We’ve established it’s all right to take a baby swimming, despite lots of noise to the contrary. But as it turns out, there is one big thing to watch for, when you take a baby swimming, that most people don’t know to worry about — because it happens after kids are out of the pool.

Dry drowning, or secondary drowning, occurs up to 48 hours after exposure to water. It’s very rare, stresses Prateeksha Ahuja, an AUSTSWIM-certified infant swimming teacher in Mumbai, who says she has become concerned only about three babies in the last year and a half of classes, all of which proved false alarms. But it’s concerning because its so insidious.

“Most parents have no idea what dry drowning is,” Ahuja says, but “its a real challenge, as its not necessarily a major incident. It could be a drop of water gone wrong. It could [happen] in a bathtub.”

What is dry drowning?

Dry drowning and secondary drowning are terms used interchangeably, but they do mean slightly different things for the body. In dry drowning, which usually occurs soon after water inhalation, the person (child or adult, but children are more at-risk) breathes in water, but the water never makes it to their lungs. Instead, the inhaled water causes the vocal chords to spasm and shut — no water gets to the lungs, but no air does, either, and breathing becomes difficult.

In secondary drowning, which is typically delayed by hours after water inhalation, the water reaches a person’s lungs and builds up — not enough to drown them, but enough to take up precious space for oxygen and make breathing difficult.

What can parents do?

The best treatment for dry drowning is prevention.

“What parents should do is never leave them unsupervised,” Ahuja says. “Even if they are independent. Till age 6. Keep an eye in the pool.”

And make sure the child isn’t overtired.

“If I feel they have spent all their energy kicking and paddling, I give them a 1-minute break where the parent just holds the child still, so he can catch his breath,”  Ahuja says. “You can’t have a panting child swimming underwater.  They are too small to use their own logical reasoning to tell me, ‘I’m tired.'”

Parents should also instill pool etiquette, Ahuja says, which goes beyond what is polite to ensure what is safe. When kids are rowdy and splashing and pushing each other into the water, it’s easy to miss the kind of minor water inhalation that can lead to dry drowning. While swallowing some water is a natural part of learning to be comfortable in a pool, a healthy respect for, though not fear of, water can go a long way, she says.

Finally, watch out for the signs after every swim (or bath). If any of these symptoms develop, don’t stress, Ahuja says — but do consult a doctor immediately and if needed, seek treatment for dry drowning.

Signs of dry drowning

• Difficulty breathing
• Chest pain while breathing
• Coughing
• Mood change after an incidence of water inhalation
• Confusion
• Unusual lack of energy, fatigue and increased agitation
• Change in skin color to pale blue or grayish