“Cook Children's is really invested in prevention in our community, and it's written into our promise,” said Jillian Mitchell, program coordinator for the injury prevention team at the Center for Community Health. 

Drowning is the leading cause of injury for children ages 1 to 4 at the highest risk. According to the 2024 Community Health Needs Assessment, Cook Children’s Medical Centers in Fort Worth and Prosper treated 224 drowning-related injuries from 2021 to 2023. These incidents occurred in bathtubs, open water (lakes, rivers, and ponds), and pools or hot tubs.  

Cook Children's Health Care System shows a slight decrease in drownings in the last five years: 

Mitchell notes that as summer vacation and hot weather arrive, families will be looking to cool off, but months may have passed since the last dip in the pool. 

“As we're heading out to any kind of open water or to a pool, it's important to have preparation top of mind,” said Mitchell. 

Lifesaving Access: Loaner Life Jacket Station 

To help protect swimmers in open water, Cook Children’s supports more than 60 Loaner Life Jacket Stations across North Texas. The stations provide five different sizes of U.S. Coast Guard-approved life jackets, ranging from infant to adult, which families can borrow and return free of charge. Each station features educational graphics detailing how to properly fit and secure the vests. 

Local officials at Lake Worth report that the stations are heavily utilized, with life jackets consistently borrowed and safely returned by the end of each weekend day. 

“We want to make sure that that resource is available for families that maybe don't have the opportunity to get a life jacket for their child,” said Mitchell. In 2025 alone, the program distributed more than 1,800 U.S. Coast Guard-approved life jackets to area lakes across Tarrant, Denton, Rockwall, and Stephens counties.  

Water Safety Tips 

• Transition time
  • Make sure to put a life jacket on children before you get out of the car.
  • If a child goes missing, check the water first.
• Designate a Water Watcher to ensure constant visual supervision.
  • A Water Watcher should be in-reach of the children in the pool.
  • A 10-15 minute shift rotation is recommended. During that time, Water Watchers should not be distracted by conversations, cell phones, reading, etc.
• Keep backyards and bathrooms safe.
  • Dump all water buckets and empty kiddie pools when they are not in use.
  • Install multiple barriers in areas leading to pools and spas: pool fences, self-closing, self-latching gates and door alarms.
  • Keep the pool area picked up and clear of toys and other items which might attract an unsupervised child.
  • Never leave children unattended in the bathtub.
• Wear “U.S. Coast Guard-Approved” or “USCG approved,” life jackets
  • As your child grows, the life jacket needs to meet their new weight.
  • Get a new life jacket if there are rips and tears or if the straps are fraying.
  • Do not rely on floats or other toys to keep children safe.
• Sign up for CPR and swim lessons.
  • The American Academy of Pediatrics recommends starting children in swim lessons as young as 12 months old to reduce the risk of drowning.
  • The National Drowning Prevention Alliance provides parents with a printable questionnaire to help identify the right swim program for their children.
• Have a safety plan in place.
  • If an emergency does happen, remember that seconds count. Call 911 immediately and then begin CPR while EMS is in route.
  • Know water conditions before you get into open water. Water conditions in lakes and oceans can vary on a daily basis.
  • Sit near a lifeguard if there is one present. 

"Combining swim lessons, life jackets, dedicated water watchers, brightly colored swimsuits, and pool fences creates multiple layers of protection," Mitchell said. "The more layers of safety you put in place, the lower the risk of drowning."

Related stories: 

• Big Game, Big Safety: Preventing Hot Car Tragedies 

• Make a Splash: Why Swim Lessons are Essential This Summer 

• The Power of Prevention: Cook Children's Reports a Drop in Drownings 

• Lifeguard Your Child: 6 Tips for Keeping Bathtime Safe in Every Season 

Drowning is the leading cause of injury, with children between the ages 1 to 4 at the highest risk. According to the 2024 Community Health Needs Assessment, Cook Children’s Medical Centers in Fort Worth and Prosper treated 224 drowning-related injuries from 2021 to 2023. These incidents occurred in bathtubs, open water (lakes, rivers, and ponds), and pools or hot tubs.  

“Spring break is really our kind of entry point of getting back into the water,” said Jillian Mitchell, program coordinator for the injury prevention team at the Center for Community Health. 

Cook Children’s Loaner Life Jacket Station provide five different sizes of U.S. Coast Guard approved life jackets, ranging from infant to adult, that can be borrowed and returned. The goal is to make sure no child or adult drowns at a public lake because they didn’t have access to a life jacket. In 2025 more than 1,800 U.S. Coast Guard life jackets to area lakes in Tarrant, Denton, Rockwall, and Stephens counties.  

Mitchell encourages families and caregivers to make a plan before heading to the water. The “Lifeguard Your Child” program teaches parents how to create a safety plan for children anytime they are around water. 

According to data from the Community Health Needs Assessment, 85% of drowning-related injuries were pool-or hot tub-related. Of those 8% were fatal, with most fatalities occurring with children ages 0 to 4. 

While many public and community pools are not yet open, families may travel to lakes, rivers, or oceans.  

“Open water behaves differently than in a pool,” explained Mitchell, “It's dark. It's deep, it's murky. Anyone that is on a lake or a river or in the ocean should wear a life jacket all the time because it is an unpredictable water source.” 

The American Academy of Pediatrics recommends kids begin swim lessons as young as 1 year old. 

Mitchell shares these tips for families heading to the water for their spring break: 

• Learn about the flag system when you go out to the beach. 

• Sit near a lifeguard if there is one present.
• Look for a life jacket that's approved by the U.S. Coast Guard.
• Spring break is a great time to pull out those life jackets from last year. You may find that your child has outgrown the life jacket.
• Make sure that your children know they should always ask permission before going to the water. 

Related Stories:  

• Expert Tips for a Safe Spring Break: Aim for Safety
• Lifeguard Your Child: 6 Tips for Keeping Bathtime Safe in Every Season
• The Power of Prevention: Cook Children's Reports a Drop in Drownings
• Lifeguard Your Child: 5 Water Safety Tips for Parents 

Surfer Bethany Hamilton knows the pain of losing a loved one to a bathtub drowning. Fifteen months ago, Bethany’s three-year-old nephew died after drowning in a bathtub. According to the family’s donation page, the toddler was sick and soaking in a bathtub with six inches of water just 15 feet away from the kitchen and living room. The page stated, “He was found unconscious--which is baffling as he's the strongest child of his 5 siblings at that age and an amazing swimmer, even in the open ocean.”

Sophia Price, trauma injury prevention specialist at Cook Children’s, offers tips to follow at bathtime:

1. Always ensure an adult stays at the side of the tub, in reach of the child, as this is too big of a responsibility for siblings.
2. Avoid multi-tasking such as talking on the phone, washing clothes, preparing dinner or anything that will cause a distraction from bathing the child.
3. Always be prepared by making sure to gather all bathtub essentials such as towels, soap, lotion and toys prior to bathing the child, so that the child is not left alone in the tub.
4. If you must leave the bathroom during bathtime, wrap the child in a towel and take them with you. If there are other children in the house, be sure to secure the door to the bathroom.
5. When bathtime is finished, be sure to drain the tub of all water, and remove all toys.
6. Use safe proof items to secure the bathroom door to prevent children from accessing the bathroom without an adult.

Drowning is preventable, and we want to help your children stay safe. Learn more about how to keep your family safe during bath time with our Lifeguard Your Child campaign.

“A drowning can occur in any body of water at any time,” said Jillian Mitchell, community health program coordinator at Cook Children’s Health Care System.

Mitchell explains that data shows infants have the greatest risk for drowning inside the home, while children ages 1-4 have the greatest risk for drowning overall. Cook Children’s has developed strategic partnerships and efforts to inform and educate families on water safety.

“After seeing that a majority of drownings were occurring during a planned swim time, it became clear that strong messaging around adult supervision is key,” said Mitchell.

Eighty-eight percent of drownings occur with at least one adult present. The “Lifeguard Your Child” program teaches parents how to create a safety plan for children anytime they are around water.

