Who is The REAL Lifeguard at Your Kid’s Pool This Summer??

Last updated on September 27th, 2025 at 12:08 am

I was doing the usual mom chit-chat at Scouts while my son worked towards his water safety badge and fielded the inevitable question from the Scout leader, ‘what do you do?’. My answer, “I’m a global activist working to end child drowning. One child drowns every minute.” And then came the typical response, “Wow, I didn’t know it was such an issue, but it is certainly needed, the lifeguards need to do a much better job.” She then related a story about how she and her husband were at a pool with their baby and 3-year old son. She was sitting at the side holding the baby, her husband was in another area, and the 3-year old suddenly went past his depth and was bobbing up and down under the water, drowning. She screamed for the lifeguard, her husband screamed for the lifeguard but also managed to get to their son before any serious injury occurred. She related the story in harrowing detail and emphasized several times how the lifeguard had clearly not been doing his job well since her son had almost drowned in a crowded pool, so she understood why drowning is such a problem.

What is your initial reaction? Quite possibly the same as hers, the fault was with the lifeguard. If he had been paying attention her son never would have almost drowned. It’s an incredibly common belief, but the reality is quite different. These are excellent, diligent and concerned parents, and they believe, just as most people believe, that if you go to a pool or beach with a lifeguard on duty, you and your children will be safe. Yes, that’s true, if you swim in an area with a lifeguard, your chance of drowning is reduced to 1 in 18 million. Those are very good odds, even better when you consider that 75% of open water drownings occur when a lifeguard is not present. There are no two ways about it: if you swim in an area with a lifeguard, you are much safer, but it’s not just the lifeguard’s job to keep you safe. I do place the blame for that misconception squarely on the shoulders of those of us in the drowning prevention field. We haven’t explained what the true role of a lifeguard is, so let me start now to change how we view lifeguards.

When it comes to water and children, especially young children or non-swimmers, you, the parent, are the first lifeguard on duty. You need to be touch distance from your young or non-swimmer, meaning you can reach out and grab them at any time. Why?

First, a child can drown in 2 minutes in 2 inches of water. Even the best lifeguard, diligently scanning a crowded pool can miss seeing a small child under water, especially if the sun is glinting off the water or there are many people in the pool obscuring visibility under the surface. Plus, most people don’t even recognize someone is drowning since it’s not like in the movies. There is no flailing of arms or screaming. Click here to read about what it really looks like, so you can know the signs.

Second, you don’t want your child to be in a situation where they need to be rescued. You know how hard it can be to spot a small child in a crowded place. Even the fastest lifeguard will take precious seconds to spot the danger and make their way to the victim, and that can be a really frightening few seconds for a child.

Lifeguards are like police and firemen. Their job is to prevent accidents by watching for dangerous behavior and educating the public, and to perform rescues when things do go wrong….but it’s not their job to babysit or watch just one child, much less the 100 children in the water on a busy summer afternoon. Think about it, you don’t let your 3-year old walk 3 blocks to preschool just because your town has police whose job is to keep people safe, do you? The good news is that having a lifeguard on duty is like having a firefighter stand in your front yard just in case a fire breaks out. 95% of a lifeguard’s job is preventing an accident in the first place and only 5% is actually rescuing someone in distress. With you on guard, hopefully it won’t ever be your child in distress.

Now that you’re thinking, ‘great, so much for relaxing at the pool this summer’, I have some very good news. Taking a baby or young child to the pool is better than having a personal trainer and Weight Watchers combined, if you take advantage of the time in the pool with them. Trust me, I worked off two pregnancies swirling my children around in the water. I hope you’ll also check out my tried-and-true ‘fun for kids, great easy workout for mom’ plan!

One Decision, Tragic Results: Please Look Before You Lock (Video)

“It could never happen to me.” “I would never leave my child alone in the car – not for a minute.” “No GOOD parent would ever forget their child!”

But it happens every day. According to The National Safety Council on average 37 children die in hot cars each year, about one every 10 days from heat-related deaths after being trapped inside motor vehicles. This year already there have been 3 child vehicular heat-stroke deaths. And this is not counting the life-altering injuries experienced by the children who survive.

