Hacker News new | ask | show | jobs
by jqgatsby 1946 days ago
Hey, wait, what is the advice to avoid drowning, other than not leaving them alone? Is there some subtle hazard I’m unaware of?
4 comments

Not leaving them alone is enough, but to make people actually follow the rule, it is useful to tell them that kids are easily able to drown even in unbelievably small amounts of water, and also in situations where drowning seems almost impossible.
Also, when kids (and especially babies) are drowning, it's usually not obvious. In adults when carbon dioxide levels increase past a threshold a lot of physically obvious manifestations begin, such as thrashing, driven by the autonomic system. And before then there'll often be coughing and other signs of distress, autonomic or otherwise. In small children this doesn't happen. Countless parents have literally watched their child drown before their very own eyes. A coworker almost lost a kid this way--the instant the kid accidentally inhaled water while playing in a hot tub, they immediately went lights out. Fortunately their other, older child was also playing in the hot tub and attentive. The parents had both briefly gone inside, proving the warning that it only takes seconds for tragedy to unfold.

I'm synthesizing here, but AFAICT a catatonic-like state is typical of small children in severe distress. (Anybody remember the Moth Radio Hour story about the man whose kid immediately went catatonic when they were surprised by burglars? IIRC, he was told this response was common of young children.) So if a baby suddenly inhales a large amount of water, they may immediately go from normal to non-responsive (possibly retaining muscle tone?), even though they're not yet physiologically drowning, and even though with lesser amounts of water they would normally cough and cry. This [lack of] behavior may be related, if indirectly, to the phenomenon of SIDS. An infant's physiology hasn't developed the various mechanisms to jump start respiration when something goes awry. (One unproven hypothesis behind SIDS is that an infant's breathing is partly moderated and even induced by their caretaker's breathing, such that if they can't hear, feel, or otherwise sense--some theories implicate carbon dioxide levels--another's breathing their own rhythm may be disrupted, or if disrupted less likely to resume. Thus co-sleeping may be better for infants, reducing SIDS risk, ceteris paribus--i.e. absent counter-indications, such as a parent who smokes or drinks.)

So with babies not only do you have to watch them to make sure they aren't presently, visibly drowning, you have to make sure (to some reasonable, mentally healthy degree) they couldn't possibly be drowning--i.e. they didn't or couldn't have inhaled water; that they're active, attentive, etc.

I learned something today, and ours is about to turn 4 months. None of this was communicated to us, probably because it's expected that you pick up most of this tribal knowledge via, pre-covid, other parents in your socio-age group.

We attended an infant cpr class via zoom, learned nothing. We at least got the message about SIDS, but the lack of tribal knowledge in the first six weeks was pretty brutal as first-time parents.

My first two kids (and especially the first one) we left hospital with a feeling of "why on Earth would they just let us walk out with a baby? That seems crazy, we have no training at all in this!" The feeling was incredibly surreal with my first one.

For my third, they made us watch a series of videos on a range of topics over about 2 hours, which made me think "Yes, of course, this should be the absolute minimum required for a new parent".

The process for getting authorized to care for helpless adults (nursing assistant) requires months of study and a thorough exam. I think children will have better quality of life when all parental guardians pass a thorough parenting skills exam before they are allowed to care for children.
There should be some... parenting Wikipedia... or something like that. But then I imagine how various people would write there all that contradictory advice. :(

We had great parenting lessons, and more importantly, got a phone number "if you have any question or problem, call us".

My wife had a problem breastfeeding: it hurt her, a lot. She asked the nurse what to do, and the nurse was like "dunno, happens to many mothers, use a formula if the problem persists". We used that phone number instead, a lady came to us "show me how you feed the baby... ah, I see, the baby is under a wrong angle, here is how you should do it instead". Problem solved. Lucky us, but less lucky all the mothers who asked the same nurse, received the same answer, and didn't have a friend on the phone. (It also makes me wonder about the utter lack of curiosity with some people. Like, the nurse probably keeps getting the same question regularly for years, and she can't even, dunno, use google, or ask a colleague?)

