baby in sea water

What is dry drowning in infants?

People spend more time in pools, rivers, lakes, and on beaches during the hot summer months. While water offers an escape from the heat, it’s important to keep water safety in mind. Recent headlines have increased awareness and concerns about dry drowning and secondary drowning, but should parents worry?

It’s hard not to worry when you see the alarming stories: a child gets out of the pool or lake and seems fine till they suddenly lose consciousness and drown, minutes or hours after they’ve left the water. But it’s not that simple — or that scary.

How common are dry drowning and secondary drowning, and can they be prevented?

When a child or adult falls in the water, it’s human nature to inhale or gulp down water in a state of panic. Once the person has been rescued from the water, most of us would assume that the danger is over.

But after taking in water through the nose or mouth, the muscles in your windpipe can become constrained to protect your lungs. Some people have labelled this condition “dry drowning,” though this is not a medical term or diagnosis. Doctors call this phenomenon “post-immersion syndrome,” and though it’s rare, it does happen.

Dry drowning mainly occurs in children. While 95 per cent of children are fine after accidentally slipping underwater, it’s important to be vigilant and aware of drowning symptoms that can happen once your child appears safe and dry. Dry drowning is a medical emergency that requires prompt attention.

You pay close attention to your kids when they’re swimming or playing in the pool, splashing in the ocean. You make sure a lifeguard is on hand, and you never leave your little ones alone near any water — even the tub. And that’s the right thing to do. But there’s still more you can do to keep them safe: Learn the signs of danger after they’re out of the water and what to do.

Health experts define drowning as trouble breathing after you get water into your airways. Sometimes that happens while swimming or bathing. But it can come from something as simple as getting water in your mouth or getting dunked.

Although it can be fatal, it isn’t always. You can survive drowning if you get help right away.

Dry drowning is an outdated term. Some have used it to describe instances in which death resulted from swallowing or breathing in liquid, but the person showed no signs of breathing difficulties.

Decades ago, the medical community largely abandoned the term, after doctors developed a better understanding of breathing capacity and drowning injuries.

Today, some people occasionally use “dry drowning” to describe cases in which liquid makes the voice box spasm and shut, reducing breathing and other vital functions.

This article will discuss the symptoms and causes of dry drowning and explain when to seek medical attention.

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What is dry drowning?

Dry drowning once referred to instances in which a person died more than 24 hours after swallowing or inhaling liquid but showed no signs of breathing trouble.

Most medical authorities and organizations now discourage the use of the term.

At present, the medical community has not agreed on a term to replace dry drowning. Some groups use “post-immersion syndrome” or, less commonly, “delayed drowning.”

Today, researchers and doctors occasionally use dry drowning to describe cases in which liquid stimulates the voice box, causing the organ to spasm and shut.

When the voice box spasms, the vocal folds close, and breathing becomes difficult. Liquids may end up in places they should not go, such as the sinuses, and it may be difficult to get air into the lungs.

baby in sea water

Dry drowning vs. secondary drowning

Dry drowning and secondary drowning are both the result of injuries that happen underwater. Dry drowning sets in less than an hour after inhaling water. But secondary drowning, which is also rare, can happen up to 48 hours trusted Source after a water accident.

Secondary drowning is caused by water that accumulates in the lungs. It’s more similar to what we think of as “real” drowning because it involves your lungs filling up with water. The water then causes breathing difficulties. Both dry drowning and secondary drowning are serious health conditions that can be fatal.

Drowning occurs when someone cannot breathe after going below the surface of water or another liquid.

When someone is drowning, lung damage and exposure to liquid cause the major lung passageways to spasm, stopping airflow. Ultimately, people who drown die from a lack of oxygen.

Some doctors once used the terms “wet drowning” and “dry drowning” before the medical community had the right diagnostic tools to examine breathing.

Once they learned that drowning results from a lack of oxygen, not the volume of water in the lungs, the single term “drowning” replaced wet or dry drowning.