It happens…

Children climb into unlocked cars to play. A child is sleeping in the back-seat and a parent “cracks open the window” and runs into the store for “just one thing” (…illegal in some states but in a NHTSA survey, 25% of parents admitted they had done this at least once). A spouse / partner / caregiver carefully buckles the baby into the car seat to drop them off at daycare. Maybe it wasn’t their day to drive…or maybe something distracts them for just one second. It’s just a little departure from the usual morning routine – only this time they forget the baby sleeping in the back seat (…more likely now since the American Academy of Pediatrics changed their guidelines to recommend that children remain rear-facing in car seats until they reach the age of two. A parent looking in the rear-view mirror no longer sees their child’s face – just the back of the car seat – whether their child is in it, or not).

It happens…

…and it doesn’t have to be 100 degrees outside for the consequences to be devastating. According to NHTSA’s Consumer Advosory: “NHTSA Issues an Alert to Prevent Child Heatstroke in Cars“, even cool temperatures in the 60s can cause the temperature to rise well above 110 degrees Fahrenheit inside your car. The inside temperature can rise almost 20 degrees F within the first 10 minutes”. Within an hour the temperature jumps around 50 degrees F. If the outside temperature is in the low 80’s F, the temperature inside the vehicle can reach deadly levels in only 10 minutes. Slightly rolling the window down has almost no impact on these temperature increases.

Take a look at this simulation produced by the SafeKids organization of how fast a car can heat up when exposed to direct sunlight

Children’s bodies – in particular infants and children under 4 years of age – are at greatest risk for heat-related illness. They absorb more heat and are less able to lower their body heat by sweating. Because a child’s thermoregulatory system is not fully developed, their bodies warm at a rate 3 to 5 times faster than an adult’s. Hyperthermia occurs when the body produces or absorbs more heat than it can dissipate. A core body temperature of 107 degrees F is considered lethal because cells are damaged and internal organs shut down.

It happens…

To the most loving, caring parents…the most responsible caregivers. These are not “those horrible people who should never have been allowed near children”. Take a minute to read Kristie Reeves-Cavaliero’s story about the day her husband Brett took one wrong turn and drove to the office instead of dropping their beloved daughter Sophia (Ray Ray to those who loved her) off at daycare. It wasn’t until they met for lunch later in the day that they realized something was wrong. By that time Ray Ray had been in his truck for 3 hours. An hour and 19 minutes later she was gone.

But this isn’t just Ray Ray’s story. More than 1 in 5 kids who die of heatstroke in a car were supposed to be dropped off at daycare that morning – and no one questioned their whereabouts until it was too late. Other parents have had similar experiences. They share the story of their children’s tragedies here, in interviews, in every public forum possible – in the hopes of saving just one family the pain they have endured.

SO WHAT CAN YOU DO TO PREVENT ANOTHER TRAGEDY??

• Child Vehicle Heatstroke Prevention Tips from NHTSA:
  • Never leave a child unattended in a vehicle. Never leave infants or children in a parked vehicle, even if the windows are partially open.
  • Do not let your children play in an unattended vehicle. Teach them that a vehicle is not a play area.
  • Make a habit of looking in the vehicle – front and back – before locking the door and walking away.
  • If you are dropping your child off at childcare, and normally it’s your spouse or partner who drops them off, have them call you to make sure the drop went according to plan. Ask your childcare provider to call you if your child does not show up.
  • Do things to remind yourself that a child is in the vehicle, such as:
    • Keep a large object such as a stuffed animal in the car seat when it’s empty. Move the stuffed animal to the front seat when you place the child in the seat as a visual reminder.
    • Place your purse, briefcase or something else you need in the back seat so that you will have to check the back seat when you leave the vehicle
  • If you see a child alone in a hot vehicle: call the police. If they are in distress get them out as quickly as possible and cool the child rapidly. Call 911 or your local emergency number immediately
• Download the KidsandCars Safety Checklist and keep it handy
• Friday May 30th is National Heat Awareness Day: Please Help Us Raise Awareness!
  • Post on every social media platform…and use the hashtag #heatstroke to spread the word – child vehicular heatstroke is the leading non-traffic, non-crash cause of death for children.

