good evening.

>> Thank you so much for watching HealthLine on PBS Fort Wayne.

I'm Mark Evans, your host tonight we'll talk about something relatively topical because it is hot.

It's summertime.

>> People want to hit the pools, the lakes and there could be some problems because of that and we're going to talk about that.

>> We're going to talk about drowning prevention and water safety.

We have pediatrician Dr. Tony Giacomino with us.

>> Nice to see you, Dr. Tony.

It's great to be here.

Thanks for having me.

Absolutely.

We've had you on the show before.

You did a great job.

>> We had a lot of phone calls.

I think we talked about vaccines at that time I'm not quite sure.

But nonetheless it's great to see you again.

>> The phone number is on the screen.

It's 866- (969) 27 two zero.

Please call that number any time in the next 30 minutes.

It is a live show and it is public television so we won't be stopping down for commercials.

>> Dr. Jack Hanna as a pediatrician you obviously think this is a very important subject especially this time of the year.

>> And why is that?

>> Well, thanks for asking.

Yeah.

This is you know, as as Fort Wayne's pediatrician, it's my job to keep our children safe and healthy and for pediatricians prevention is our jam and that's why I came to talk about vaccines and that's why I'm here today to talk about something that really is a real danger for our children and that is drowning.

In fact, drowning is is really important to talk about because it's one of those things where water is ubiquitous, it's everywhere and like you said, it's summertime.

>> We like to be around water especially in northeast Indiana with all of our lakes.

But did you know that drowning is the number one cause of death in children ages one to four did not know that.

Yeah, it's a major cause for concern which is a big surprise for a lot of families.

I mean I hate to give parents something else to worry about.

Parents are always thinking about ways to keep their children safe and you walk into a house with a toddler and you're going to see lots of areas of prevention.

You're going to see the electrical outlets plugged.

You're going to see cabinet locks.

You're going to see the TVs bolted against the walls.

These are all really important .

But something one thing that parents just aren't really always aware of is how dangerous water can be and that's really why I'm here today is to promote water safety and discuss drowning prevention.

>> All right.

And you did mention it's the leading cause of children of death of children one to four isn't high up there with the teenagers as well.

>> What do you think it really is when you go older accidental causes of death are still the number one cause of death in children and even that age five to nine range of drowning is the second cause of accidental death right behind auto accidents.

>> Oh wow.

Wow.

So we really need to talk about this and let's talk about ways to prevent that and especially with smaller children.

>> What are we going to do?

We've got to pretty much watch them all the time, don't we?

Well, yes and no.

>> I mean absolutely there are lots of different ways to prevent drowning.

But what's important to remember and what I remind my families is that there is not one single prevention strategy that could save your child.

And so what we recommend as pediatricians and the American Academy of Pediatrics is what we call layers of prevention.

The analogy would be kind of like Swiss cheese if the hole in a Swiss cheese would be a way for your child to find the water and drown if we layer all of those Swiss cheese layers together, those layers of prevention then all of a sudden we blocked all of those holes and explain that very well.

>> That's a very good way to explain that.

Good.

And I'd like to take a little bit of time to kind of talk about all of those layers of prevention.

>> Sure.

What would you like to start with?

I see one here who's really top of the list is adult supervision supervision.

Yeah.

So and no family of mine that has a toddler leaves my office without them hearing this from me and that is never assume supervision when you are around water you always have to keep a very close eye on your child.

This is really, really important and probably the most paramount way to save your child from a really dangerous drowning accident and really what we what we recommend is always being aware of when water is around.

I say recognize water number one and when water is around we have to always make sure that when children are around the water that we aren't just assuming that they're being watched.

A lot of times we're outside or around water or pools or there there's water everywhere and we just assume that since there's lots of adults around that they're being supervised.

But what I tell parents is that when you feel like everybody is watching it means that probably nobody is.

>> That's a good way to put it.

And even with pools and beach sides with lifeguards, you still have to be very careful they've got their minds on other things.

>> Absolutely.