Those tips include:

• Designate an adult Water Watcher to ensure constant visual supervision of children in and around water.
• Implement 15-minute shifts for Water Watchers.
• No Distractions: The Water Watcher must have no distractions, including conversations, phones, reading, or consuming alcohol.

“We know that distractions are a key component of unintentional injuries around planned swim time, so sharing these messages are strong reminder that drowning-related injuries and fatalities are preventable with non-distracted supervision,” said Mitchell.

Swim Lessons

Learning to swim can reduce drownings by more than 80%. Cook Children’s recognizes there is a disparity in access to swim lessons and saw an opportunity to collaborate with swim schools in the community. As a result, free Water Safety lessons are provided in select areas in under-resourced neighborhoods through community partnerships.

“By committing to taking a multi-layered strategic approach, the goal is to encourage safer choices in and around open water activities,” said Mitchell.

It is not just pools but ponds and lakes where water safety is important, and life jackets can help. Cook Children’s has a partnership with the Brazos River Authority in Granbury and Possum Kingdom Lake to provide water safety education at local schools and camps. The efforts extend into more than a dozen counties with loaner life jacket stations that Cook Children’s has built and supports.

“We hope to instill the importance of choosing the safest floatation device for their child,” said Mitchell. She adds that life jackets are not a substitute for supervision.

Choosing the right life vest:

• If the lifejacket does not say “U.S. Coast Guard-Approved” or “USCG approved,” you can assume it is not safe. Always check the label.
• As your child grows, the lifejacket needs to meet their new weight.
• Get a new lifejacket if there are rips and tears or if the straps are fraying.
• Do not rely on floats or other toys to keep children safe.
•  Always assign an adult water watcher when children are swimming, even if they are fitted with a life vest.

Water safety is year-round

Mitchell adds that water safety continues well into the winter months.  Drowning can happen in only an inch or two of water, just enough to cover your child’s nose and mouth.  Last year, Cook Children’s saw an uptick in bath-related drownings.

“We know that bath-related drownings are 100% preventable,” said Mitchell. “Much of our education focuses heavily on behavior change around preparedness, 100% adult supervision, and general safety concepts.”

Bathtub safety tips:

1. Ensure an adult stays at the side of the tub within reach of the child throughout the entire bath. This is too big of a responsibility for siblings and other children, so don’t ask them to take over for you. 
    
2. Avoid multitasking. Preparing dinner, folding laundry, or any other housekeeping tasks can and must wait until after the bath is over.
    
3. Ignore distractions like the doorbell or cell phones. Stepping or looking away from your child for even a few seconds can put them at risk of drowning.
    
4. Be prepared. Keep a towel and bath supplies close at hand, so you do not need to get up and leave during bath time. 
    
5. Treat every bath as a time to relax and bond with your baby or toddler. Bath toys like foam letters, animals that shoot water, and waterproof books are a great way to make the bathtub more fun and teach your child new things at the same time! 
    
6. Safety proof your home to prevent young children from accessing the bathroom without an adult. The more barriers in place, the safer your child will be.
    
7. If you absolutely have to leave during bath time, swaddle your child in a towel and bring them with you. 
    
8. Remove all toys and drain the tub immediately after each use.

The American Academy of Pediatrics (AAP) recommends starting children in swim lessons as young as 12 months old to reduce the risk of drowning. The AAP says always keep in mind that swim lessons are just one of several important layers of protection needed to help prevent drowning.

“You are never too old to learn how to swim,” said Jillian Mitchell, community health program coordinator at Cook Children’s Health Care System. “There are instructors who specialize in teaching adults or co-teach adults and children.”

The National Drowning Prevention Alliance (NDPA) provides parents with a printable questionnaire to help identify the right swim program for their children. They suggest some questions for the program you are looking at, including asking for information about the instructor’s experience, swim lesson curriculum, length and frequency of classes. 

“Choosing the swim instruction style is a personal choice, and it should be an informed one,” Mitchell said.

Before choosing a program, the AAP recommends keeping your child’s emotional maturity, physical and developmental abilities and limitations, and comfort level in the water in mind.

“It is important to consider what unique needs your child has in addition to visiting a school, asking questions about their curriculum or teaching philosophy,” Mitchell said.

Swimming lessons teach the basics of swimming and, for toddlers, it introduce them to get them comfortable with water, teaching them physical movements in the water like kicks and “ice cream scoops” with their hands. It also shows them how to get in and out of the water. Infant Swimming Resource (ISR) teaches infants and toddlers how to roll in the water in emergencies.

When should you sign up a child for swimming lessons?

The AAP says most children are ready for swim lessons by age 4. However, parents of younger children should look into classes that allow a parent or caregiver and child to be in the water together with an instructor, whether swimming lessons or ISR. The AAP explains that by age 4, children can usually learn basic water survival skills such as floating, treading water, and getting to an exit point.

What is Infant Swimming Resource (ISR)?

Parents may feel their child is ready to learn as young as 6 months old. ISR instructors are unique in that they work specifically with infants. ISR focuses on teaching children to roll onto their backs, float, and rest. It is designed to give children instinctive reactions to emergencies if they find themselves in the water unexpectedly. Children learn how to “float, swim, float” until they reach the edge and can exit safely or be pulled out of the pool by an adult.

Cook Children’s recommends asking questions and choosing an instructor/school that fits families’ budget, schedule, and child’s unique needs.

Drowning is the leading cause of accidental death for children ages 1 to 4, and the second leading cause for kids 1-14 in Texas. 88% of drownings occur with at least one adult present. 

That’s scary information, but there are steps you can take to help protect your child around water, whether it is swim time, unplanned time around water or even bath time:

1. Designate a Water Watcher to ensure constant visual supervision.

• Drowning occurs silently, so designate a Water Watcher to watch children in and around all water, even when a lifeguard is present. A Water Watcher should be in-reach of the children in the pool. The safest way is to be in the pool with them.
• A Water Watcher tag can be used to designate responsible adults to watch the water when you have a party at the pool, lake or beach. At social gatherings, 10-15 minute shifts are recommended. During that time, Water Watchers should not be distracted by conversations, cell phones, reading, etc.
• Stay alert. There isn’t a more important responsibility.

2. Keep backyards and bathrooms safe. 

• Dump all water buckets and empty kiddie pools when they are not in use.
• Install multiple barriers in areas leading to pools and spas: pool fences, self-closing, self-latching gates and door alarms.
• Keep pool area picked up and clear of toys and other items which might attract an unsupervised child.
• Never leave children unattended in the bathtub. Keep a towel and bath supplies close at hand, so you do not have to leave during bath time.
• Install safety latches on toilets

3. Wear lifejackets. 

• The single most important thing when it comes to open water safety is a life vest. Especially in murky water with a current, it can be the difference between life and death. If the lifejacket doesn’t say “ U.S. Coast Guard-Approved” or “USCG approved,” you can assume it’s not safe. Always check the label.
• As your child grows, the lifejacket needs to meet their new weight. Get a new lifejacket if there are rips and tears or if the straps are fraying.
• Do not rely on floats or other toys to keep children safe.

4. Sign up for CPR and swim lessons. 

• Studies show that formal swim lessons for children under age 4 reduce drowning by 88 percent.
• Take swim lessons with your child if you don’t know how to swim yourself. Even adults who are strong swimmers should never swim alone.
• Need help finding swim lessons? Check out this list of providers in the Tarrant County Area. If you’re not in Tarrant County, you may want to contact your local YMCA, Red Cross, or parks and recreation center for information in your area.
• Learning CPR can be the difference between life and death while waiting for emergency personnel to arrive. Check your local Red Cross and YMCA for CPR classes.

5. Have a safety plan in place. 

• If an emergency does happen, remember that seconds count. Call 911 immediately and then begin CPR while EMS is in route.
• Know water conditions before you get into open water. Water conditions in lakes and oceans can vary on a daily basis.

