When I was a young boy I repeatedly heard warnings from my mother, such as “Look both ways before crossing the street” and “Don’t get in a car with a stranger.” Now there is a need for parents to adopt another potentially life-saving mantra to help end the tragic deaths associated with shallow water blackout (SWB). While statistics are unclear and range from hundreds to thousands of deaths a year, these numbers can be greatly reduced if education begins at a young age.

Simply put, shallow water blackout is the loss of consciousness caused by prolonged breath-holding, often preceded by hyperventilation, while swimming or diving in water 16 feet or less. From kids at a summer pool challenging each other to see who can hold their breath the longest to experienced swimmers going for distance underwater, death can occur without any warning. The reflexive drive to breathe is delayed and the swimmer or diver is susceptible to losing consciousness and dying whether near the top of the water or deeper.

Many unexplained drowning deaths may be from shallow water blackout. Persons are left to ponder how an accomplished swimmer or diver could have drowned — even in a guarded pool. When consciousness is lost, there is often perceived normal movement with no obvious struggle. Victims’ lungs may fill with water and they can drown, or other causes associated with prolonged breath-holding can result in death. Because oxygen going to the brain has been significantly depleted from breath-holding, brain damage and death can occur much faster than in a regular drowning.

Recently, I watched children playing in the same pool where days before a talented young swimmer had been found dead. He would have wanted them to enjoy the water, but I wondered if they wouldn’t be safer had parents had warned them of the perils of SWB. While various aquatics organizations have done their part to educate constituents, the majority of people are still unaware of this silent and tragic phenomenon. I became convinced of the need to warn parents and as many others as possible.

As an aquatic safety advocate, it strikes me that shallow water blackout should be higher on the educational priority list for parents, safety personnel, coaches and others. Statistics are fuzzy, but it makes sense that SWB in children occurs less in darker and scarier open water than in clear and inviting swimming pools. However, the critical carbon dioxide and oxygen imbalance of SWB can and does happen anywhere.

When we were kids, my buddies and I often challenged each other to see who could swim the farthest underwater.

We were fortunate. Victims have drowned trying to hold their breath the longest while onlookers unwittingly thought they had great staying power.

Instilling fear is not the answer, but a responsible distinction must be made between acceptable underwater practices and those that can lead to death. Holding one’s breath to retrieve a toy from the pool bottom or doing somersaults with friends in the water is not the culprit for shallow water blackout. Some lifesaving maneuvers such as the recovery of a submerged victim and certain competitive swimming and free diving training require underwater breath-holding. These and other activities, always must be closely supervised. Participants must be educated about shallow water blackout, and lifeguards informed about the nature of the activity so they can be extra-vigilant.

Requiring pool signs to prohibit prolonged underwater breath-holding, directing program managers and coaches to regularly inform swimmers of the dangers of shallow water blackout, and mandating that lifeguards be notified when any underwater breath-holding is required would be a good start. But perhaps parents may be the best defense against shallow water blackout that can result in near death or death.

Just as Mothers Against Drunk Driving united to save lives by changing the world’s perception of drinking and driving, so parents can save lives by understanding SWB and making it part of their children’s early education. With parental understanding and warning, children can safely enjoy swimming and diving and the wonders of the water.