Drowning of babies in bath seats: do they provide false reassurance?

Aims To investigate the problem of children drowning in bath seats by examining case reports, by looking at the epidemiology of bath drowning in children under two years of age and by reviewing the literature. Methods We describe two babies: one who drowned and one nearly drowned in the bath whilst in a bath seat. We examined the RoSPA/RLSS UK database of cases of children under two years drowning in the bath for the years 1989-2003. Cases are ascertained through a press cutting system. We conducted an all language literature search of original articles, references, textbooks and conference abstracts 1951 - October 2004 in 11 standard databases. Results The two cases illustrate how parents can have a false sense of security with bath seats. We found six cases of babies under two years drowning in the UK associated with bath seats in the time period 1989-2003. They were all boys: five of the six were under one year of age. This compared with 47 children of similar age drowning in the bath not associated with a bath seat. The literature is sparse with only four papers since 1966. Discussion A baby drowning after being placed in a bath seats is a rare but definite cause of death. Bath seats appear to give a false sense of security (even if not encouraged by the manufacturers). It is unclear whether putting a baby in a bath seat represents an increased risk of drowning compared with a baby without a seat. Without knowing the numbers of mothers that use bath seats it is difficult to come to firm conclusions on the risks to babies. New research is needed to clarify this issue. Whether in a seat or not it is clear that the main risk to babies in the bath is being left unsupervised.