Dry drowning once described cases in which other complicating factors were present, such as:

  • no early breathing difficulties or signs of a lack of oxygen
  • no or very little water in the lungs
  • no one else knowing if the person had swallowed, inhaled, or submerged in liquid

Today, doctors realize that a person can die if even a little bit of water enters their lungs. According to the Surfer’s Medical Association, this amount may be as small as 2 millilitres of water per kilogram of body weight.

Some researchers and doctors still occasionally use the term dry drowning. When they do, it typically refers to cases in which water or another liquid cause the voice box and vocal folds to spasm. A severe spasm can reduce airflow enough to be fatal.

Aside from dry drowning, most health authorities and organizations discourage the use of the following medically inaccurate terms:

Dry drowning symptoms and what to do

The good news: You’re going to see warning signs

No matter your child’s age, be on the lookout for these dry drowning signs and symptoms in babies, toddlers and big kids:

  • Water rescue. Any child pulled from the pool needs medical attention. At the very least, call the pediatrician.”
  • Coughing. Persistent coughing or coughing associated with increased work of breathing needs to be evaluated.
  • Increased “work of breathing.” Rapid shallow breathing, nostril-flaring, or where you can see between the child’s ribs or the gap above their collarbone when they breathe, means they’re working harder to breathe than normal. This is a sign that you should seek medical help immediately.
  • Sleepiness. Your kid was just excitedly playing in the pool, and now she’s fatigued? It could mean not enough oxygen is getting into her blood. Don’t put her to bed until her doctor gives you the go-ahead.
  • Forgetfulness or change in behaviour. Similarly, a dip in oxygen level could cause your child to feel sick or dizzy.
  • Throwing up. Vomiting is a sign of stress from the body as a result of the inflammation and sometimes a lack of oxygen, also from persistent coughing and gagging.

Any time you’re concerned about your child and think he could have symptoms of a submersion injury, whether you’re in your backyard pool or on a beach vacation, call the pediatrician right away for advice. Your child’s doctor should be able to talk you through it and might advise you to go to the ER, a primary care doctor, or a national urgent care centre.

But if your child is struggling to breathe, call 911 and/or head to the emergency room right away. Necessary treatment may not be available in settings other than the ER.

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Treatment for dry drowning

If you see symptoms of dry drowning, you need to call for emergency medical assistance—dial 911 without delay.

In the meantime, try to keep yourself, or your child calms for the duration of the laryngospasm. Keeping calm can help the windpipe muscles to relax more quickly.

Once emergency help arrives, they will administer treatment at the scene. This may involve resuscitation if someone has passed out due to lack of oxygen.

Once the person is stable, they’ll be taken to the hospital for observation. Having symptoms of dry drowning after a submersion incident requires medical observation to make sure that regular breathing resumes and to rule out other conditions, such as secondary drowning or bacterial pneumonia. A chest X-ray or evaluation by a pulmonary specialist may be necessary to rule out water in the lungs.

If a person seems to lack oxygen or may have drowned, anyone trained should immediately begin CPR and get someone else to call for emergency help.

Once the person arrives at the emergency room, they will often undergo medical tests to determine how well they are breathing. Doctors will also check their vital signs, such as their heart rate, body temperature, and oxygen levels.

If the vital signs are all normal, healthcare professionals will usually monitor the person for around 4–6 hours, then allow them to leave the emergency department. If not, they will admit the person to the hospital for longer-term monitoring and care.

Preventing dry drowning

Dry drowning is a type of drowning, which is one of the leading causes of death in young children. But you can minimize the chances of drowning by doing your best to prevent water accidents altogether.

In the case of children two years old and younger, any water submersion is a serious risk. Even if a child is just under the water for a minute or two, take them straight to the emergency room after a water scare.

Keep these safety rules in mind when you have small children in your care:

  • Supervise children who are under four years old in any body of water. This includes the bathtub.
  • Children under four years of age should never swim or bathe unassisted.
  • Passengers of all ages should wear lifejackets while boating.
  • Consider taking an infant CPR class if you frequently supervise children at the pool or the beach.
  • Invest in swimming lessons for yourself and your children.
  • Keep pool gates closed at all times.
  • Don’t swim or play near the ocean without a lifeguard present.