I recommend trying a child carrier with a little baby. Not the giant type where you wear a huge metallic construction with the seat for the baby, but the ones made from cloth, where your child is on your body, vertically, facing you. -- You can walk around your house, carrying your child with you, and both of your hands are free. You can walk outside in winter, and don't have to worry whether your child is sufficiently dressed. You feel your child's heatbeat and breath, so you don't worry about SIDS. When the child doesn't want to sleep, you can take a walk outside, and maybe read a book. (Then the tricky part is removing the child from the carrier without waking it up. I learned to lay down on my back, unfasten and open the carrier, roll over and leave the child on the bed; still only about 50% success rate.)

Never ever leave them on the bed alone even if they are sleeping and you have cushions around them. They will still find a way to roll and fall off the bed (happened to us). 9 times out of 10 it will be fine but I've read horror stories online so be careful.
Never leave them for even a second in the bath (drowning) and never leave them alone with food (choking).
It sounds so obvious, until your dog gets his head stuck in the ficus tree planter and you can hear him running around, destroying your entire living room. You have to resist that initial urge to go help him until you've cleaned up the 16 blueberry puffs you've been coaxing your child to eat.
This is like saying "don't speed if you don't want a speeding ticket".

Yes, you can use absolute qualifiers like "never" and "always" to stupid proof general advice to a greater extent than you can with phrases like "common sense" and "where reasonable" but that doesn't automatically make the advice any more useful..

I'm perfectly fine with the size of the drowning risk that comes with spending ~1min removing something from the oven when the timer goes off and other reasonable allowances like that. Of course I'm not gonna stop and watch TV with an infant in the sink. And if traffic's going 85 I'm going 85 but I won't be the first person going 85.

It's not like that. Everyone knows the risk of a speeding ticket comes with speeding.

Not everyone knows that it takes 20 seconds for a baby to drown in a bathtub.

> I'm perfectly fine with the size of the drowning risk that comes with spending ~1min removing something from the oven when the timer goes off

Completely making up numbers here, say you do this for every 20-minute bath, your child bathes 1x/day, and they fall over in such a way that they might drown were you not there once every 10000 baths. Doing the math... 5% chance of being absent at the critical moment * 1/10000 baths * 365 baths/year = 0.18% chance of death in first year of life.

You may be willing to take that risk, but given the 4 million infants born each year in the US, that would be 7,300 infant deaths from drowning in the bathtub annually -- so as a societal rule, saving 7,300 infants a year seems worth the use of the word "never".

The actual number of deaths attributed to bathtub drowning each year is much lower; I'm glad the vast majority of parents appear to take "never" to heart.

You forgot to multiply by the likelihood that the timer (or some other "too small to take the baby out" distraction) goes off mid bath.

When you say "the vast majority of parents appear to take 'never' to heart" I can't help but suspect that missing factor is doing a lot of the heavy lifting.

I assumed that it happened once per bath, but this is very context- and parent-dependent too.

If you don't perceive of a 1-minute absence as a problem, presumably you are much more likely to step out of the bathroom.

Not really, it's just the simple advice not to let go of them or leave them is correct, common sense and important in that case.
If you don't know just how little water it takes to drown in, then the risk isn't obvious. A newborn that can't easily move and roll over can drown face down in an inch of water if they manage to get into that position, which even gentle sliding around in a baby tub can facilitate.
Have some advice from this experienced dad with 12 kids: the baby tub is a poor way to clean a baby. The water instantly gets disgusting from poo or whatever it is you are trying to remove, and then that gets all over the baby. Plus the baby tub costs money and takes up space. It's more clutter to trip over in the dark.

Babies can be washed in sinks, with the drain open and the water running. (don't let them kick the water temperature control though) Babies can be washed in a normal shower, held in the arms of a parent.

We did the sink when they were really little, then switched to the big tubs that sit on top of the sink because the kids loved it, the warm water, splashing, or just vegging out as we poured warm water through their hair. But yeah, plenty of times it was a double bath: The 1st one, and then the second one where we got them clean after draining pee water.