Related Stories

• Lifeguard Your Child: Prevent Bathtub Drownings 
• Lifeguard Your Child: Don’t Take a Vacation From Water Safety
• What Color Is Your Child's Swimsuit? Experts Say Choose Safety Over Fashion 
• In the Words of a Grieving Mother: Teenagers & Open Water Drowning 
• What's a Water Watcher Tag? How One Item in Every Household Can Help Prevent Drownings
• Checklist: Keeping Your Pool Safe for All Swimmers 
• Keeping Kids Afloat: Infant Swimming Resource Self-Rescue 
• Swim Lessons Save Lives: Answering Top Questions With a Professional Swim Instructor
• Try on for Size: Tips for Best Fit, Safe Practices for Wearing Life Jackets

It's the end of summertime, and that means it's time to get in one last vacation. With families taking trips over the Labor Day weekend, it is important to educate parents and caregivers on drowning prevention and safety outside of their normal environment. We talked to experts at Cook Children’s Medical Center – Fort Worth, about their advice when families travel out of their normal environment with children who will be around water.

“Parents have to be very vigilant. They need to use whatever locks and barriers that may be in place. Let the children know they are not supposed to go out to the water unless an adult is with them,” Sharon Evans, Trauma Injury Prevention Coordinator, said. 

Parents need to be prepared when it comes to their children being around water at their destination. Evans suggests parents buy traveling alarms to put on the doors that either buzz or siren when the door is open. Along with alarms, communicating with your partner is vital so that someone is always on watch. This can look like communicating taking naps separately. 

Even with putting safety measures and communication in place, be prepared and know CPR and the address in case there is need to call 911.

Evans addresses when children should start swim lessons by recognizing that each parent has to decide what is right for their child. The American Academy of Pediatrics (AAP) suggest children start swimming lessons around the age of one year where they are learning how to be safe and float on their back in the water. Now is the perfect time to remind parents to choose safety over fashion when it comes to their children’s swimwear.

“There are studies showing brightly colored swimsuits are easier to see in the water than more mundane colors. It’s hard to keep your eyes on the child when they are jumping in and splashing around in the water, so any help with a brightly colored swimsuit or life vest would be a great help,” Evans said.

Whether you are traveling to an Airbnb or a family home, recognize that your child is going to explore whether you want them to or not. It is smart to become familiar with the new environment before they do.

“You want to become familiar with the environment first. What kind of access points can the child use?” Jillian Mitchell, Program Coordinator, Community Health, said.

Mitchell encourages parents to pack temporary locking devices for doors and gates. She also emphasizes that communicating with your children and setting expectations of what the trip will look like is important. When it comes to the water, Mitchell emphasizes that a child’s first interaction with water will be bath time as an infant at home. In order to help with the child’s interaction with water in other locations, like on vacation, parents should aim to make bath time a hands on and positive experience.

When you travel to the beach or the pool, Mitchell highlights that you get to choose where you sit. Knowing this information, it should be key in parents’ minds to position themselves where they can see their children.

“Try to sit near a lifeguard, in a designated swim area on vacation. That area is designated for a reason,” Mitchell said.

Two of Cook Children’s values are imagination and safety. For this scenario where families travel out of their normal environment, parents’ should focus on uncovering new solutions and discoveries when it comes to their children being around water, and creating an environment that is physically and psychologically safe for their kids. Learn more about how to lifeguard your child here.

Drowning is the number one cause of unintentional death in children ages 1-4. It only takes a second for a child to slip underwater, and oftentimes, babies and toddlers are unable to pull themselves up.  

It is vitally important to practice water safety not just in pools, oceans, and lakes, but also in the bathtub. Drowning can happen in only an inch or two of water—just enough to cover your child’s nose and mouth. 

Bathtub Safety Tips

Cook Children’s has seen an increase in bathtub drownings in the last few years, and we want to help you keep your little ones safe. We started the Lifeguard Your Child™ Campaign to spread water safety awareness far and wide, and we’ve shared some of our tried and true tips below: 

1. Ensure an adult stays at the side of the tub within reach of the child throughout the entire bath. This is too big of a responsibility for siblings and other children, so don’t ask them to take over for you. 
    
2. Avoid multitasking. Preparing dinner, folding laundry, or any other housekeeping tasks can and must wait until after the bath is over.
    
3. Ignore distractions like the doorbell or cell phones. Stepping or looking away from your child for even a few seconds can put them at risk of drowning.
    
4. Be prepared. Keep a towel and bath supplies close at hand, so you do not need to get up and leave during bath time. 
    
5. Treat every bath as a time to relax and bond with your baby or toddler. Bath toys like foam letters, animals that shoot water, and waterproof books are a great way to make the bathtub more fun and teach your child new things at the same time! 
    
6. Safety proof your home to prevent young children from accessing the bathroom without an adult. The more barriers in place, the safer your child will be.
    
7. If you absolutely have to leave during bath time, swaddle your child in a towel and bring them with you. 
    
8. Remove all toys and drain the tub immediately after each use.

The Importance of Family CPR Lessons

While we wish all cases of childhood drowning could be prevented, sometimes they can’t. And when they can’t, every second matters. If something goes wrong, quick, efficient CPR can be the difference between life and death while waiting for emergency personnel to arrive. 

Learning CPR is an important part of any family’s safety plan. We can’t stress enough the importance of being ready to act in critical situations. To sign up for classes, check with your local Red Cross or YMCA. 

Help Us Share the Message 

Now that you know all the ways to protect kids from drowning in the bathtub, help us spread the #LifeguardYourChild message. It takes a village, and together, we can save another child’s life. 

 

As families and friends come together to celebrate Independence Day, it's important to keep safety in mind. According to experts at Cook Children's, drowning is the primary threat to children during this holiday. Drowning patients are commonly seen in the emergency room and these incidents can often have severe outcomes.

To ensure a safe and enjoyable holiday weekend, consider the following safety tips:

• Always supervise children when they are in or near water, even if they know how to swim.
• Designate a Water Watcher, an adult who will watch all children while they are in or around water with no distractions.
• Keep pool areas fenced and locked when not in use and remove all pool toys/floats. One to 4-year-olds are at the most risk to drown in a pool.

DROWNING PREVENTION

From June 1 to June 23, 2023, there were 10 drownings treated at Cook Children’s, two of which were fatal. Most of these patients have been in the 5 years old and under age group.

Since Jan. 1, 2023, there have been 25 drownings at Cook Children’s, three of which were fatal. Most drownings in 2023 have occurred in a swimming pool or hot tub.

While most patients survived these incidents, drowning injuries can result in severe effects, especially on a child’s brain development.

Drownings can happen silently and quickly. A submerged person might not attract attention or appear to be in danger

Drownings can occur even with many adults present. When there are children around water, always designate a Water Watcher, an adult who is in charge of watching all children without any distractions. The Water Watcher should not use a cell phone, socialize, drink alcohol or do anything else that might be a distraction.

Parents can put barriers in place to help prevent a child from accessing the water or make it more difficult to access when an adult is not present. Barriers – such as locks, alarms and fencing – can help keep unsupervised young children from getting into swimming pools.

Go here for more information on Water Watcher tags. Lifeguardyourchild.org shares many resources and tips for drowning prevention.

HEAT SAFETY

In very hot weather, high humidity, and other conditions, heat in the body can build to dangerous levels. This can cause heat illness, such as heat cramps, heat exhaustion, or heatstroke.

With highs in the upper 90s, be sure to keep these heat safety tips in mind. 

Wear appropriate clothing: Choose lightweight, light-colored, loose-fitting clothes. Wear a hat to shield yourself from the sun, until you feel yourself getting warm. Then remove any items covering your head that can trap heat close to the body.

Schedule outdoor activities carefully: Heatstroke can occur in less than an hour when you are participating in a strenuous activity on a hot day. Try to limit outdoor activity to when it’s coolest, like morning and evening hours. Rest often in shady areas so your child’s body has a chance to recover.

Hydrate: Drink plenty of water during the day, especially if you are engaged in any strenuous activity. Be sure to drink water or a sports drink before, during and after any strenuous activity.

Wear sunscreen: If you go outside, use sunscreen, wear a wide-brimmed hat and sunglasses, and put on sunscreen of SPF 15 or higher 30 minutes before going outside. Continue to reapply according to the package directions.

