Children's swimming: When to stay out of the pool

Your children may love to swim, but is it a good idea for them to be in the pool? Consider pool do's and don'ts from a Mayo Clinic specialist.

Jay Hoecker, M.D.

Is your diaper-clad toddler begging to splash in the local pool? Are you worried about your child's cast or ear tubes in the water? Does the thought of bacteria lurking in the pool give you the creeps? Before you help your children suit up — or abandon any thoughts of splashing in the pool — here's some practical advice from Jay Hoecker, M.D., a pediatrics specialist at Mayo Clinic, Rochester, Minn.

Can young children wear diapers in public swimming pools?

Various brands of diapers are designed for underwater use. They're water-repellent and fit snugly around a child's thighs and waist. But they're not waterproof. If your child has a bowel movement in the pool, fecal material may escape the diaper. If that happens, all swimmers must leave the pool while the water is disinfected.

A dirty diaper may contain diarrhea-causing germs, including the parasite cryptosporidium. This parasite can contaminate pool water or other swimming areas. In otherwise healthy people, a cryptosporidium infection causes severe diarrhea lasting from one to two weeks. The consequences can be more severe for people who have weak immune systems.

Urine in a pool is less risky than feces. But when you have a child who wears diapers, it's difficult to separate the two. I generally discourage parents from allowing children in diapers to enter a pool.

Can children who have casts go swimming?

With the doctor's OK, children who have water-safe casts — made of fiberglass and lined with a water-repellent material — can safely swim. Plaster casts shouldn't get wet.

Can children swim if they have ear tubes?

Swimming with ear tubes is a controversial topic. Some doctors argue that ear tubes prevent ear infections by draining fluid — so if water gets into the middle ear while swimming, it'll probably drain out through the tubes. Other doctors, however, don't want children who have ear tubes to swim. The concern is that mixing water and wax in the ear canal may lead to a bacterial infection, which could jeopardize the ear tubes.

I'd suggest a reasonable compromise. For children who simply want to splash in the water without submerging their heads, swimming is fine. For children who want to swim with their heads underwater, provide individually molded earplugs. Tightfitting swim caps may help, too. Diving is off-limits for children who have ear tubes.

Can children swim when they're sick or have cuts and scrapes?

It's fine for children who have colds or other minor illnesses to swim, as long as they feel well enough to do so. Likewise, it's OK for children to swim with a minor cut or scrape, as long as the wound isn't bleeding. If your child has an open sore or break in the skin, keep him or her out of the pool.

What about swimmer's ear?

Swimmer's ear is an infection that's often treated with prescription eardrops. While the infection is healing, it's important to keep water out of the ears. Have your child wear a shower cap over the ears while showering or bathing. Swimming is usually OK after one week of treatment or when the ear canal no longer hurts.

Is it OK to swim after eating?

It's OK to swim immediately after a light meal or snack. If your child feels lethargic after eating a heavy meal, encourage him or her to take a break before swimming.

Are hot tubs safe for kids?

Children can quickly become overheated in a hot tub. Keep young children out of hot tubs, and allow only brief dips for older children. Never allow children to submerge their heads in a hot tub. Long hair caught in a hot tub drain can cause drowning.