Secondary drowning and dry drowning: A guide for parents

Taking our little ones swimming should be a fun and enjoyable activity, but it’s always important to be aware of the risks so we can be extra vigilant when it comes to avoiding accidents.

Two terms which you might have heard of but be unsure what they actually mean are secondary drowning and dry drowning. Also known as ‘submersion injuries’, they are little known conditions that can have an effect up to 24 hours after a child has left the water.

You may have heard the terms before, but it’s important to remember the two are different conditions, with different symptoms. As scary as the thought of a thrashing toddler in a swimming pool is, the signs of secondary drowning or dry drowning are much more subtle, and identifying them could mean the difference between life and death.

The term ‘submersion injury’ is given because the injury itself occurs whilst in the water, but it’s the subsequent symptoms, often hours after swimming, that can be dangerous.

Read our guide on secondary and dry drowning and always remember to take extra care when little ones are near the water.

Secondary drowning: What is it and how does it happen?


Secondary drowning can actually take affect a while after a child has left the water – up to 24 hours in some cases, and in the most extreme cases it’s been reported to have occurred an entire week after swimming.

Secondary drowning is the term given when water settles on the lungs during submersion. In the hours afterwards, it can cause inflammation or swelling, which then impacts a child’s ability to breathe. It can cause severe discomfort and in the worse case scenario, death.

Dry drowning: What is it and how does it happen?


Dry drowning, unlike secondary drowning, normally occurs fairly promptly after leaving the water, but is equally dangerous.

This is when a small amount of water is inhaled through the airways during swimming. This then triggers a spasm in the trachea, causing it to close up, again interfering with the respiratory system.

How to avoid a submersion injury

Though submersion injuries sound – and of course, are – terrifying, they’re pretty uncommon and can be quickly identified and prevented. The important thing is not to dismiss symptoms, and to think practically if your child has been in water recently (this includes baths).

Swimming lessons
From the age of four upwards, all children should have swimming lessons and be aware of water safety measures so they can protect themselves around water. A child who cannot swim well is more likely to cough and splutter in the water, maximising the chances of water in the respiratory system.

Supervision
Children around water – any body of water, including baths – should always be under the supervision of at least one adult, who can keep a close eye on what happens in the water.

Be aware of potential dangers
Even confident swimmers can get into difficulties in the pool or sea. Are there high waves that could cause them to inhale water? Is there a drain in the pool that their hair could get tangled on? It’s important to consider different elements around bodies of water, especially if you’re in a new place (i.e. on holiday).

How to spot a submersion injury

Increased breathing
A child’s breathing may become rapid and shallow, the nostrils flare (with the rib cage or collar bone becoming visible when inhaling), all of which could indicate your child is struggling to breathe and should be assessed immediately.

Persistent coughing
Persistent coughing or coughing associated with increased breathing is an indicator your child has taken in water and is suffering from a submersion injury.

Sleepiness
Registering sleepiness as a warning sign of a submersion injury can be difficult if they’ve worn themselves out at the beach or pool, but it’s important to monitor them closely. It could mean they’re not getting enough oxygen to their lungs, a symptom of secondary drowning, and can also affect cognitive function.

Vomiting
Finally, vomiting after a swimming trip could just be a reaction to chlorine in the gut, but it could also be your child’s body reacting to the stress caused from trying to regulate oxygen.

If they suffer any of these symptoms in the hours following swimming, it’s vital to think fast and act quickly. Depending on the severity of the symptoms, you may need to take them to A&E, but a phone call to your GP will best advise what to do.

Often, the child will simply require close supervision, but in more severe cases doctors may also do a chest X-ray or provide extra oxygen.