Infants & Pools

Dear Lisa,

How old should an infant be to bring into the pool?

"Infant in the pool"

Dear "Infant in the pool",

Every parent would like to know the exact age it is safe for an infant to go into a pool. Most parents will not get the green light that it is 100% safe for any child to go into the pool. Unfortunately, infants and children who go into pools are at risk for catching Recreational Water Illnesses. Infants can suffer from more severe illness than others because of their immature immune system. These Recreational Water Illnesses are spread by swallowing, breathing or having contact with contaminated water from swimming pools. Infants and children can develop skin infections, eye infections, respiratory infections and diarrhea illnesses. (1) Diarrhea illnesses in particular have become a great concern since there has been a steady increase in reported diarrheal outbreaks. The Centers for Disease Control reported in an issue of the Morbidity and Mortality Weekly Report that during the period from 1984 to 2002, there were 19,000 outbreaks due to swimming pool use. (1)

Cryptosporidium, Girardia, Shigella and E.Coli are some of the pathogens that cause diarrheal illnesses. These diseases are spread when infected people swim in pools. Some parents may feel that diapers protect the stool from contaminating the pool. Other parents do not realize that their child should not swim in pools for 2 weeks after a diarrheal illness finishes. Most parents polled by the CDC believe that pool water is sterile and that chlorine kills everything.(2) Unfortunately, this is not the case. Both Girardia and Cryptosporidium can be excreted for several weeks after a person’s diarrhea is gone. Therefore the recommendation is that children should stay out of the pool for two weeks after a diarrheal illness finishes. (2)

Children should also be taught that they should not swallow the water. Even properly chlorinated water can harbor germs. One of the germs, Cryptosporidium is chlorine-resitant and can live for days in chlorinated water. This microorganism is responsible for about 2/3 of recreational water illness outbreaks. (1). On a positive note, both HIV and Hepatitis B are killed by a properly chlorinated pool.

Even if chlorine can kill some microorganisms, the concern is whether or not community pools are reinforcing policies in order to protect the swimmers. Parents should not be allowed to change diapers near the pool, people should shower before getting into the water and children with diarrhea should not be allowed to swim for two weeks after their illness ends. Additionally, there is no proof that diapers prevent the stool from entering the pool. There should be a procedure for disinfecting the pool if a swimmer vomits or has a stool in the pool. I myself have visited town pools and found the only procedure followed for a “fecal matter accident” was that everyone was asked to get out of the pool. After the life guard removed the stool, everyone was allowed immediately back in the water. I’m not surprised that data from 22,000 swimming pool inspections in the United States performed during the summer of 2002 found 54% of the pools had one or more violations and 8% needed to be closed.(3).

Now that you read this you probably won’t let your child go into the water until after he graduates college! Basically, you just have to use common sense. If you notice that your community pool is not abiding by these precautions I would be leery about letting your infant into the pool. If you checked with your community pool and are comfortable with their policies, it is your decision as a parent if you want to let your baby go into the water. Plenty of parents hold their babies and let their feet get wet. Some parents feel better about letting their infant go in their own pool at home because they are sure that the water is properly chlorinated and know if the other swimmers are sick or not.

I would not recommend infants less than three months old go into a pool, and not until after he receives his first set of immunizations. Infants this young are more susceptible to infection due to their immature immune system. Also, an infant will not socially or developmentally benefit from swimming at this young age. An infant would be just as happy looking at a mobile or sucking on his hand. I would be concerned that an infant who puts his hand into the pool water and then puts his hand into his mouth may contract one of these germs. Pathogens such as Cryptosporidium and Giardia have such low infectivity doses which means there only is a small volume of water required for disease transmission. (3)

Swimming is very good exercise and a popular sport. I encourage all parents to teach their children water safety and allow them to enjoy the fun of swimming. For more information about safe and healthy swimming log on to the Center for Disease Control’s website, www.cdc.gov/healthyswimming.

(1)Rusk J. The CDC asks pediatricians to get the message out about healthy swimming. Infectious Diseases In Children. 2006;May:48-49.
(2)Castor M. Safe Swimming. AAP News. 2004;May:226.
(3)Castor M., Beach, M. Prevention of recreational water illnesses. Infectious Diseases in Children. 2004;17: No. 5.


Lisa Kelly R.N., P.N.P., C.
Certified Pediatric Nurse Practitioner

Pediatric Advice about Keeping Kids Healthy