“If you think it can’t happen to you, then it could and it might… Tell yourself it COULD happen to me, and then do whatever it takes to make sure it doesn’t.”
…kidsandcars.org

And if you ever catch yourself saying…”I’ll only be gone for a moment”… please do two things:

1. Consider the following question: If someone gave you a million dollars – would you leave it sitting there unattended in your car – even for a moment? Isn’t your baby’s life worth more?
2. Consider watching this video…and then maybe even share it:
   Before you do, know that it is very graphic and may be upsetting…so please think twice before you watch it.

Please also know that this was a re-enactment – no one was harmed in the making of this film

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Editor’s Note: This post was originally published in July of 2013. We are republishing it today to commemorate this year’s National Heat Awareness Day.

Summertime Bugs, Bites and Burns: A Pediatrician’s Perpective

Last updated on July 6th, 2025 at 03:15 pm

The beginning of summer signals a time of spending more active hours outdoors. The weather is warming up, the days are longer and children are getting out of school and probably staying up longer than they did during the school year. It is a time to let loose and enjoy the sunshine and freedom that comes with the season.

Certain issues should be addressed and some summer safety tips followed in order to keep everyone as healthy as possible.

Burns: While exposure to sunlight is important to the innate production of vitamin D and hence calcium metabolism, there are dangers that our dermatology friends have been warning about for quite some time: too much sun can be as dangerous as too little. The highest rates of Melanoma (serious form of skin cancer) occur where there is an increased and constant exposure to sunshine, such as the southwestern part of this country. Why is this? It has been determined that both UVA and UVB light frequencies can at times alter the structure of DNA, that is the microscopic building blocks for forming all types of life forms. This is most prominent in the largest organ in our bodies, our skin. This can lead to the formations of all types of skin growths- melanoma being the most serious as it can shorten one’s life.

So avoiding sunlight would be the best way of avoiding this problem, but this is virtually impossible. Therefore try to avoid the maximum sunlight times of the day and spend more time outdoors before 10 AM and after 3PM, and cover up as much as is practical. At all times children should have a good sunblock on their skin- one that will block both UVA and UVB frequencies, and if continued exposure to sunlight is taking place or if one enters the water, this sunblock should be re-applied; the higher the SPF the less often it need be applied.

One blistering sunburn in a child can raise the chances of developing melanoma as an adult manifold. Once a sunburn is present there is practically nothing you can do except to keep your child comfortable with cool compresses and Tylenol if he/she is very uncomfortable.

Bug Bites and Stings: Not only are bugs a nuisance but some may carry diseases. Just as an example, the increase in concentration on the Zika virus in 2016 highlighted the need to be alert to insects (mosquitoes), as the Zika virus was not even recognized 5 years before. In 2024 we started to see a rise in West Nile virus in the United States, also caused by mosquito bites. There are other known illnesses that can be transmitted through the bites of insects, but as a rule these are not very common- it still makes sense to wear appropriate clothing and use insect repellent at appropriate times. These repellents should contain DEET in concentrations up to 30% for children and should not be used under the age of 6 months – use lower concentrations (10%) if kids will only be outside for an hour or two.

In general the ubiquitous honey bee usually will not be interested in stinging humans unless they are threatened- inadvertently sat on, or a child is actively trying to catch them. Even the large black and yellow bees seen buzzing around certain plants and flowers are not particularly aggressive.

This is not necessarily true of other stinging insects in the same family (hymenoptera). Hornets and wasps can be aggressive depending on the situation, and the fairly new “Africanized bee” population has grown in size- they tend to swarm and have been responsible for deaths in the past. So better off to avoid these creatures altogether. Of course if there is a known bee allergy present in your child certainly more stringent avoidance procedures should be undertaken as this can be a life threatening situation. Be sure to consult your pediatrican about what precautions you should take if you believe your child might be allergic to bees.