FIREWORKS

Fireworks can cause severe injuries that are both harmful and painful to children. Children should never handle fireworks. Even seemingly harmless sparklers can heat up to more than 1,200 degrees, making them dangerous for young children. 

Some people light sparklers at home or even set off their own fireworks, but this is dangerous. Some of the people hurt each year aren't the ones setting off the fireworks, but people who are nearby.

The safest way to enjoy fireworks is at a professional display.

If setting off fireworks at home, adults should only set them off in a designated “kid-free” zone. Adults should not hold fireworks in their hands or keep any part of their body over them while lighting. Wear eye protection, and don't carry fireworks in your pocket — the friction could set them off.

Point fireworks away from homes, and keep away from brush and leaves and flammable substances. The National Fire Protection Association estimates that local fire departments respond to more 50,000 fires caused by fireworks each year.

It’s also important to keep children away from bonfires and grills to help prevent any accidental burns.

ATV SAFETY

Though often thrilling for children, off-road motorized vehicles — including all-terrain vehicles (ATVs), ATV mules, go-karts, and even golf carts — can be extremely dangerous for them to ride, especially if they don’t use safety measures once they get on board. Cook Children's sees many patients with injuries from ATV accidents every year.

To prevent such injuries among children, the American Academy of Pediatrics (AAP) recommends that children under 16 should not drive or ride as passengers in two- and four-wheeled off-road vehicles.

ATV Safety:

• Always wear protective gear such as:
• Helmet
• Eye Protection
• Boots, gloves, long pants, jacket
• Do not ride an ATV at night
• Take an ATV safety course
• Never ride on public roads
• Perform ATV safety checks

RELATED

A Cautionary Tale: The Misadventures of Summer & Top Injuries Seen at Cook Children's (checkupnewsroom.com)

Should My Child Ride ATVs? Cook Children's Experts Weigh In (checkupnewsroom.com)

A Pediatrician's Advice for a Safe and Fun Fourth of July (checkupnewsroom.com)

As families start their summer traveling, water safety vigilance is key at all ages and no matter where your family might be. Swimming pools, lakes and beaches all pose risks but with the right preparation, you can avoid tragic outcomes.

“Many families stay on rental properties with pools and they may not have a pool at home,” said Sharon Evans, trauma injury prevention coordinator. “Knowing ahead of time what questions to ask and the kind of barriers to put in place lowers the risk of a drowning event.”

Cook Children’s has already treated 10 drownings so far this year, one of which was fatal. Parents need to remember that 70%  of toddler drownings happen during unplanned swim time. This is when parents didn’t expect their child to be in or around the water. 

Ensuring the pool is completely secure after swimming for the day is extremely important. Remove all toys and floats from the pool area so children are not tempted to get close to the water. For above-ground pools, make sure the ladder is removed and not accessible when it’s not swimming time.

Staying Afloat with the Right Life Jacket

Evans says it is not always a matter of strong swimming. Especially with murky water, your child could hit his head on an object underneath and quickly become disoriented. That is why life jackets are a must at lakes and beaches. Texas state law requires all children under 13 years old to wear a U.S. Coast Guard-approved life jacket on boats under 26 feet in length. With so many life jacket options, be sure you choose one that fits properly and is Coast Guard-approved.

A life jacket that is too big will cause the flotation device to push up around your child’s face but too small means it will not be able to keep your child’s body afloat. If there is excess room above the openings and the life jacket rides up over your child’s chin or face, it does NOT fit properly.

A snug fit in these areas signals a properly fitting life jacket. Do not buy a life jacket for your child to grow into – it must fit your child just right. Check the weight limits on the label – and try it on before getting in the water.

A Safe Day at the Beach

At beaches, pay close attention to the warning flags as they can change throughout the day. A red flag is a high hazard meaning high surf and/or strong currents. A yellow flag is a medium hazard meaning moderate surf and/or currents. A green flag is a low hazard meaning calm conditions, exercise caution. A purple flag means dangerous marine life spotted.

“The safest way to play at the beach is with a life jacket,” Sharon said. “Strong waves can come out of nowhere and pull a child down to the bottom causing you to quickly lose sight of them.”

Preparations to make before landing at your vacation spot:

• Check to see if the pool has barriers such as fencing.
• Ask if there are locks high up on doors leading to the outdoors and door alarms.
• Ask if there are dog/pet doors that have direct access to the pool area. Young children can fit through these doors without triggering the door alarm.
• Bring bright swimsuits for your children – choose swimsuit colors that do not blend into the body of water in which your child will be swimming. Light colors, like white or light blue, tend to blend into the swimming pool, making the child harder to see. Neon colors are more noticeable and contrast against the water at pools, lakes and beaches.
• When there are children around water, always designate a Water Watcher, an adult who is in charge of watching all children without any distractions.
• Pack water watcher tags for adults to wear at the pool.
• Refresh CPR and first aid skills.
• Bring portable door alarms and body alarms for additional layers of protection.
• Bring doorknob covers.

RELATED STORIES:

• What Color Is Your Child's Swimsuit? Experts Say Choose Safety Over Fashion (checkupnewsroom.com)
• Tips for Best Fit, Safe Practices for Wearing Life Jackets (checkupnewsroom.com)
• Pediatrician Shares Top Beach Vacation Tips (checkupnewsroom.com)
• Water Watcher Tag: 1 Item Can Help Prevent Drownings (checkupnewsroom.com)

Kids everywhere are counting down the days until they can take their first leap into the water for summer swim season, which has parents on the hunt for the perfect swimsuit. But before you purchase those cute swim trunks or that adorable suit for your little swimmer, it’s important to look beyond the latest fashion trends and consider safety, too.

Yes, a swimsuit’s color can be a safety hazard or help, according to water safety experts.

“The color of a swimsuit helps with visually keeping an eye on the child and being able to watch and make sure that they're obviously still moving and swimming in the water. Typically, we recommend bright colors,” said Kathryn Lammers, a professional swim instructor, owner of The Swim Lesson People and chair of Safe Kids North Texas - Fort Worth.

A video demonstrating the visibility of swimsuit colors in the water recently made a viral splash on social media and sparked a number of media stories. For good reason, experts say. A child’s swimsuit color is one of the many layers of protection parents and caregivers can use to help prevent drowning.

Children ages 1 to 4 have the highest drowning rates, according to the Centers for Disease Control and Prevention. Most drownings in children 1 to 4 happen in swimming pools, so it's important to be able to spot your child quickly. Cook Children’s has treated 10 drownings so far this year, one of which was fatal. 

Adult Water Watcher

Other layers of protection include teaching your child to swim, wearing Coast Guard-approved life jackets when in and around water, installing physical barriers and alarms to pools, ensuring your pool drain is fitted with a safety cover, learning CPR and, most importantly, closely watching your child when they are in and near water.

“It really goes back to that active supervision, no matter how many layers we put in place,” Lammers said. “We can teach swim lessons all day long, do CPR and have protective barriers. But those layers are there to help us if we have a lapse in supervision because, being a mom, we know that we're tasked with so many different things, and as much as we try to be vigilant and hypervigilant little things happen, but that active supervision is the most important.”

Water Watchers are adults designated to watch children who are in or around water at all times. They should have no distractions, this means no phone, magazines, books, eating, or conversing with friends.

Choosing a Swimsuit Color

Choose swimsuit colors that do not blend into the body of water in which your child will be swimming, be it a pool, lake or ocean. Consider the color of the bottom of the body of water. Is it light or dark? Think about how the swimsuit may appear or disappear both floating on top of the water or under the water when there is agitation, like splashing. Light colors, like white or light blue, tend to blend into the swimming pool, making the child harder to see.

Bottom line? Bright, contrasting, neon colors are the most visible in most bodies of water, according to tests performed by aquatic safety experts from Alive Solutions. Neon yellow, green and orange are the winners in pools with dark bottoms and in lakes. Neon pink, yellow and orange win out in light-bottomed pools.