And that's one strategy that I do recommend is that when water is around and you're supervising children assign what's called a water watch, a water watch or is somebody who their only task is to keep their eye on the children in the water and that way you're not watching just individual children but you're watching the water in general.

You're not on your phone.

You're not grilling, you're not talking with friends.

You're watching the water and that is your job one strategy that I tell parents that they can do is make a lanyard and put some sort of symbol or icon or logo on it and that's that lanyard then goes to the water catcher when that person goes inside to go to the bathroom or to get refreshments, then they take that lanyard and put it on somebody else and they're very deliberate.

>> They point out that person said you are the water watcher until I get back.

Oh well that's a good way to do it and it's a good way of bringing a sense of community as well.

We're watching out for the little ones.

>> That's right.

And we know that probably in the that hours of about six to eight p.m. are the most common hours of children to drown and that's because those are the hours of dinnertime when we're preparing meals we might be watching the water and then we say well it's dinnertime, I'm going to do other tasks and it takes our focus off of supervision.

I can see that.

What about fences or barriers?

I mean those help absolutely.

>> I think that barriers are probably the second most important strategy to prevent drowning and that is basically my my second set of instructions which is don't let your child find the water, OK when you aren't around make sure that that water is protected.

We know that in 70 percent of cases of drowning there isn't even a person around which really emphasizes that need for a barrier and that's why the American Academy of Pediatrics recommends that if you do have a water source, whether it's a pool or whether it's permanent or in ground or temporary, having a four foot enclosure around all four sides of that pool is what's required and necessary to keep your child from finding the water for four feet from the ground four feet from the ground.

>> Yeah, yeah.

We know that toddlers are very good at climbing and and so four feet from the ground, four feet and surrounding all four areas of the pool.

>> All right.

Well also when you think that learning how to swim would help as well.

>> Absolutely.

Yeah.

We really do recommend swim lessons and this is really the most difficult I think or at least the biggest barrier that we have to implement.

>> We really need to change how we view swim lessons in our community.

>> We value lots of life skills like throwing a ball or one could say even walking.

But I would argue that learning to swim is just as crucial of a basic life skill that we in the community really need to invest in.

And we know that there are a lot of disparities that do exist between the haves and have nots into attaining those and it requires a community partnership with everybody to really invest in and make swim lessons ubiquitous and a basic life skill for all children.

>> You know, when I was growing we had actually a very nice family just down the street.

>> They lost her daughter age three and it was an accidental drowning and I was 11 years old and my mom said OK, then my brother was nine .

>> She says That's it boys.

You're taking swimming swimming lessons and a lot of the people in my neighborhood thought well they're just kids are 11 years old.

>> I mean he's 11 and nine .

>> Well, the younger you are and when you learn how to swim the better it is.

I would believe so.

But some people were even appalled that I didn't even learn how to swim until I was 11 years old.

I mean I would I'd be out there Dogpatch and all that but the formal swimming and the diving I didn't even learn until I was much older.

Well, you're not alone and swimming isn't emphasized in every culture and and every community and that's something that we really need to work to change.

Fort Wayne's actually made a lot of really nice efforts in that regard.

If you go to the Fort Wayne Parks and Rec website, you know they're really good about linking up families with area swim lessons and the YMCA is another really great resource for that.

>> There's the Red Cross.

They'll do it.

In fact it is a partnership with the Red Cross.

That's who taught me.

Is that right?

Yeah.

And so they have recognized that boy drowning is again a major health hazard.

It's again I can't say this enough the number one cause of accidental death in children ages one to four and so much so that you know about five hundred kids that's almost two children every day die from drowning and it's something that we really need to take seriously and emphasize all of these layers of protection and that does include swim lessons.

>> OK, and I would imagine though if you were a parent you know a big brother, big sister having a couple of little ones there wouldn't maybe some CPR lessons come in handy.

>> Yeah, and that's probably our fourth biggest layer of protection and that's making sure that, you know, as many people as possible get trained and again basically saving skill and that's CPR again, you know, a lot of easy efforts through the American red Cross are available to take training to make sure that it is something that's affordable and accessible and gosh, you know, when you're able to layer all of these things together really hopefully we can prevent some of these really preventable but but common problems it's so common that I think that northeast Indiana lost a child in the last couple of days and and the and these are just so tragic.