So summertime is a wonderful time for families and especially children; be sure to keep your child safe from the indigenous dangers that summer presents.

Other summer topics to be discussed in my next article include water hazards, plant contact (poison ivy, etc), heat exposure and dog and cat bites, not to mention animal safety in general.

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Editor’s Note:

We have also seen an increase in Lyme Disease here in the United States. Lyme disease is a bacterial infection spread to people through the bite of blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. If your child has come into contact with a tick (or if you think they may have, but are not sure) and they experience these symptoms or a characteristic rash, please contact a health-care professional as soon as possible.

Keeping Your Family Safe from Frostbite

Last updated on March 29th, 2025 at 04:03 pm

This year we had an extended break over the holidays in order to visit the Canadian grandparents and ski the Canadian Rockies in Alberta. It’s a very beautiful part of the world and I do love visiting there….but in the winter, it is COLD! Which is why I couldn’t help but laugh while we were packing for the trip – in our Midwest American winter – when my husband asked if I was packing the sunscreen. Seriously?! Whatever for? You see, however much sunlight might reflect off snow while skiing, creating a risk for sunburn – in the Canadian Rockies – EVERYTHING needs to be covered up, even your face.

Our 12-year old son learned this the hard way, when he began getting frostbite on his cheeks after extensive time out on the slopes on one of the colder days. We took care of it in fairly short order, but when I returned back to the U.S. and discovered it was actually COLDER in the Midwest than it had been in Canada, the idea of a frostbite post seemed like a good idea.

Windchill and Frostbite

When considering frostbite risk, a good place to start is with windchill, which is the term used for the rate of heat loss from the human body resulting from the combined effect of low temperature and wind. As winds increase, heat is carried away from the body at a faster rate, driving down both the skin temperature and, eventually, the internal body temperature.

It’s important to note that the only effect that windchill has on objects (or people) is that it shortens the time that it takes the object to cool to the actual air temperature (it cannot cool the object down below that temperature). Windchill matters because, for any given temperature, with increasing winds, it increases the risk of – and reduces the time for – frostbite of exposed skin to occur.

A Frostbite Primer

At or below freezing (32 °F or 0 °C), blood vessels close to the skin start to constrict, and blood is shunted away from the extremities, like fingers, toes, ears and nose. The same response may also be a result of exposure to high winds. This constriction is helpful as it preserves core body temperature. However, in extreme cold – or when the body is exposed to cold for long periods – this protective strategy can reduce blood flow in some areas of the body to dangerously low levels. This lack of blood leads to the eventual freezing and death of skin tissue in the affected areas.

The level of severity of frostbite is characterized in degrees – similar to burns – with the least severe level known as first degree, or the quaint, “frostnip”. Below is an outline of the degrees of frostbite severity:

First degree (aka Frostnip)

• Superficial cooling of the surface of the skin, without destruction of the skin cells.
• At onset, there is itching and pain, then the skin develops white, red, and yellow patches and becomes numb.
• Affected area usually does not become permanently damaged as only the skin’s top layers are affected – though long-term insensitivity to both heat and cold can sometimes happen after suffering from frostnip.

Second degree

• If freezing continues, the skin may freeze and harden (destroying skin cells), but the deep tissues are not affected and remain soft and normal.
• Injury usually blisters 1–2 days after becoming frozen. The blisters may become hard and blackened, but usually appear worse than they are.
• Most of the injuries heal in one month, but the area may become permanently insensitive to both heat and cold.

Third and fourth degrees

• If the area freezes further, deep frostbite occurs. The muscles, tendons, blood vessels, and nerves all freeze and can be destroyed.
• The skin is hard, feels waxy, and use of the area is lost temporarily, and in severe cases, permanently. The deep frostbite results in areas of purplish blisters which turn black and which are generally blood-filled. Nerve damage in the area can result in a loss of feeling.
• May result in fingers and toes being amputated if the area becomes infected with gangrene. If the frostbite goes untreated, they may fall off.