“They just stand out better,” said Jillian Mitchell, child safety program coordinator for the Center for Community Health, led by Cook Children’s. “If they're wearing blue or green or even like a muted purple, those kinds of colors, they kind of blend in and are harder to see. So it might make a difference as far as noticing a child at the bottom of the pool for too long, or they're not playing anymore and may be in trouble.”

The same goes for life jackets, especially in the lake. It’s much easier for a boater to spot a swimmer or fallen skier who is wearing a neon orange or yellow life jacket than it is for them to see a black life jacket in murky water.

Mitchell says parents should consider a few other swim season fashion factors, too. For young children whose swim skills are still developing, choose suits without frilly and dangly design features that could become entangled in a pool toy or an old pool drain that does not meet current safety standards. Pull long hair back with a hair tie or braid to keep their faces clear while in the water.

“Think about your environment and what that entails,” Mitchell said. “If you're going to the beach, especially later in the season, the sand is hot so you want to protect your child's feet with well-fitted water shoes that are safe for that age. I'm not going to say no one should wear flip flops, but understand where your child is developmentally and what's going to prevent them from tripping and falling.”

Other tips for splashing safely:

• Before you let your child loose in the water, have them practice wearing anything they plan to wear while swimming, like water shoes and life jackets, so they get used to the fit, feel and function of the item in the water.
• If your little one wears a long-sleeve swimsuit or cover up, don’t forget to put sunscreen on their hands.
• Be cautious about allowing kids to swim in attire other than swimwear because of the drag regular clothing can cause in the water. For example, denim shorts and a cotton t-shirt are heavier than a swimsuit and will weigh a child down, making it more difficult for them to swim.
• Don’t choose one layer of safety over another. They are meant to all work together.

“Do not depend on one piece or one layer of protection,” Lammers said. “Know that these are all best practices. So even though we're promoting multiple layers, the layers work together and it's not just relying on one piece over another. If you go to the pool or the lake, don’t just rely on the life jacket or on swim lessons or on having a water watcher, but use everything in combination with each other. That is the overall best practice.”

The Center for Community Health will be at these upcoming free safety and community events:

Additional information from organizers:

Run4Elise

The Run4Elise is a 5K and 1 Mile fun run that benefits the Swim4Elise Foundation and the Elise Cerami Memorial Scholarship. This family-friendly community event honors the life of Elise Cerami by promoting water safety through swimming scholarships and community outreach education. Go here for more information.

The Center for Community Health led by Cook Children's will share information and resources for Lifeguard Your Child. 

Pop Up Safety Center/Diaper Hub

The Center for Community Health will share information and resources for Lifeguard Your Child, Safe Baby Sleep, Aim for Safety and many other campaigns from the Center for Children's Health and Cook Children's. 

Super Safety Saturday- Burleson

Bring the entire family to Super Safety Saturday. The Burleson Fire Department is partnering with Texas Health Burleson for a family-friendly safety event that will include pool & sun safety education, home safety, bike safety and fire safety. There will also be free bounce houses, fire truck, ambulance and much more. Go here for more information.

The Center for Community Health led by Cook Children's will share information and resources for Safe Baby Sleep and Aim for Safety campaigns.

Argyle Child Safety Fair

It's almost that time again. The 3rd Annual Child Safety Fair is just around the corner on June 10th and it will be bigger and better (though still FREE) than before. There will be a water slide, a rock climbing wall, a water gun arena, a dunk tank, free snow cones, and so much more. And if you're an expectant mother or are looking to ensure that your car seat is installed correctly, we will have a car seat fitting event prior to the Child Safety Fair. Mark your calendar now! There will also be free drug lock boxes, free gun safes, free booster seats, and free bike helmets. Go here for more information. 

The Center for Community Health led by Cook Children's will share information and resources for Lifeguard Your Child, Safe Baby Sleep, Aim for Safety and many other campaigns from the Center for Children's Health and Cook Children's.

Defenderpalooza 2023

We’re excited to host our 2nd Annual Defenderpalooza event and making this event even bigger and better! Go here for more information.

The Center for Community Health led by Cook Children's will share information and resources for our Aim for Safety campaign.

Cook Children’s has treated nine drownings so far this year, one of which was fatal. As the weather warms up, parents and caregivers should take time to review how to keep their young children safe around water.

With the recent news of a Tampa Bay Buccaneers player’s 2-year-old daughter drowning in their swimming pool, we are reminded of how quickly water can turn into a tragic accident. It only takes a minute for a child to drown, and most of the time it is silent.

According to Safe Kids Worldwide, drowning is the leading cause of injury-related death among children between 1 and 4 years old. Even if a child survives a drowning, it's possible to have lasting neurological effects. Cook Children’s leads a campaign called Lifeguard Your Child for parents and caregivers to learn how to protect children in all kinds of water.

Drownings can occur even with many adults present. One key tip is to designate a “water watcher” – a responsible adult who agrees to watch the children in the water without distractions.

Sharon Evans, trauma injury prevention coordinator at Cook Children’s, said it is vital for parents and homeowners to realize they must be on guard at all times if they have a pool.

“All of the barriers along with swimming lessons can prevent drownings,” Sharon said. “Not only having these barriers in place but ensuring the alarms work and are on and the gates remain closed is important as well.”

Drownings can happen silently and quickly. A submerged person might not attract attention or appear to be in danger. Younger children most often drown in swimming pools by falling in while unsupervised. Parents can put barriers in place to help prevent a child from accessing the water or make it more difficult to access when an adult is not present.

Top Pool Barriers
The more barriers in place, the safer the child will be.

• Four-sided isolation fences with self-latching gates
• Alarms (pool, door, gate)
• Automatic pool covers
• Doorknob covers and high locks on doors leading to the outdoors
• Reroute dog/pet doors that have direct access to the pool area

Lifeguard Your Child

Cook Children’s initiated a drowning prevention campaign called Lifeguard Your Child in 2015 in response to a high number of drowning injuries treated in the Emergency Department and medical center that year. The Lifeguard Your Child campaign is spread through the Safe Kids North Texas Coalition, which is based in Fort Worth and led by Cook Children’s.

The campaign’s strategies include Cook Children’s Loaner Life Jacket Stations at many lake entry points across the region. Families can go to the stations to find U.S. Coast Guard-approved life jackets in a variety of sizes with easy tips for a proper fit.

Safety tips for home swimming pools: 
• Restrict access by installing door locks high out of children’s reach. Door and window alarms can signal if someone leaves the house. 
• Install four-sided fencing around pools with a self-latching gate that only opens out. The fence should be at least 4 feet (preferably 5 feet) high. 
• Remove all toys and floats from the pool area so children are not tempted to get close to the water. 
• For above-ground pools, make sure the ladder is removed and not accessible when it’s not swimming time. 
• Consider a pool surface alarm to alert if anyone/anything falls into the water. 

Safety tips for the bathtub: 
• An adult must stay at the side of the tub in reach of the child. 
• Pay attention. This is not the time for multitasking. 
• Ignore distractions like the doorbell or phone calls. 
• Drain the tub after each use. 
For more information about drowning prevention, go to www.lifeguardyourchild.org.

As summer draws to a close, one mother, Dana Gage, is sharing her journey to making her son’s tragic drowning death matter.

On Aug. 31, 2012, Dana's son, Connor, left for a friend’s birthday party at a rented lakehouse. Little did either of them know, it would be the last time Dana would see what she calls her son’s “1000-watt smile.”

Hours later, Connor drowned in a swimming incident that was 100% preventable. He was 15 years old.

In the 10 years since Connor’s death, Dana and her family established The LV Project, to raise awareness about drowning prevention and advocate for the use of life vests on lakes. We asked Dana to share with us how Connor inspired what has become her life's work since his death.

What is one of your favorite memories of Connor?

I spent my career in marketing and advertising. One of my favorite memories is sitting with Connor and watching TV. An ad would come on and he’d say, “Mom, that’s a really good commercial.” Then, in great detail, he’d proceed to tell me why. And he was always spot on. I remember thinking, how on earth does this little kid have the ability to discern between good advertising and bad advertising? How does he deconstruct these ads down to the nuances that result in a great commercial?  But he did, and it was fun. For me, it was sort of like having a pint-sized work buddy at home. 

