said Andrea Gielen, Director of the Johns Hopkins Center for Injury Research and Policy.
And don't forget to apply the sunblock before the bike ride. Helmets don't usually shade the face completely.
WEATHER: Lightning claims the lives about 300 people in the United States annually. If a lightning storm is coming, head indoors. Do not stay in an open space, like a football field or a golf course, where you would be the tallest object, Smith cautions. Common wisdom still holds: Do not stand under a tree during a lighting storm.
PLAY: Prevent injuries with supervising children at the playground and by making sure the surface of the playground where your child plays can absorb impact during falls.
"Supervision is important, but we also know that kids will push their limits," Smith said. "They'll jump a little bit further, they'll reach a little bit higher each time. We want them to do that, that's how they develop. ... Eventually they're going to fall, that's certain, they will fall, that's going to happen."
Proper surfacing on the playground, he said, is "automatic protection, a vaccine approach to injury prevention. We know vaccines work."
BUGS: During evenings and cooler times of day when mosquitoes are likely to bite, cover skin with a bug repellent that includes DEET, experts say.
"Of all the pesticides, it's the one that's been recommended by the American Academy of Pediatrics," Smith said.
Brown agrees. "Parents are very afraid of DEET and they shouldn't be. DEET is a very effective chemical," when used properly, she said. Brown said, for typical use, that means applying a bug repellant with DEET once a day, and washing it off at end of day.
A repellent with 10 percent DEET will last a few hours; 30 percent will last 5-6 hours, she said.
For those uncomfortable using the chemical, she recommends looking for products that contain picaridin, or oil of lemon eucalyptus, which is approved for use in children ages 3 and up. All three options repel not only mosquitoes, but tics too. She also suggests using a mosquito net over a baby stroller.
While there's no shortage of things to worry about this summer, with a little thought to prevention -- helmets, supervision and a lot of lathering up -- there's still plenty of room for fun for the kids, and for you, too.