After Emily Keefe had twins in 2018, the pool in her backyard in Boxford became a source of constant concern — especially after the children learned to walk.
“We were just terrified,” Keefe said. “I can’t even describe how anxious we felt.”
Then, she discovered a program that teaches survival swimming to children between the ages of 6 months and 6 years by training them to float if they fall into the water.
Since then, the program — Infant Swim Resource, or ISR — has not only alleviated Keefe’s anxieties about her children, but has become her career. Unable to locate anyone trained in ISR within driving distance of Greater Boston, Keefe trained to be an instructor and now runs ISR Boston North. The first session she taught in July 2021 “filled instantly,” she said, and within a few months, Keefe had a waitlist of 150 to 200 families.
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ISR itself isn’t new — it was founded by a psychologist in 1966. But in recent years, social media platforms like Instagram and TikTok have popularized its style of survival swimming. The clips often show babies in the water, flipping themselves from facedown to faceup and floating — a skill that could save their lives if they fell into a pool.
The viral videos have also sparked controversy, in part because survival swimming like ISR isn’t endorsed by the American Academy of Pediatrics, which recommends against any swim lessons for infants under the age of 1. According to its policies, babies below 1 are “developmentally unable to learn the complex movements, such as breathing, necessary to swim.”
Keefe suggests otherwise: To be taught to float, infants just need to have the core strength to sit without support.
“I have seen quite a few babies under a year successfully complete the program and retain those skills,” said Keefe, who has worked with infants starting at 7 months. “In my opinion, a baby that can potentially reach the water unattended, either by crawling or walking, can and should be taught the survival float.”
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Lauren Campion — who teaches survival swimming with Infant Aquatics under a similar structure to ISR — echoed that sentiment.
“It’s beneficial to get started earlier than 1 because they can safely acquire the skills and it could help potentially save their lives,” Campion said.
Campion has a strikingly similar story to Keefe. She feared for her son’s safety around her pool, and saw a video about survival swimming on TikTok, which inspired her to become an instructor. Now, she runs Champion Infant Aquatics part time out of her home in Maynard. This summer, she received 200 inquiries for 12 spots.
Both ISR and Infant Aquatics have a strict structure for sessions, which span about six weeks; instructors meet one-on-one with students four or five times a week for lessons that last about 10 minutes.
Lessons focus on survival skills. For infants, the objective is that they learn to roll onto their backs and float in the water while they wait for help to come — a technique termed “rollback to float.”
Toddlers and older children are also taught a sequence called “swim-float-swim” — swimming a short stretch, floating on their backs to breathe and rest, and then turning over to swim again, in the hopes that they are able to reach the edge of a pool.
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Children practice the techniques in an array of circumstances, including while wearing winter clothes, and after falling into the water from various angles.
Dr. Michael Flaherty — a pediatric critical care physician and director of the Trauma & Injury Prevention Outreach Program at Mass General for Children— said he cannot recommend survival swimming because of a “general lack of data.”
“We still just don’t know enough about the safety of these survival classes for infants and babies,” he said. “We don’t know how effective they are.”
Specifically, Flaherty said there’s little information on whether children are able to actually use survival swimming skills in a crisis. He said he also fears that parents will be too reliant on survival swimming and won’t continue to take proper precautions around the pool.
“Just because they know how to swim, that doesn’t replace close supervision, that doesn’t replace barriers around swimming pools,” Flaherty said. “Swim lessons do not make children ‘drown-proof.’”
Keefe and Campion emphasize that survival swimming skills are only for emergencies. They educate parents on multiple layers of water safety, like keeping children within an arm’s reach at all times until they are skilled swimmers, and only swimming under strict supervision. They also discourage the use of floaties in pools, since they teach children to feel “confidence without competence” in the water.
Beyond the limited number of instructors in New England, lessons in survival swimming also aren’t cheap. Keefe charges $170 per week for five to seven weeks, though she offers some scholarships; Campion charges $850 for four weeks and $950 for six weeks.
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Danielle Kilgour was so intent on having her almost 2-year-old son learn ISR that she drove an hour each way from her home in Hollis, N.H., for lessons with Keefe every weekday for six weeks. But it was “totally worth it,” she said, for the “peace of mind” it has provided.
“It’s probably the most proud I’ve ever felt of my child — and us, for making that sacrifice,” Kilgour said.
Vivian Okoro of Milton made a similar choice for her daughter, Naomi, 5, to learn to swim with Campion. Okoro, who’s from Nigeria, never learned to swim as a child, and was worried about the heightened risk for drowning among children of color, especially African Americans.
She first enrolled Naomi in a traditional type of swim lessons, but after three months, “didn’t see any progress.” Then, Okoro heard about Campion. Despite the distance between Milton and Maynard, she decided to take Naomi to try the lessons for a week, and saw “a drastic improvement.”
“Naomi went from not knowing how to float to floating for five seconds,” she said — so she committed to the rest of the classes.
The recent rise of survival swimming has benefited from advocacy by champion skier Bode Miller and his wife, Morgan Miller, who became staunch supporters of ISR after their daughter drowned in 2018 at the age of 19 months.
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Sarah Girouard of North Reading, who is related to the Millers by marriage, said the death of Emmy Miller was “devastating” and motivated her to search “high and low” for ISR for her sons. It wasn’t until she had her second son, Jagger, that she found Keefe.
Jagger started lessons as soon as he was able to sit on his own, at around 7½ months.
“If they can crawl, they should be able to float. If they walk, they should swim,” said Girouard.
Girouard said she sometimes receives pushback from parents who say they couldn’t stand to see their children cry in the pool. (According to Keefe, about 90 percent of students shed tears at the start of a session.)
To such skeptics, Girouard replies, “I would rather hear my child crying than seeing them drown. A crying child is a breathing child.”
In the summer, traditional types of swim lessons are offered (ages 4 to 12) for free by the Massachusetts Department of Conservation and Recreation and the City of Boston’s Swim Safely Partnership with the Greater Boston YMCA (all ages).
Camille Caldera was a Globe intern in 2022.Follow her on Twitter @camille_caldera.