At a very young age, Connor seemed to understand that connecting with people emotionally is the way to get people to think, and hopefully, act. On one of his school assignments, Connor was asked what he would do with his life. He wrote, “I’ll probably go into advertising or something.” In many ways, he has, as we share his story in hopes of preventing drowning deaths.

As you reach the 10-year mark of Connor's death, what do you want people to know about his legacy and remember about his life?

It’s taken every bit of the last 10 years to pry my broken momma heart loose from the magnetic force of lament mode and force myself into joy mode. It’s like weightlifting. It’s a constant struggle not to be crushed under the loss. There are many days I am still on the floor, in a heap of grief. But I get up. I fall down. Then I get up. After 10 years, as my grief muscle continues to develop, I find that I’m getting up more quickly, and I’m falling down less. 

I’m trying not to dwell in the lament of what Connor could have been and, instead, genuinely celebrate what Connor was. A happy kid who enjoyed his life. I guess when people think of Connor, they’re naturally going to remember the boy who died. But what I truly hope is that they remember the boy who LIVED. Connor lived joyfully, happily, buoyantly. He made his 15 years count far beyond his 15 years. There are no guarantees in this life, and there are no do-overs. Connor made his count.

We remember his buoyant spirit. We remember his smile, and we remember that come what may, we can keep going.

How does Connor's life inspire the work of The LV Project?

I started The LV Project in November 2012, just two months after we lost our boy. Why? Honestly, because it was the only alternative to losing my mind. I had to do something. Doing nothing wasn’t an option.

On that awful day, Riley lost his only sibling and his best friend. Brett and I lost our family, our dreams, our hearts, our future. It was too horrible to be true. Yet, it WAS true. My baby DID die. This WAS now my life. And I had no idea how to face it. Broken open, shattered in a million pieces, sitting in the rubble, I spent my days walking in literal circles over and over inside my house. From the living room to the kitchen to the dining room and repeat. Groaning and walking. Walking and groaning. I guess you could say, all those circles led straight to The LV Project.

Most people think of LV’s mission as drowning prevention, but in reality, it’s heartbreak prevention and hope. We’re in the buoyancy business. That’s true on water and in life. No mom, dad, brother or sister should feel the way Brett, Riley and I do every day. Not when it can be prevented. And the thing is, it really is possible to end these tragedies. Drowning really is a problem we can fix. The LV Project is where we make our suffering matter. If you live long enough, you’re going to suffer. We have to make it count. Because suffering without meaning is just despair. That’s why The LV Project isn’t just about how Connor died. It’s about how he lived. And Connor lived buoyantly.

Why is it important that parents, health professionals, lawmakers and anyone responsible for a child's safety and life understand The X Effect?

The seeds for The X Effect were planted pretty quickly after Connor’s death, though we didn’t know it at the time. In the weeks that followed, we were surrounded by the loving support, but also stunned by how few people mentioned the fact that the boys weren’t wearing life vests at the lake party where he died. No one brought it up. The blame seemed to fall on Connor. It was chalked up to “boys will be boys” and “reckless teenage behavior” or just “a terrible accident.”  That sickened me. Still does. Terrible it was, but accident it wasn’t. Connor’s death was not some random, unstoppable event. It was preventable.

Even more shocking was how little people understood the dangers of open water. If my underage son had died in a car because the driver didn’t require seat belts there would’ve been shock and rage at the carelessness. If Connor had been killed by a drunk driver there would’ve been a certain fury at the recklessness. But very few people seemed to understand that allowing a kid to swim after sunset and jump from high places in an unfamiliar lake without a life vest is every bit as dangerous. 

There was a time when people didn’t wear seat belts. And there was a time when people drove while drinking alcohol. But, unnecessary deaths—deaths like Connor’s—created the change necessary to save lives. Now is the time for people to understand that knowing how to swim does NOT make a kid drown-proof. Now is the time for people to understand that a life vest in a lake is like a seat belt in a car. Now is the time for people to understand that it’s our responsibility to protect those at the highest risk—teenagers age 15 to 19—from drowning in open water.

What everyone needs to understand is this: you can’t out-water the water. The water always wins. We hope The X Effect opens a lot of eyes to the reality of drowning for ALL kids—little and big.

What do you think is the biggest misconception about teens and drowning?

Absolutely the biggest misconception is that people think good swimmers are drown-proof. Nothing could be further from the truth, especially in open water.

There were many factors that contributed to my son’s death. Paramount is the fact that I did not ensure that my son would be required to wear a life vest, nor did the host family require the boys to wear them. That was a recipe for disaster. The five boys at this party were given permission to swim very late in the day. Connor went under at 8:15 pm. The sun had set that day at 7:55 p.m. It was entirely too late to be in the water. It’s impossible to see anything in lake water at high noon, much less after sunset. We have a saying, “When the sun’s low, the kids gotta go.” Low light conditions can turn an already risky situation deadly.

The other challenge is our life vest laws which, I believe, work against us. The law in Texas says life vests only need to be worn by kids 12 and under, and only in boats. That leads most parents and kids to a false sense of security. The irony is that in Texas, 80% of open-water drownings happen beyond the boat, meaning in open water settings such as shorelines or simply swimming in the lake. So, there’s this presumed assumption of safety because the law says you don’t need a life vest when you’re 13 or older. Meanwhile, our strong swimmers are drowning. Per the CDC, open water drownings triple at age 15, and the drowning rates remain elevated through adulthood. So as the life vests come off, the drowning rates spike.

But the most important thing is to know the numbers. In open water, more teens and adults drown than small children. We love our littles. We love our bigs. We have to protect them both by making life vests a must.

What work still needs to be done when it comes to action and awareness of this issue?

Raising the current mandatory life jacket wear age from 12 to 16 as a law would be an amazing first step. That would save a lot of lives, and also serve as an effective signal to parents and their teens that good swimmers can drown and do.

Secondly, everyone should have the opportunity to learn how to swim. Getting swim lessons into our school curriculums as a basic life skill would be a fundamental lifesaver. In those lessons, bridging the gap between pools and open water is important. Swim lesson instructors should plant the seeds early about the differences between closed and open water so the safety measures continue as the kids age into adolescence.

Lastly, just like every young parent learns how to keep their kid safe when they’re babies with car seats, poison control and more, we need to educate our young moms and dads about the reality of teenage drowning. Water safety goes beyond learning how to swim. It’s the second leading cause of death, after automobile accidents, for kids ages 15 to 19. I’m sure if more adults knew that, requiring teenagers to wear a life vest wouldn’t be a maybe, it would be a must.

Lifeguard Your Child

Lifeguard Your Child offers parents these tips for keeping their kids safe in open water:

• Life vests should be “US Coast Guard Approved (USGA).” Check the inside label for this stamp of approval. They should also be worn inside the boat or in the water, as most drowning fatalities in natural water are non-boating related.
• Know before you go. The water conditions of lakes, rivers and oceans can change daily, from clear to murky and calm to rough. Be aware of the conditions before you get in and know that there may be harmful debris under the surface that you can’t see.
• Children, whether toddlers or teens, should be watched by an adult when in or near the water. Teens are often fearless and unaware of danger. They need responsible adults to help them avoid risky behavior.
• Have a safety plan in case of an emergency. Learn CPR so that you can administer rescue procedures while EMS is in route.

For more information about keeping children and teens safe in and around water, check out www.lifeguardyourchild.org, a program of The Center for Children’s Health, led by Cook Children’s.

Ten years ago this week, Connor Gage blew his mother a kiss as he left for a friend’s birthday party at a rented lakehouse. Little did either of them know, it would be the last kiss he’d ever give her and the last time Dana Gage would see what she calls her son’s “1000-watt smile.”

Hours later, Connor drowned in a swimming incident that was 100% preventable. He was 15 years old.