I mean these are children.

These are investments.

These are our future and and every effort that we can make to prevent a really common cause of death should be invested in I believe that was in the Kendall gallery in the last I heard it was not a it wasn't confirmed as a drowning but it is a suspicion so unfortunately.

>> All right.

Well, I want to go ahead and remind our viewers in case you just checking in with us telephone numbers on the screen 866- (969) 27 two zero and we're talking to Dr Tony Equina who is a pediatrician and something very important during the summertime drowning prevention and water safety.

So please call with your questions.

I want to go ahead and talk about we talked about the swimming lessons for children but how early can you start and how early should you start swimming?

>> This is actually a topic of a little bit of debate.

There are some people that recommend for really early swim lessons as early as six months old believe it or not.

So a child that's not even walking maybe we should start training to prevent drowning.

And again, the effort is worthwhile because of how common and how dangerous water can be for children and how quick and exploratory children are.

>> I mean you think about it drowning for a toddler.

Toddlers are fast.

They're exploratory.

They don't think before they act and drowning is quiet, OK?

>> They find water and you don't even realize it.

It's not like there's alarms that go off or you know, a drought.

We look at videos and TV shows of children drowning and it's a lot of splashing and noise but in fact drowning is very quiet and so emphasizing when we should do swim lessons is a really great question.

One of the methods is called Isar where they teach children if they fall into the water to flip over onto their back and be able to kick to safety when to do that timing is a little bit debatable.

Again, some do it as early as six months old.

The American Academy of Pediatrics does not recommend doing that quite so young but certainly at more age developmental age over one is something that we think is probably more reasonable and then until then really emphasizing the other layers of protection.

>> OK, yes.

The other says the barriers, the swimming lessons, the adult supervision and of course having somebody around who's trained in CPR that would be very that's right.

>> And remember too that not all swim lessons are are created equal and and we want parents to really look into what the swim lessons entail.

They should have an experienced coach.

The swim lessons should really teach the children what to do if they accidentally fall in and they should really kind of also train parents and children on just overall basic water safety safety elements making sure that they're not walking too close to the pool, making sure they're not running around the pool, things like that.

And so and making sure that swim lessons it's not just a one time deal but they should be successive in nature for them to be really successful.

>> Mine lasted all summer.

Yeah, probably the best summers of my life .

Hey, hang out at the pool.

What's wrong with that?

You go OK and we were talking about the water hazards for children.

>> I was amazed that I came across information that water hazards at home children can drown in just one to two inches of water.

>> How does that happen?

Is that tub related or well it could be the truth is is that again water is ubiquitous even in our own homes and the bathtub is no exception.

We we we cannot emphasize enough that if you have a young infant in water, whether it's a bathtub or one of those inflatable pools, you cannot let your eyes off them for even a second because children can drown in one to two inches of water.

So that does include bathtubs but more commonly it also includes all the water tables and water pools that we fill up with a hose and then just kind of forget about.

That's why we really recommend that after you're done with especially baths but also those portable tubs outside that you do take all of the water out of those tubs after the after it's use.

>> All right.

And what about when we talk about bathtubs but something too about toilets and buckets?

>> There's there's drowning in those two items.

>> It can happen and it's preventable and it's easy to prevent you take the water out of these devices and then it no longer poses a hazard.

So while it may seem silly, the worth is the risk is worth it to remove water from all of those sources.

>> The bucket thing has me a little concern.

I guess if a child was bending over maybe head first going into the bucket not able to get out and that would make sense.

That's right.

Yeah.

OK, well we got to watch out for that.

Let's go into another segment here.

We've got about ten minutes left and of course we've got our phone lines open for anyone who wants to call on this subject.

We're talking about drowning prevention and water safety boat and lake safety.

>> I mean, my gosh, again, it's so common this time of the year it seems like everybody has a boat and if they don't have a lake cottage they know where they can go for water.

So because they know somebody who has a lake cottage.

Right.

