Accidents and child abuse in bathtub submersions

• Published in: Archives of disease in childhood Vol. 70; no. 5; pp. 435 - 438
• Main Authors: Kemp, A M, Mott, A M, Sibert, J R
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.05.1994; BMJ; BMJ Publishing Group LTD
• Subjects: Accidents, Home - statistics & numerical data; Adolescent; Baths; Biological and medical sciences; Child; Child Abuse; Child abuse & neglect; Child Abuse - statistics & numerical data; Child, Preschool; Developmental Delays; Differential diagnosis; Drowning; Drowning - epidemiology; Drowning - etiology; Drownings; Epilepsy; Female; Homicide; Humans; Infant; Infant, Newborn; Injuries of the thorax. Foreign bodies. Diseases due to physical agents; Male; Medical sciences; Medical Services; Near Drowning - epidemiology; Near Drowning - etiology; Neonates; Pediatrics; Population studies; Traumas. Diseases due to physical agents; British Isles; Human; Child abuse; Accident; Etiology; Drowning; Bathtub; Child
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.70.5.435

Non-accidental bath drowning is an infrequently reported form of child abuse. Details of 44 children who suffered from drowning or near drowning in the bath were analysed from a two year (1988-9) UK study to investigate factors that might point to abuse. Cases of near drowning were notified through the British Paediatric Surveillance Unit inquiry system and drowning cases from the Office of Population Censuses and Surveys, the Scottish Government Record Office, and the Northern Ireland Office. In 28 cases the story was of accidental submersion with a baby of modal age 9 months being left unsupervised in a bath. Two other neonates briefly slipped from the parents arms while having a bath. Four bathtub drownings were related to epilepsy. In contrast 10 cases (six drowning and four near drowning) had stories very suggestive of abuse with inconsistent histories, previous history of abuse, and late presentation for medical care. A diagnosis of abuse should be considered in the differential diagnosis of atypical bathtub immersions in the absence of epilepsy and developmental delay.