“He was funny,” Gage said describing her son. “He was a Justin Bieber doppelganger. He was silly. He loved to run. He was smart. He loved his friends. He was his brother’s best friend. He was a great writer. That boy was creative. Even at a young age, his mind bent toward the art of great storytelling.”

Connor was no stranger to lake life, either. His family owned a lakehouse and spent many summer days on the water boating, swimming, tubing and wakeboarding. Even though both of their boys were great swimmers, Brett and Dana Gage were cautious. Wearing a life jacket was non-negotiable. “Toe in, vest on,” they would always say.

Dana Gage assumed every family did the same.

“The biggest mistake of my life was assuming everyone else had the same rule,” she said. “I never asked. That mistake changed my life forever.”

As the sun began to set over the lake on Aug. 31, 2012, the teen boys attending the party were given permission to jump into the water from a high boat dock. None of them were wearing life vests.

At 7:30 p.m., Gage received a text from Connor: “jumping in, brb.” About an hour later, Connor flipped from the dock, landed badly and never resurfaced. It took a dive team 45 minutes to locate and pull his body from the water.

After attempts to resuscitate him, Connor was pronounced dead just five hours after blowing his mother that final kiss in the driveway.

“Connor died at age 15, just as he was starting his freshman year of high school, and just as he was turning the corner from boyhood to manhood,” Gage said. “There’s truly no way to describe it. We’d worked so hard, my husband and I, so long, so intentionally to get to this point. We’d been married 20 years. Our two teenage boys were now a freshman and junior in high school. Best friends who just happened to be brothers running on the same varsity cross country team.

"The future was so bright, and it was a magical time. All the pieces of our family’s puzzle were fitting together perfectly, and we were just so expectant. So eager for this incredible chapter in our family’s life. The best was yet to come. Until, that day. That Friday when our perfect family puzzle got blown to pieces.”

LiVe and LoVe Buoyantly

In the 10 years since Connor’s death, Dana and her family have been working hard to heal their broken hearts and make their suffering matter. As much as the family wants to bring awareness to how Connor died, they also want to honor how he lived. They say Connor lived and loved buoyantly—always full of joy and life—and want to give others a chance to do the same. Just two months after Connor’s death, the Gage family started The LV Project to help others “LiVe and LoVe buoyantly on the water and in life.”

“Something amazing happens when life deals you an unimaginable blow,” Gage said. “Suddenly, everything becomes incredibly clear. The things that matter, matter more. And the things that don’t, don’t. 

"I’ve talked about this a lot with other grieving moms, and we all agree that this remarkable clarity is a rare silver lining among the dark clouds of despair. Soul-crushing heartbreak can be a way-paver to crystal vision. At least it was for me. The color in my world was gone, but the resulting black and white view was profoundly crisp. No ambiguity. No fog. No nonsense.

"As I began to acclimate to this new life lens, one fact became indisputably clear: Connor should not have died on August 31, 2012. It was so preventable. So unnecessary. So wrong. This wasn’t an accident. This was 100% preventable. I decided to do something about it. I immediately quit my job in corporate America, and I started The LV Project.”

During the summer months, The LV Project raises awareness about drowning prevention and advocates for the use of life vests on lakes. Had Connor been wearing a life vest, even with an injury, he would have resurfaced and could have been rescued quickly for a chance at survival.  

Once the lake and swimming season is over, The LV Project turns its attention to helping people who need a lift in their everyday lives through what Gage calls life buoyancy projects. The LV Project has funded the construction of a soccer field in Ghana for West African children rescued from trafficking, for example. Closer to home, The LV Project has completed projects with several Dallas/Fort Worth-area organizations to help support their missions, including Achieve DFW, The Gatehouse, Project ELF Dallas and many more.

Gage is also a friend and supporter of the Lifeguard Your Child program through the Center For Children’s Health, led by Cook Children’s. She has shared Connor’s story at several Lifeguard Your Child events, helping the program bring awareness to the dangers teens face in open water and the easy steps parents can take to protect and save their lives.

The X Effect

When Gage started The LV Project, she first went to work pouring over drowning data. She knew Connor was one of many who had lost their life to a preventable drowning death, and she wanted the numbers to help her make a case beyond her own experience for the importance of life vests. The LV Project needed a clear target for their mission. What they got is what Gage calls The X Effect.

“You know that saying, ‘you can’t hit a target you can’t see?’” she asked. “I wanted to know the target. I wanted the numbers. I wanted to know how many deaths like Connor’s were happening every year across the country. I quickly discovered that drowning data in the U.S. is scattered and siloed. Worse yet, the data that does get shared doesn’t tell the full story. It’s like a book that’s unfinished. The chapter about teenage drownings often gets left out.”

Gage began searching every data source she could find, from the Centers for Disease Control (CDC) to the Texas Department of Health and Human Services to USA Swimming and more. She plotted all of the data she gathered in an Excel spreadsheet by age and drowning location of pool versus open water. The work took months. When it was done, she said, a simple pattern emerged from the graph: an X.

That pattern illustrates how younger children are more likely to drown in a swimming pool, most during an unplanned swim time. As kids age, the likelihood they’ll drown in a pool decreases while the risk of drowning in a natural body of water increases. By age 15, a teen’s chance of drowning in open water triples.

“The short story is drowning is a risk for the littles, and most of those are happening in pools,” Gage said. “But it’s also a risk for the bigs, and most of those are happening in open water. Nobody is drownproof, regardless of swim ability. We have to protect our kids at all ages, in all water. Always.”

Teens are naturally impulsive, fearless and often unaware of risk, especially boys, which puts them at higher risk, according to the CDC. Running through the water-safety checklist and identifying hazards such as water depth or debris beneath the murkiness is not always the first thing that pops into a teen’s mind before jumping in. 

The ability to swim gives many a false sense of security, too. Adults often assume teens are strong swimmers and that will protect them from drowning. But swimming in a lake or ocean with currents, unclear water, and unseen hazards below the surface is altogether different from swimming in a pool.

According to the U.S. Coast Guard, 79% of boating-related deaths in 2019 were drowning related. Of those who died from drowning, 86% were not wearing life jackets. When it comes to open water, teens are at great risk. Adults in charge in open water environments have a responsibility to protect teenagers, just as they would protect a small child. That’s why Dana channels her grief into advocating for the use of life vests on lakes. So not one more parent has to experience the tragedy of losing a child to drowning.

Lifeguard Your Child

Drownings are the No. 1 cause of unintentional death in children ages 1 to 4 and second leading cause of unintentional injury death, after car accidents, for kids ages 1 to 14, according to the CDC. From May to August 2022, 47 children were treated for drowning incidents in Cook Children’s emergency department.

“Some of the most tragic things we see as emergency room physicians are injuries and deaths that could have been prevented, and that’s the case with most drownings,” said Corwin Warminck, M.D., emergency department medical director at Cook Children’s Medical Center. “Parents can help prevent drownings by having layers of protection. In open water that means wearing life vests at all times regardless of their swim ability and lifeguarding your child no matter their age.”

Lifeguard Your Child offers parents these tips for keeping their kids safe in open water:

• Life vests should be “US Coast Guard Approved (USGA).” Check the inside label for this stamp of approval. They should also be worn inside the boat or in the water, as most drowning fatalities in natural water are non-boating related.
• Know before you go. The water conditions of lakes, rivers and oceans can change daily, from clear to murky and calm to rough. Be aware of the conditions before you get in and know that there may be harmful debris under the surface that you can’t see.
• Children, whether toddlers or teens, should be watched by an adult when in or near the water. Teens are often fearless and unaware of danger. They need responsible adults to help them avoid risky behavior.
• Have a safety plan in case of an emergency. Learn CPR so that you can administer rescue procedures while EMS is in route.

For more information about keeping children and teens safe in and around water, check out www.lifeguardyourchild.org, a program of The Center for Children’s Health, led by Cook Children’s.

From May to August, there were 47 drownings treated at Cook Children’s Health Care System, two of which were fatal, marking a decrease compared to the same timeframe in 2021.

While most patients survived these incidents, drowning injuries can result in severe effects. Drownings can happen silently and quickly. A submerged person might not attract attention or appear to be in danger.