But let's talk about the hazards in at the lake and you know what we can prevent.

>> Well, I'm glad that you brought that up and again, you know, I hate to be the fun police.

I mean we associate water with fun and because of that we sometimes have a tendency to let our guards down.

And so again when we're at our lakes, even though we're excited and we're thinking about fun, we also have to remember to have fun in a safe way.

And this is again all in lieu of preventing a really common cause of accidental death in children.

And so what we recommend really as a pediatrician is when you are around water, especially a lake, go ahead and just assume safety and put that life jacket on.

You know, for my kids whenever we go up to the lake, especially when they were toddlers, it was just part of their routine.

They'd come up to the lake, they'd put on their life jacket and we kind of felt like that was their their body armor in a way that's going to keep them protected.

It's going to enforce that layer of protection so that it's just one little one less way that you know, a child can escape from our supervision.

>> OK, well on that topic, I mean if you have a life jacket on, is it guaranteed that if you happen to get out there in the water you're not going to sink?

>> Well, great question.

And because not all life jackets are created equal waterfloods you know those big things that we put on our arm.

>> I was going to ask you about it.

Yeah.

So those are toys.

Those are not those are not life preservers and so we have to really separate those from Coast Guard approved life jacket and it's easy to find it'll say Coast Guard to prove on them good.

And that includes really that that full buckled up vest life vest or the ones that go around our neck.

>> But those are the ones that we want to look for and I'm never I've worn many like this.

>> I had a grandfather had a boat and we didn't get in the boat unless we had a life vest on.

But I've never been in the water with one of those so I don't know what the sensation would be or how that would actually help keep me above the water line.

>> Yeah, it's certainly important that they stay on but again I can't emphasize this enough even especially for children under the age of four.

The American Academy of Pediatrics always recommends that you keep your child within arm's reach away even if they do have a life jacket on.

>> And plus that's going to keep you from going to enforce you guys having fun and interacting but it's also going to keep your child safe.

OK, very good.

We have some calls coming in fact two of them to take care of and Susan would prefer to stay off the air which is fine.

>> That's our job.

We'll go ahead and transcribe your question for you, Susan.

>> She says How would you recommend finding swimming lessons, swimming lessons or nonverbal autistic child?

>> Great question.

Boy, it's a really great question because children with autism are just as much a risk for drowning as other children.

And so, you know, I think that this is a great question for when you're looking at the different swim programs, you know, really asking and coming up making sure that they are prepared and understand what autism is, how children with autism communicate and importantly what are some of the things that might make a child with autism really uncomfortable children with autism always express pain and discomfort in the same way as other children.

I remember as a swim coach, as a child and not knowing a lot about autism, I was really fortunate that the mom who child had autism really brought me aside and really talk to me about things that would make him comfortable and uncomfortable because he was floating.

He might have a smile on his face but was also very uncomfortable.

So you don't want to assume that they would be comfortable just because they weren't voicing discomfort.

So I think that talking with the life , the life or the swim coach really beforehand and discussing what autism is and some of the things that make him or her comfortable would be a really important part of that.

>> All right.

>> Another good question coming up here from Margaret.

She's asking is water safe for children with epilepsy?

Absolutely.

Yeah.

Every child deserves to have fun playing and enjoying the water and that's not what I want to do.

I don't want children to avoid the water because it's such a wonderful safe healthy activity .

We just want to make sure that we're approaching it with safety and emphasizing safety.

So children with epilepsy absolutely can enjoy the water as well.

We just want to make sure that we are still layering all of those protections together.

And when you do that, absolutely a child with epilepsy can definitely enjoy the water as much as any other child.

Very good.

That's good to know.

Let's talk about swimming in the safe places like the public beach and staying within the boys.

>> There's a reason for those correct have for sure.

You know, I think I think it's it's tough when you're around friends and you're excited and you might want to push yourself a little bit or show off you might push yourself to kind of exceed your own swim level and you know, the lifeguards are really good at kind of patrolling their area.

But you know, those areas are a little bit off their radar.

>> And so I think when you exceed those limits it's really increasing your risk quite a bit.