Frostbite Prevention

In order to avoid frostbite in the first place, it’s helpful to keep track of both the actual temperature – and the windchill or apparent temperature – and plan your time outdoors accordingly. For example, at an actual temperature of -10 °F, a light wind of 5 mph will make it feel like -22 °F and could cause frostbite after 30 minutes of exposure. But if the wind increases to 25 mph, it will feel like -37 °F and frostbite could occur in just 10 minutes – which might explain all the recent school delays and closures! The National Weather Service has a helpful windchill chart with estimated times for frostbite to occur.

When you and your family are outdoors in cold weather it’s also important to consider the following:

• Dress in layers of loose, warm clothing – and check for gaps in the coverings (such as between gloves and sleeves)
• Wear a hat or covering on your head – and make sure your ears are covered
• Wear mittens rather than gloves – so your fingers can share warmth
• Wear socks and sock liners that fit well, wick moisture and provide insulation
• Consider using hand or foot warmers – we got a lot of benefit from these skiing in Canada
• Try to keep moving outside to get blood flowing

Most of all, be aware of and check for signs of frostnip and frostbite, such as red or pale skin, and prickling feelings or numbness in the skin.

Frostbite Treatment

Frostnip – or mild frostbite – can be treated at home. It’s important to get out of the cold soon after the signs appear and change into dry clothing if needed. Warm the area gradually using warm (not hot!) water – about 100 to 150 degrees Fahrenheit (no hotter!) – or body heat such as a warm hand pressed on the cold skin. A couple of watch-outs:

• Do NOT rub or massage the area – this can further damage the skin
• Do NOT use direct heat from a heating pad, lamp, fire or radiator – as your skin will be numb and you will not be able to detect when it is burning

More serious frostbite needs medical attention immediately. Again, warm the area gradually, but do not start warming if the area may become exposed to cold again – this can make the situation worse. Remove any tight or wet clothing, and rest affected areas (e.g. do not walk on frostbitten feet). Also, leave any injured tissue intact for a physician to address – and follow the restrictions above for frostnip.

Thanks to my husband for the inspiration and much of the research for this post!

Summer Camp Health Tips – a Pediatrician’s Point of View

Last updated on September 7th, 2024 at 06:26 pm

Letting go of your child for a day, a week or even a month of camp during the summer is often a very difficult thing for parents to do, and initially, might be very difficult for the child. Most children, however, when they return from such an experience almost invariably have enjoyed themselves and gotten the first taste of living without parents. This can be an extraordinary experience for your child as he or she learns to live and be accountable for certain rules and restrictions.

Of course, you as a parent will worry the first couple of times your children go off “by themselves”. It may help to know that every camp is equipped with fairly up to date equipment and at least a very experienced nurse or Doctor. I myself did this (physician for an overnight camp for a 6 week period) just as I completed my Pediatric Residency and prepared to enter the Air Force. It was a rewarding experience for me and my family.

Most incidences of a medical nature are minor although very rarely a serious issue may occur. When you first apply for the camp for your child they will ask for a complete medical history including chronic or serious conditions that your child may have and any and all allergies, medication or non-medication related. This is an extremely important bit of information so try to be as specific as possible.

Teach your child ahead of time about the importance of such simple things as the proper use of insect repellents and sun blocks as these constitute the causes of the majority of the “problems” in the camp setting. They must also need to be taught the importance of reporting to the nurse or physician any issues they are worried about or are experiencing, as some children will do all they can to avoid seeing these people. If your child has a chronic disease such as asthma, he or she must be aware of the problems they can experience as a result of their illness and report such occurrences to the medical staff. Of course, the medical staff will also be familiar with such individual problems. They should also know about how to self-medicate (inhaler, etc.) if necessary.

Poison Ivy is also a very common occurrence as children spend more time outdoors, they should be told what it looks like and feels like so they can see the medical staff when necessary.

Other “problems” are injury-related and should be brought to the attention of the medical staff – fortunately the majority of these are also of a minor nature.

