Toddler drowning prevention through self-rescue: can 1-year-old children learn to float?

Drowning is a leading cause of toddler death. Prevention must be multifaceted but could include training children to protect their own safety in water. Efforts to teach toddlers self-rescue water survival skills are widely promoted but scientifically untested. A pre-post study evaluated whether self-rescue training effectively teaches 1-year-olds to survive independently in water.

50 toddlers aged 12-23 months participated in this phase I clinical trial. Structured in-water behavioural assessments evaluated self-rescue ability both at baseline and after 20 training sessions of 10 min each, scheduled daily on weekdays for 4 weeks, using behavioural strategies to teach toddlers self-rescue skills.

At baseline, all participating toddlers failed the first assessment phase, which required safe independent engagement in water for 5 s. Following training, 40 of the 48 retained toddlers (83%) passed all 5 assessment phases without failure, including safe independent engagement in water for 3 min while clothed following face-down release. When offered a second attempt to pass advanced assessment phases, 47 of the 48 (98%) successfully completed all assessment phases. Parents generally judged the programme positively, although a minority felt their toddlers experienced 'a little trauma or distress', especially in early training stages.

Almost all 1-year-olds appear capable of learning skills to survive independently in water while clothed for short time periods, offering an additional strategy to multi-layered toddler drowning prevention efforts. Given training intensity and potential for negative emotions, parents and paediatric providers should consider cost:benefit ratios; in particular, at-risk toddlers might benefit from self-rescue training.

NCT05977530.