And so, you know, even though you might you might be feeling a little bit courageous or pushed by your friends, we still recommend to really follow the rules of the road, so to speak and and stay within those margins.

>> OK, very good.

James is calling in asking us to read his question are there any boating laws or regulations you would like to see implemented in the future to increase swimming and boating safety?

>> Well, you know, isn't that a great question?

I mean the truth is it feels like anybody can jump into a boat or on a sea do with no training whatsoever and just take off and enjoy and enjoy the water.

>> And boy, I mean that really does pose a lot of risk.

We would never do the same thing.

We certainly don't with cars and yet boats are something that deserve a lot of of of training really understanding the rules of the road again, you know who has the right away what to do when a boat's coming at you, what to do with a boat has skiers and so I'm not quite sure that there is enough emphasis on safe boating laws and how to appropriately drive and operate a boat especially in Northeast Indiana.

As we know our lakes can get very congested and when boating accidents occur the big concern there is are the people on board going to be able to be safe if they end up in the water.

And so again that just loops back and drowning and water safety.

So I suppose if there was something that I would emphasize is it is you know, we need better boating education courses and maybe trying to work out ways to creatively enforce those.

>> I would totally agree with you, sir.

All right.

And I want to ask you on these notes that I have here never swimmers supervised after drinking alcohol that makes sense.

Never swim.

But if you're supervising, that means you might have to get into the water to save someone so you don't want to be drinking, is that correct?

>> Well, I think both of those I think certainly if you have to get in to save your child or to save somebody that would make it a lot more difficult.

But I think the bigger issue there is again it decreases your awareness of what's going on and especially if there's a lot of children in the water and there's a lot of activity going on outside the water, you know, then we're really not being a directive about supervision and I think that that's the big issue is that we're not as competent supervisors if you're not drinking exactly.

>> All right.

That is great.

Now I want to talk about the length of time a child should stay in the water or anyone stay in the water.

>> When is it the the signal that I need to get out at least for a while?

Yeah.

I mean most pools are pretty good about having kind of forty five minute on 15 minute off regulations and I think that that's a good rule to live by is make sure that you know you're you're able to make sure kids are having fun and living up to their swimming competency but also making sure that children have breaks in the meantime and that seems to be a good rule to follow maybe forty five on 15 off believer in sunscreen.

>> I'm a big believer in sunscreen and my dermatologist friends would agree as well.

You know I always tell families when their children are young that is their only time when you can really be rest assured that you can protect their skin because at some point they're going to be teenagers and they're going to be, you know, going off to the pool themselves and it might be a little bit easier to enforce yourself and we have one layer of skin and boy, these moles are absorbing UV rays every day so we might as well protect it when their their youngest so that those UV rays aren't having lasting effects for their whole lifetime.

So I tell families, you know, there's a lot of families that are worried about what type of sunscreen to use and I tell families that you know, the best sunscreen is the one that you have with you.

I'm much more worried about the sun than I am the sunscreen.

>> Well, speaking of the sun, even if you're not in the water that you're on the beach that the reflections from the water come up and of course it's bright and sunny advocate a sunglasses.

Absolutely.

Yeah.

All of these things are really important to protecting from the sun is very important especially in the summer when the sun is hot, it is out and we are outside for so long we've got one body when you're a young boy we've got to really take care of it because of preventing lasting effects.

>> All right.

We have about 30 seconds left the floor is yours any take home?

>> Well, again, thank you so much for inviting me on.

I want families to have a lot of fun this summer in and around the water.

Swimming is something that I grew up with and both of my kids are on swim teams and they love going to the lake but it is not without its risk.

And that's one thing I just want all families to remember is that water drowning is the number one cause of death in ages one to four and that we have ways to really prevent and reduce at risk so that we can still have fun in and around the water.

>> And thank you so much for sharing your information and advice.

Doctor, thanks for having me.

>> Dr. Tony Jackson, a pediatrician.

Pleasure to have you on the show.

We'll be back next Tuesday for another interesting topic.

>> Until then, thank you so much for watching.

Good night and good