If a child is drowning, call for emergency help immediately and get something that floats to the child as fast as possible, without jumping into the water yourself. Every second matters: most drowning victims lose consciousness within 2 minutes, and irreversible brain damage typically begins within 4 to 6 minutes of submersion. Survival rates drop sharply once submersion exceeds 5 minutes.
Step 1: Call for Help and Stay Out of the Water
Your instinct will be to jump in. Resist it. An untrained rescuer who enters the water risks becoming a second victim, especially if the child is panicking and grabbing at anything nearby. Shout for someone near you to call 911 (or your local emergency number) while you stay on scene and keep your eyes on the child’s location in the water.
The safest course of action is to reach out to the child from solid ground. Extend a pool noodle, a towel, a branch, a paddle, anything with length. If the child is too far to reach, throw something that floats: a life jacket, a cooler, an empty water jug, a kickboard. Even a sealed plastic container can keep a small child’s head above water long enough for help to arrive.
If you can talk to the child, do so. Simple, loud directions like “Kick toward me” or “Grab the red float” can help orient a panicking child toward safety. Try to pull or guide them to the edge without entering the water yourself.
Step 2: If You Must Enter the Water
Sometimes there is no other option. If the child is unconscious, too far to reach, or sinking, and you are a competent swimmer, bring flotation with you. A life jacket, a boogie board, even a large plastic bin can serve as a barrier between you and a panicking child and help you tow them back. Approach from behind whenever possible so the child cannot latch onto your head or arms and push you under.
Once you reach the child, get their face above water and move toward the nearest edge or shore. If the child is unconscious and you’re trained, you can begin rescue breaths in the water while moving toward solid ground, but for most people the priority is simply getting the child out as quickly as possible.
Step 3: Start CPR Immediately
Once the child is out of the water and unresponsive, begin CPR right away. Drowning is fundamentally an oxygen emergency, so rescue breaths are critical here in a way they aren’t for other types of cardiac arrest. The American Heart Association recommends trained rescuers start with two rescue breaths, then follow with 30 chest compressions, and continue that cycle until emergency responders arrive or the child starts breathing on their own.
For children over age 1, tilt the head back gently, lift the chin, pinch the nose, seal your mouth over theirs, and give breaths just large enough to make the chest visibly rise. For infants under 12 months, the technique is different: keep the baby’s head tilted only slightly upward (not as far back as for an older child), and seal your mouth over both the baby’s mouth and nose at the same time. Blow gently for about one second per breath and watch for the chest to rise.
Place the heel of one hand (or two fingers for an infant) on the center of the chest, between the nipples, and compress hard and fast. For children, push down about 2 inches. For infants, about 1.5 inches. If you haven’t been trained in CPR, chest compressions alone are still far better than doing nothing.
Do Not Try to “Push Water Out”
A common mistake is attempting abdominal thrusts, sometimes called the Heimlich maneuver, to force water out of the lungs. This does not work for drowning and can be dangerous. The American Red Cross has stated clearly that abdominal thrusts are neither effective nor safe for removing water from drowning victims. The reason is straightforward: most drowning victims aspirate only a small amount of water, and it gets absorbed into the bloodstream quickly. It does not sit in the airway like a piece of food. Some victims don’t aspirate any water at all because their throat muscles spasm shut or they hold their breath. Attempting abdominal thrusts wastes precious time, risks vomiting and aspiration of stomach contents, and delays the CPR that actually saves lives.
Why Cold Water Changes the Timeline
In warm water, the window for rescue without brain damage is narrow: roughly 4 to 6 minutes. Cold water changes the equation significantly. When the body’s core temperature drops rapidly, cellular metabolism slows down, and the brain’s oxygen demand decreases by about 5% to 7% for every degree Celsius the temperature falls. This is partly driven by the diving reflex, an automatic response (strongest in children) that redirects blood to the heart and brain and slows the heart rate.
In water above about 43°F (6°C), survival is unlikely after 30 minutes of submersion. But in ice-cold water below that threshold, children have survived after more than 60 minutes underwater. Current drowning guidelines recommend continuing CPR for up to 60 minutes after any submersion, with no fixed time limit if the water was ice cold. This is why you should never assume a child pulled from cold water is beyond help. Continue CPR until paramedics take over.
What to Watch for After Rescue
A child who was submerged but seems fine afterward still needs close monitoring. When water enters the lungs, even in small amounts, it can trigger progressive inflammation and fluid buildup over the following hours. This delayed reaction is sometimes called “secondary drowning,” and symptoms can appear anywhere from one to 24 hours after the incident. Look for these warning signs:
- Persistent coughing that continues or worsens after the child has been out of the water
- Labored breathing, including rapid breaths, shallow breaths, or visible pulling-in of the skin between the ribs
- Unusual fatigue or lethargy, suggesting the body isn’t getting enough oxygen
- Chest pain or complaints of tightness
- Vomiting, which can be triggered by low oxygen levels
- Behavioral changes like confusion, irritability, or sudden mood shifts
- Pale or bluish skin, particularly around the lips and fingertips, which signals oxygen deprivation and requires immediate emergency care
If your child was submerged and shows any of these symptoms, even hours later, take them to the emergency room. The inflammation in the lungs can escalate quickly, and early treatment with supplemental oxygen makes a significant difference in outcome.
Recognizing Drowning in the First Place
One of the most dangerous aspects of childhood drowning is how quiet it is. Drowning almost never looks like it does in movies. Children rarely wave their arms, splash dramatically, or scream for help. A drowning child is typically silent, with their mouth bobbing at or just below the water’s surface. Their arms may press down at their sides in an instinctive attempt to push up, but they cannot wave or reach out. Their eyes may be glassy or closed, and their body may be vertical in the water with no visible kicking.
This is why active supervision matters more than proximity. A child can drown in a backyard pool while adults are sitting feet away, simply because no one recognized what was happening. If a child in the water is unusually quiet, not responding when you call their name, or their head is tilted back with their mouth at water level, act immediately. Pull them out first, ask questions later.