Infants in diapers/Swimming facilities/Illness

Think twice before allowing your kids to swim in water where there are many infants.  The more infants in the water, the greater is the risk that the water is polluted with intestinal disease-causing microorganisms. 

Here is what you should know:

1. Recreational water is an underappreciated source of intestinal diseases. Such water includes swimming pools, hot tubs, water parks, lakes, beaches and oceans. In the past two decades, there has been a substantial increase in the number of cases of intestinal disease from such water. Many different types of organisms are involved.  In one recent year, one organisms,  cryptosporidum, which is resistant to chlorine,  caused 10,500 known case, says the Centers for Disease Control (CDC). And this is only the tip of the iceberg. No matter which organism is involved, only large outbreaks or outbreaks involving hospitalizations and deaths are reported.

2. Infants in recreational water are a fairly recent phenomenon. In the distant past, placing infants in water was just not done.  More recently, parents kept infants out of pools, believing that chlorine was bad for them. However, now there are water-based swimming and exercise classes for infants and infant-parent bonding programs, generally conducted in the same facilities used by others. And there are loads of accessories: swimming diapers, water toys and floating paraphernalia.

3. Do infants belong in recreational water? Exposing infants to water does not help them overcome a fear of water. Teaching them to swim does not “drown-proof” them; generally, they swim only when adults hover over them, not if they fall into water unseen, possibly giving parents a false sense of security. And infants don’t learn to swim in less time than older children or become more proficient than if they started lessons at a later age.

4. Infants in diapers are a major source of diarrhea-causing organisms. Infants are more likely to have intestinal illnesses than older children and adults, do not control their bowel movements, and tend to shed organisms for many days after symptoms have disappeared. Individuals with infectious diarrhea should not swim for two weeks after symptoms disappear.  

5. Infants are more likely to become ill from ingesting polluted water. Infants swallow water when their heads are dunked. Older children can be encouraged – with varying degrees of success – to keep water out of their mouths and, when ingested, to spit it out. Becoming ill is related to the number of organisms swallowed. Stomach acidity and immune mechanisms protect the body from some organisms, but the body is overwhelmed by too many. Because of infants’ small size and immature immune systems, it takes fewer organisms to make them ill, infants are often in the water with other infants, increasing the risk of exposure, and if illness does occurs, have more severe symptoms.   

6. Small inflatable, plastic pools increase the risk of spreading disease. The CDC recommends not using such pools. They are generally filled with tap water. While most tap water contains chlorine, the concentration is inadequate to kill many types of organisms. Yet CDC advises not to add additional disinfectant. The dose cannot be easily determined nor safely monitored, and the pools lack filters to remove particles that prevent disinfectants from working optimally.  

7. There is no way to prevent infants from urinating in the water. (But adults do this too. CNN reports that 16% of adults are guilty, including U.S. Olympic medalists.) Urine is sterile, but it emits a chemical odor, and causes mild eye irritation and coughs. Sweat and urine combine with chlorine, creating chloramines, hence the odor and symptoms. (It is a myth that a chemical exists that, when added to pool water, will combine with urine and turn the water around the perpetrator bright red. Apparently, some pools have such signs to scare swimmers!)

8. Swim diapers have limited effectiveness. These are designed to keep stool from leaking into the water. Swim diapers don’t disintegrate when immersed in water, fit snuggly around waist and thighs, and have a plastic outer lining. Some swim facilities insist that infants wear them. Most experts believe that, at best, swim diapers slow the leakage of stool into the water.  

9. There are problems with using chlorine in pools. While it is effective in killing most organisms in less than a minute, it does so only when present in adequate concentrations and if the water pH and temperature are within certain ranges. Moreover, there are important disease-causing organisms that are quite resistant to chlorine.

10. Pollution monitoring of natural water is haphazard.  Private or remote waterfronts are rarely tested. Public waterfronts may be randomly checked every few days or less, with results sometimes not available until days later, and with no efficient system of informing users of problems. Water quality at long stretches of beaches may vary substantially from place to place and change hourly, with the water tested at only a few locations. Sources of organisms include swimmers, animals, sewage runoffs, boating wastes, and malfunctioning septic systems in the area, to mention just a few.

Bottom line: Never swallow water when swimming.