Published online October 1, 2007
PEDIATRICS
Vol. 120
No. 4
October 2007, pp.
926-927
(doi:10.1542/peds.2007-1672)
Criticism of Infant Swimming Practice Is Political, Not Scientific
Jonathan D. Reich, MD, MSc
Department of Cardiology,
Watson Clinic LLP,
Lakeland, FL 33813
To the Editor.—
The Pediatrics article by Bernard et al,1 which purported to link infant swimming to the later development of asthma, had a number of epidemiologic and statistical problems but, more importantly, seems to be an article published for political rather than scientific purposes. The press release by the American Academy of Pediatrics (AAP) on June 4, 2007, trumpeting this very weak study as evidence against infant swimming was in poor taste.2
The AAP clearly opposes infant swimming.2–4 Its press release stated that infant swimming gives the child a "false sense of safety."2 There is no evidence to indicate that children who are taught to swim in infancy are more likely to drown. Because 5 to 10 million infants and toddlers have taken swimming lessons, such evidence should be available if it exists.3,4 A false sense of swimming security is truly caused by flotation devices, which convince kids not only that they can swim but also that they can swim standing. When my 4-year-old niece, minus her water wings, nearly drowned while watching her younger cousins swim, I stopped objecting to infant swimming.
Bernard et al enrolled only 25 infant swimmers whose parents did not smoke. A significant association was found for infant swimmers and doctor-diagnosed asthma and/or exercise-induced bronchoconstriction (EIB). Neither the doctor-diagnosed asthma/EIB association nor recurrent bronchitis was corrected for parental smoking, yet EIB by itself was? Furthermore, there was no swimming information given on the 298 "other children." Did they learn to swim? Inside or outside? The comparison should be between children who learn to swim in infancy and those who learn after age 4 (as recommended by the AAP)3,4 while controlling for site. The Bernard et al study demonstrated that swimming indoors may be weakly related to lung pathology; we already knew this.5
Bernard et al did not state that infant swimming causes asthma but, rather, that infant swimming in indoor pools, along with other factors, is associated with airway changes that may predispose children to asthma. The conclusion was qualified because the study was too small to draw a conclusion. Certainly, there was no increase in hospitalizations, emergency department visits, or mortality.
It seems obvious that swimming prevents drowning at all ages. Treading water means a better rescue chance. At luxury hotel swimming pools, I see toddlers who can swim and others who wear flotation devices. Every family that stays at these hotels can afford swimming lessons. Parents postpone lessons, and the AAP promotes this dangerous choice. I suspect this leads to drowning, but I need data to draw a conclusion; it is unfortunate that the AAP does not.
REFERENCES
- Bernard A, Carbonelle S, Dumont X, Nickmilder M. Infant swimming practice, pulmonary epithelium integrity, and risk of allergic and respiratory diseases later in childhood.
Pediatrics. 2007;119
:1095
–1103[Abstract/Free Full Text]
- American Academy of Pediatrics. Infant swimming may risk future respiratory health [press release]. June 4, 2007. Available at: www.aap.org/advocacy/releases/june07studies.htm#infant. Accessed August 16, 2007
- American Academy of Pediatrics, Committee on Sports Medicine and Fitness and Committee on Injury and Poison Prevention. Swimming programs for infants and toddlers.
Pediatrics. 2000;105
:868
–870[Abstract/Free Full Text]
- American Academy of Pediatrics. AAP publications retired and reaffirmed.
Pediatrics. 2004;114
:1126[Free Full Text]
- Bernard A, Carbonnelle S, Michel O, et al. Lung hyperpermeability and asthma prevalence in schoolchildren.
Occup Enviorn Med. 2003;60
:385
–394[CrossRef]
PEDIATRICS (ISSN 1098-4275). ©2007 by the American Academy of Pediatrics