Finally, they will likely be taught about insects and other critters that can be encounter in the wild during the first days or weeks of camp; snakes, small mammals, spiders, etc. The camp staff will be very particular and complete when describing such encounters and will err on the side of conservatism while they are in charge of your child.

Wishing you and your kids a happy, healthy, and safe summer.

Water Workouts: Fun for Kids, Great (& Easy) Exercise for Parents

Last updated on June 3rd, 2024 at 04:31 pm

I am not one of those moms. Not the one who has an endless repertoire of educational and enjoyable crafts activities. Not the one who is genuinely excited about the endless games of trains or Candyland. Not the one who invites 10 5-year-olds over to make designer cupcakes from scratch, with matching hand-cut doilies, after the personalized pedicures. And I never really enjoyed watching many children’s TV shows or movies, with the exception of Lazy Town when my kids were little.

Sadly my motivation for watching Lazy Town was not very pure. A truly wonderful show which encouraged an active lifestyle, exercise, friendship and kindness, I admit that I let my kids watch every afternoon when they were young because the star was a hunk and in those early days of sleep deprivation, baggy and stained clothing, my rear and stomach wobbling and sliding south and what felt like zero physical appeal it was like watching mom porn. Fit! Active! Positively Perky!

And then I found the answer. The pool. Not swimming laps, because I’d manage maybe 10 minutes of that before I was recalled to active mom duty, but in the best possible way that also played to my mom-strengths – teaching my kids to be safe while we all had active fun in the water. I got my mojo back (and my figure), which made me a much better mom who happily did some crafts and games and always made time for our beloved story time when my kids were happy and worn out from being in the water and we’d snuggle together.

Not that long ago, I wrote about how parents are the first lifeguard on duty for your child, which means you need to be in the water with less confident swimmers and arms-length from non-swimmers. I promised my tried-and-true fun for kids, great easy workout for mom or dad, so here it goes! Repetition is key, as many times as your child is enjoying the exercise and every time you go in the pool. Think of how many times you say ‘look both ways before you cross the street’ as your inspiration. The goal is to teach your child to not panic, to be able to possibly save themselves if they do find themselves in water unexpectedly, or at least give you a couple more minutes to find your missing explorer, and to give them a positive and enjoyable introduction to water.

Humpty Dumpty’s for upper body. Sit your young child on the side of the pool (mine started when they were 4 months old). Recite the nursery rhyme and when Humpty Dumpty falls off the wall, lift your child and ‘fall’ off the wall, gently forward with their head always above water, then say the same words every time ‘turn around and hold on’ and place their clenched little fists against the wall. As your child gets older they will learn to turn and hold the wall on their own, they will be willing to have their head go under water as they ‘fall’, and eventually you can spot them while they fall, turn, and climb out themselves.

Monkey Hands for a full body workout. Hold on to the wall with your hands and have your child do the same. You are vertical and your feet will be against the wall helping to move you. Use ‘monkey hands’ to scoot around the pool to the ladder or steps. Start with a short distance, expand to the entire side or around the entire pool as you and your child build strength and endurance. You are teaching them to get to a place where they can climb out safely and building their confidence and muscles.

Helicopters for core and arms. Hold your child under their arms and twirl them around in the water with their feet in the water and their head and shoulders held well clear of the water. Children love the feel of the water rushing against their legs, and it’s better than a thousand crunches for you.

Coral Reef Dives for legs. When your child is old enough to dive under, stand with your legs wide and have them dive between your legs without touching. You can start with lifting one leg and then the other to give them more space. For my son, the budding marine biologist, he knew that coral is sharp and if he rubbed the coral and was cut it would attract sharks, which increased his determination, but that might be too much information for many children, so use your judgement. Fun, not fear is the goal.

Finally, anything you do in the water, whether it’s walking at the edge of the surf, walk in the water holding a baby, catching your child as they practice big jumps – it’s going to the gym times two because of the resistance of the water. No matter how you move in the water, it’s going to make you stronger, healthier and in much better shape. But you probably already knew that if you watched Katie Ledecky or Caeleb Dressel, or maybe you were a secret Lazy Town viewer like me.

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