You’ve seen the news reports, so what’s the real story with delayed drowning and dry drowning in children?

Written by Connecticut Children’s Physician, Chris Carroll, MD, MS

Summer is here, and with it comes a perennial worry for parents: drowning. This fear is justified, as drowning is the second most common cause of death in children aged 1-14 years, and is potentially preventable.

Following a recent tragic death of a child in Texas, there have been several stories in the news about “dry drowning.” However, some of these stories don’t address the difference between dry drowning and delayed drowning in children, and have caused confusion for many caregivers and parents.

Dry drowning occurs when a child is submerged in water, and during this sudden shock to the system, their larynx, or throat, spasms and closes up and the child’s heart may stop beating. The child’s lungs are “dry” since the closed throat keeps water from being aspirated, or getting into their lungs. Children with dry drowning have immediate and severe symptoms. This is different from “wet” drowning, which is when a child aspirates or inhales water into their lungs. Dry drowning is estimated to account for 10-15% of all drowning deaths.

Delayed drowning (sometimes called secondary drowning) is different from dry drowning and far less common. Delayed drowning follows a child’s inhalation of water, but severe symptoms can develop one to 24 hours after the event. Children with delayed drowning may have milder symptoms at first, but then these symptoms worsen over time. At first, these symptoms can be hard to detect, particularly in young children. Symptoms include trouble breathing (breathing fast or use of chest or stomach muscles to help with breathing), coughing, vomiting, chest pain, sleepiness, decreased energy level, or irritability. Since these symptoms can be hard to spot, if something about a child concerns a parent or caregiver following an event, the child should be evaluated by a healthcare provider immediately.

The CDC recommends several steps for reducing the risk of drowning in children. These include designating a responsible adult to supervise children swimming, always swimming with a buddy, teaching your child to swim, learning CPR, and avoiding the use of water wings or “noodles” which may provide a false sense of security for poor swimmers.

Symptoms following submersion and inhalation of water can be difficult to spot. If a parent or caregiver has any concerns about a child’s breathing or mental status after an event, they should take the child to a healthcare provider for evaluation.

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  1. But even if your child is well supervised and has a normal swim session, couldn’t delayed drowning possibly occur anyway? Sorry, articles and news stories about this type of subject are disconcerting and make me want my child to shy away from something like this.

  2. In your delayed drowning description, you mention seeking care if symptoms are noticed “following an event.” Can you please be more specific about the word “event” – e.g. What does it take for a child to inhale enough water to cause symptoms? (And please compare to bathtime or even when your drink “goes down the wrong pipe…” and they cough. Can that result in water remaining in the lungs? Is coughing on water enough to warrant a closer eye for breathing trouble? This article needs more detail. Thanks.

  3. I agree this article needs more details on what type of event can cause delayed drowning. My daughter is learning to swim and often takes in a mouthful or two of water during a lesson. She usually coughs it back up and keeps going but hearing more and more about delayed drowning makes me worried to have her take in this water at all. Would there need to be a significant intake of water to cause this delayed drowning to happen?

  4. Do not be too fearful over this. Secondary drowning is extremely rare. Your child will not just one day fall down from this. If in the incredibly rare event that your child inhales enough water to irritate the lining of his lungs and suffers ‘pneumonitis’ there are symptoms. Simply ingesting water, which we all do to some extent when swimming will not cause secondary drowning. Your children should learn to swim and practice this skill. It is the best way to equip them for a life of enjoyment in and around water.

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