Should my toddler in diapers be allowed to wade in a pool?

You can buy some diapers that are supposedly safe for use in pools. These diapers are water-repellent and fit snugly around the child's thighs and waist. Even so, if your child defecates while in the pool, fecal material may escape the diaper.

When that happens, everyone has to leave the pool while maintenance workers put in more chlorine, a bacteria-killing agent that keeps water safe for swimming. Then they have to wait for the added chlorine to disperse and check for safe levels of chlorine and other chemicals in the water.

A dirty diaper may contain diarrhea-causing germs, including the parasite called Cryptosporidium. This parasite can contaminate swimming areas. In otherwise healthy people, a Cryptosporidium infection causes severe diarrhea lasting from one to two weeks. People with severely weakened immune systems, however, may not survive the infection.

Urine in a pool is a little less risky than feces. The only trouble is that when you have a child at diaper age, it's hard to separate the two. So for the most part, I discourage parents from allowing babies in diapers to enter a pool.

What precautions should parents take to keep germs from spreading in pool water?

Everyone should always shower or bathe before and after swimming. If your child is not fully toilet-trained, it is important for him or her to wear a waterproof diaper in the pool. Put a fresh diaper on the child just before he or she gets into the water.

Can a child with a cast go swimming?

Some casts are water-safe. They're made of fiberglass, and the lining is a material like Gore-Tex that's found in some water-repellent garments. If children have a water-safe cast, they can swim if their doctor says it's OK. But if children have a traditional plaster cast over a cloth wrapping, they have to stay out of the water. Trying to water-protect such plaster casts with plastic bags generally doesn't work.

Can children swim if they have ear tubes?

This is controversial. Basically, there are two perspectives. On one side, some physicians argue that the tubes are placed in the ear to prevent ear infections by draining fluid. So if water should get into the middle ear, it will probably drain out the tubes.

On the other side are physicians who don't want children with ear tubes to swim at all. They say that if you mix water and wax in the ear canal, you could get certain bacterial infections. These infections could jeopardize the tubes and even make it necessary to remove them.

A reasonable compromise is this: If children with ear tubes just want to splash around in the water without submerging their heads, it's OK. If children do want to put their heads under water, then it's best to first fit them with individually molded earplugs. In any case, children with ear tubes should not dive.

My children often get swimmer's ear. How can I prevent it?

You can use a prescription product containing acetic acid otic solution (VoSol, Acetasol, others) and put drops in your children's ears before and after they swim.

Here's a cheap, quick and effective home solution. Mix 1 part white vinegar with 1 part alcohol. The best alcohol to use is pure ethanol, but you could use rubbing alcohol.

Pour 1 teaspoon of this mixture in each ear �?just let it roll in and roll out. Do this when your children are ready to go swimming and again when they're finished. By finished, I mean they're not going to swim, shower or otherwise submerge their heads in water. In addition, you can carefully direct a hand-held hair dryer toward the ear to dry it out.

Please note that this home solution is not a treatment for an ear canal infection. It's only a preventive measure. Also, the mixture should not be used in children who have ear tubes or in children who already have swimmer's ear (acute otitis externa).

How long do you need to treat swimmer's ear before it's OK to go back in the water?

Children can typically re-enter the water after one week of treatment or when the ear canal no longer hurts. Until your child's ear infection heals, it is important to keep water from getting in his or her ears. You might suggest that your child wear a shower cap while showering or bathing.

What's the earliest age you recommend for children to start swimming lessons?

Your child's readiness for swimming lessons really depends on his or her comfort level in the water. Before their first birthday, some babies love to splash around while a parent holds them. Others, however, are not keen on getting in the water. In general, children can start learning to swim around the time they learn to ride a bike, which is near the time they enter school, at age 5 or 6. A parent or other responsible person should always stay in the water with a child age 5 or younger. Beginning swimmers should stay in the shallow end of the pool and be closely supervised. More experienced swimmers still need supervision by certified lifeguards during water activities.

Can you offer some other guidelines on when it's not wise for a child to swim? For example, can a child swim with a scraped knee or a cold? What about right after lunch?

It's OK for a child to swim with a scraped knee �?if it's not bleeding. Likewise, it's fine for children with colds to swim, as long as they have energy and feel well enough to do so. And it's OK for kids to swim after lunch, unless lunch was a large feast and the child feels lethargic. After a snack, children don't have to sit beside the pool for an hour. Let them go in the water and enjoy it.

What's a good preventive measure or remedy for chlorine-sensitive eyes?

Red or puffy eyes after a long day of swimming in a pool may just mean that your child is sensitive to chlorine. To ease discomfort and reduce redness after swimming, rinse your child's eyes with a sterile eyewash or an artificial tears solution. Also, consider having your child wear swim goggles for protection from pool water.

Is it risky for a child to swallow pool water?

Children are bound to take a few gulps of pool water at one time or another, especially when first learning to swim. A little swallowed pool water is no cause for worry, but it's never OK to use the pool as a source of drinking water. Make sure your children use the water fountain, or take plenty of bottled water to the pool with you.

Are there any other common medical conditions that might restrict swimming for generally healthy children?

Children should never swim alone. Even the best swimmers should have partners. This is especially true for children with physical impairments, seizure disorders, or heart rhythm disorders, such as long QT interval syndrome.

Are indoor pools any more or less likely to contain bacteria than outdoor pools are?

Indoor pools are just as safe as outdoor pools. In threatening weather, though, outdoor pools are strictly off-limits. To ensure your child's safety and the safety of others, always read pool safety guidelines before entering any swimming pool or beach.

Is it safe for children to go into hot tubs?

Children should stay out of hot tubs and spas until they are tall enough to keep their heads completely out of the water with their feet firmly touching bottom. Youngsters can quickly get overheated in hot tubs, so their visits should be kept brief. No one, adult or child, should ever submerge his or her head in a hot tub or spa. Because the temperature encourages the growth of certain microorganisms, an earful of water from a hot tub or spa can lead to an external ear infection. Far worse, long hair, which fans out when the head is submerged, can get caught in a spa or hot tub grate and cause drowning.