By Charnicia E. Huggins 3/18/03

NEW YORK (Reuters Health) - Nearly one in three young children are left alone in the bathtub by their parents for some amount of time, putting them at risk for drowning, according to a report released recently.

The American Academy of Pediatrics' Committee on Injury and Poison Prevention advises parents to "never--even for a moment--leave children alone in bathtubs, spas, or wading pools...or other open standing water."

Yet the new study findings show that the "Academy says one thing, and parents are doing another," study author Dr. Harold K. Simon told Reuters Health.

"We need to improve on this disconnect and just raise public awareness," said Simon, an associate professor of pediatrics and emergency medicine at Emory University and Children's Healthcare of Atlanta, both in Atlanta, Georgia.

What parents think is a few seconds away from watching their children can become a few minutes and then "a tragic situation," Simon added.

In 1999, nearly half of the 1,345 accidental drownings among Americans younger than 20 were among children five years old and younger, according to the National Center for Injury Prevention and Control. Thirty-two percent of the drownings occurred among toddlers and infants who had not yet turned two years old.

And almost 60% of unintentional drownings among children up to one year old occurred in bathtubs.

In their study of 259 families, Simon and his team investigated the level of supervision parents and guardians gave to their children while bathing.

They found that 31% of parents and caregivers left a child alone in the bath, for as little as a few seconds to as long as five minutes or more.

Twenty-one children age two or younger--when drowning risk is especially great--were left unsupervised at some time. Five of them were unsupervised for more than two minutes, as were four children age one and younger.

In one case, a five-month-old child was left alone for more than two minutes as the caregiver went to get a towel. In another, an eight-month-old was left unsupervised for more than five minutes as the caregiver cooked a meal.

Parents also left their child unsupervised so they could talk on the telephone, get diapers or check on their other children, the investigators report in the March/April 2003 issue of the journal Ambulatory Pediatrics.

In other findings, although most young children were usually supervised by an adult during bath time, some families relied on the child's older siblings. Five families reported that a sibling younger than 10 watched over a younger child in the bathtub--including a five-year-old who was left responsible for a 22-month-old.

About 8 percent of study participants said their children bathed alone before the age of five.

Although the study concentrated on bathtubs as a potential drowning location, children are also at risk of drowning in high standing buckets and even toilets, Simon said.

At young ages, he explained, children tend to be more top-heavy, with large heads, so "if they tip into (a bucket or other object), it's a situation where they just can't tip out of it," and can drown in a small amount of water.

Simon hopes that the study's findings can help raise awareness that the lack of bathtub supervision "is a problem," and that healthcare providers can make people more aware of it.

"Even a short period of time in a high-risk situation can be devastating."

SOURCE: Ambulatory Pediatrics 2003;3.