What to do in the event of secondary or dry drowning.

There are warning signs for these syndromes, and if they’re going to occur, they will most likely follow a near-drowning event. Watch your child closely after a near-drowning to see if he or she starts to show symptoms of dry drowning or secondary drowning.

If you believe your child is showing symptoms of dry drowning or secondary drowning call your child’s pediatrician. They can advise you on what to do and whether to seek medical attention.

Can a child swim again after a dry drowning event?

This is such a rare condition that there is very little data about the likelihood of recurrence. The decision to participate in water sports or go into the water again should be made with a health care professional and include a close discussion of risks, benefits and precautions.

The condition, also called noncardiogenic pulmonary edema, can also result from anesthesia, infections, certain medications and a number of other scenarios.

Parents and children should mention having had a drowning-related episode if they ever require surgery, need a medical procedure or need hospitalization so that future health care providers can take appropriate precautions.

Drowning remains a leading cause of unintentional death for people of all ages – especially for children under 14, according to the Centers for Disease Control and Prevention. On average, there are 3,500 fatalities annually from drowning – or about ten people a day who die from drowning.

Drowning occurs when you can’t get oxygen into your lungs because you are in or below water, noting there are two primary causes for drowning.

“When people experience drowning events, typically one of two things occur. There will be reflexes of panic, agitation and air hunger. And, when you can’t avoid taking a breath underwater, fluid will rush into the lungs. This is what we see in about half of the cases.

The other type of drowning occurs when the voice box closes off. Known as a laryngospasm, “it’s a reflex that happens to prevent fluid from getting into the lungs. This could happen if you are below water, holding your breath to the point where you pass out.”

He notes that swallowing water while in the ocean or the pool is not drowning. “Drowning is when you can’t get oxygen into your lungs. Some people misassociate this with swallowing water when you’re in the ocean or in the pool, which results in water going into the stomach. Although this can happen concurrently with water going into your lungs, that in itself does not truly represent a drowning event.

When kids are in a pool, for example, and they start coughing or spitting out water, it’s likely because they have taken a lot of water into their stomach and some has gotten into their lungs. “But the body is smart. It will try to get that fluid by itself. And the cough is the body’s natural defence mechanism to do that. “In many cases, when there is a small amount of water aspirated into the lungs, coughing will allow it to be cleared.”

If the episode lingers or the person seems to be in distress, he advises calling for medical assistance. “If symptoms of respiratory dysfunction, such as prolonged cough or trouble breathing develop — whether 30 minutes after you’ve been in the water or a week — always seek medical attention.”

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The best prevention

Know the risks for, and symptoms of, drowning, and to always keep a watchful eye on children when they are in or around water.

The best thing we can do is to be aware of and prevent drowning. And this means being diligent with close, constant adult supervision that is not distracted by cooking, cleaning, reading or talking on a cellphone. It means somebody is watching the water at all times.”

Small children don’t need a large volume of water for drowning to occur. Hot tubs and bathtubs — even buckets of water — could represent risks for infants or toddlers, he says.

Dry drowning is an outdated, widely misused term. Some have used it to describe the breathing problems that occur when liquid causes the voice box to spasm.

The outlook for those who experience so-called dry drowning depends on the extent of the injuries and symptoms. The longer someone cannot breathe, the more serious their injuries, and the greater the risk of death.


If a person shows symptoms of trouble breathing or a lack of oxygen, receiving medical care immediately will increase their chance of survival.

Always practice water safety, and supervise children in pools or hot tubs, at beaches, and by other bodies of water.

People who are treated immediately when symptoms of dry drowning occur to have a high probability of recovering with no lasting side effects.

The most important thing to guarantee a good outcome is carefully watching for symptoms after a water accident. The minute symptoms occur, call for emergency assistance. Do not try to wait it out.

As long as you practice water safety, pay close attention to your kids after swimming, and get them checked out if you notice any signs of trouble breathing, you shouldn’t have to constantly stress about dry drowning or secondary drowning (submersion injuries).

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