Drownings can occur even with many adults present. When there are children around water, always designate a Water Watcher, an adult who is in charge of watching all children without any distractions.

May – August 2022:

• Total drownings: 47
• Fatalities: 2

May – August 2021:

• Total drownings: 67
• Fatalities: 7

May – August 2020:

• Total drownings: 27
• Fatalities: 1

May – August 2019:

• Total drownings: 54
• Fatalities: 3

May – August 2018:

• Total drownings: 68
• Fatalities: 10

Parents can put barriers in place to help prevent a child from accessing the water or make it more difficult to access when an adult is not present. Barriers – such as locks, alarms and fencing – can help keep unsupervised young children from getting into swimming pools.

Water safety is important at any age. When it comes to drowning, seconds count. It is silent and can happen in an instant. Drowning is the leading cause of accidental death for children ages 1 to 4, and the second leading cause for kids 1-14 in Texas. But with your help, we can change that.

RELATED: Water Watcher Tag: 1 Item Can Help Prevent Drownings (checkupnewsroom.com)

Checklist: Keeping Your Pool Safe for All Swimmers (checkupnewsroom.com)

Parents and caregivers should ensure that a home swimming pool has an effective swim safety plan and extra layers of protection. Most drownings seen at Cook Children’s happen in a swimming pool during the least expected moments. Drowning is the leading cause of accidental death among children ages 1 to 4 and the second leading cause for kids 1 to 14 in Texas.  

Commonly, during unplanned swim time, children sneak off unnoticed, curious and looking for adventure, and that’s when drowning most often occurs. It’s vital never to lose sight of your child when you are in or around a swimming pool.

Drownings are preventable - more often than not, parents do not hear their children drowning; this is why children must be given undivided attention at or near the swimming pool. 

Don’t be the person to think, “It won’t happen to me.” Drowning can happen to anybody in a split second, not just neglectful parents not watching or paying enough attention to their children, and not just children who can’t swim. 

A parent’s water safety job is not over when their child learns to swim. Even experienced swimmers are susceptible to drowning and should still be watched, or wear a life vest at all times.

When choosing a life vest for your child, always check the label. If it does not read “US Coast Guard Approved” or “USCG Approved”, do not use it - assume it is not safe and untrustworthy. As your child grows, the lifejacket needs to meet their new weight. Get a new lifejacket if there are rips and tears or fraying of the straps.

Sharon Evans, trauma injury prevention coordinator at Cook Children's, shared tips and insight on safety at the pool. 

What are some tips you have for parents this summer while they’re at their home pools?

The biggest thing is  keeping your eyes or hands on your kids at all times. The large majority of our drownings we see at Cook Children’s are in backyard pools. It’s not always the homeowner's child - a lot of times they’ve gone to somebody else’s house for a barbecue or party. 

When you have a pool party for example, the more people you have at a pool, the higher the risk a child will drown because everyone assumes someone else is watching the kids. Wear a Water Watcher tag for 15 minutes, while you wear it, you cannot eat, drink or talk to anyone else- you’re strictly just watching the kids in the pool. Then, pass the tag onto someone else.

What are common incidents seen at Cook Children’s?

We see similar stories every time: The child will be in the pool, swimming with a life vest on, and then they get out of the pool to go to the bathroom or get something to eat and the parents will take the life vest off and somehow they get back into the pool. Drownings are always silent, not like in the movies where we see the kid thrashing and screaming. We’ve had parents sitting on the edge of the pool on their phones, unaware that their kid is drowning because it is so silent. 

Are life vests the safest option for children?

Anything that is Coast Guard approved is safe. We see a lot of parents using puddle jumpers and those are safe too, as long as they are Coast Guard approved and are not inflatable. Blow- up floaties or anything that’s inflatable can deflate at any moment.

Does drowning prevention differ from age to age?

Generally, drowning prevention is the same for all ages. We’ve had older adolescents/early teenagers go to the pool and they get tired and are unable to swim. You should always be watching, even if they’re a great swimmer, that doesn’t mean you can take your eyes off them. 

Pool Safety Checklist:

Choose a Water Watcher

• A child must have constant supervision while near or in a swimming pool. Decide on a designated Water Watcher and make sure they have no distractions. 
• If more than one adult is present, switch water watching jobs every 10 minutes. 
• Put your phone or other possible distractions away.

Install fences around home pools

• Proper fencing around pools could prevent 50% to 90% of childhood drowning incidents. 
• Four-sided isolation fencing should be around your home pool. 
• Fences around pools should be at least 4 feet tall.
• Self-latching/self-latching gates that only open outwards.
• Gates with childproof locks should remain locked at all times if the pool is unattended. 

Be aware of pool drains

• Teach your children to stay away from pool drains or any equipment with strong suction that hair or clothing can get caught in. 
• Make sure any swimming pool your child is at has compliant, working drain covers.

Use pool/door/child alarm

• An alarm can give you crucial seconds that could save a child's life.

Empty inflatable or portable pool immediately after use 

• Even shallow pools are a drowning risk.
• Store them upside down so they cannot collect water.

 Know what to do in an emergency

• Take family CPR lessons. 
• The adult should call 911 immediately and then begin CPR while EMS is on the way.
• Schedule water safety and swim lessons. 

For more information and resources, go to LifeguardyourChild.org.

The Food and Drug Administration (FDA) is warning parents, caregivers and health professionals about the dangers of inflatable neck floats after the death of one baby and the hospitalization of another. The flotation devices are especially dangerous for children with developmental disabilities such as spina bifida, spinal muscular atrophy (SMA) type 1, cerebral palsy and Down syndrome, according to the FDA. 

The floats are much like an innertube but fit around a baby’s neck to keep their head above water while their body and limbs float freely. They have been used in bathtubs, swimming pools and water therapy sessions. 

Like anything inflatable, there is a potential for the float to spring a leak, deflate and put the infant at risk of drowning. One popular infant neck float manufacturer issued a recall of its product in 2015 for this reason. 

The FDA contends the floats may also cause injury from the strain on an infant’s neck, but this claim is disputed by at least one manufacturer. According to a statement on the manufacturer’s website, the company is working with the FDA to “help them properly evaluate the benefits and the risks of neck floats, specifically around the concerns of potential neck strain which have never been reported to us after millions of … sessions.”

Lydia Robey, a Cook Children’s physical therapist, shares the FDA’s concern about neck traction, or pull on the spine, that infant neck floats may put on small children and babies.

“Some developmental disabilities have a higher likelihood of bony neck anomalies that could be compromised, or a condition exacerbated if traction is placed on the neck,” Robey said. 

Children with disabilities do benefit from water therapy, she said. They can move more freely and comfortably in the water thanks to the decrease in gravitational force on their muscles that buoyancy provides.

"I recommend that parents hold their child while they move in the water to be sure they are 100% focused on the child's safety," Robey said.

Sharon Evans, trauma injury prevention coordinator at Cook Children’s Medical Center, worries that if a baby is left unattended in the float and it overturns in the water, it would be difficult, if not impossible, for the baby to turn the float and themselves upright.

Infant neck floats are not approved flotation devices by the United States Coast Guard (USCG). The USCG establishes and oversees marine safety regulations, including the proper fit, function and use of personal flotation devices such as life jackets. Their stamp of approval means the personal flotation device meets certain criteria when put to the test in various water conditions.

“If they're not USCG-approved, then they don't have to pass any kind of USCG guideline or safety test to see if it will actually even keep your kid afloat,” Evans said.

Drowning is the No. 1 cause of death in children under the age of 4. In June, 19 children were treated for drownings at Cook Children’s Medical Center. While not all drownings result in death, they can cause severe brain damage. 

Drownings are preventable. Wearing a USCG-approved life jacket is one way to be safe around water. Keeping your eyes on your child at all times while in or near the water, be it the bathtub, pool or lake, is critical even if they are wearing a life jacket or any flotation device. In both of the neck float cases that prompted the FDA warning, neither infant was being directly monitored by their caregiver, according to the FDA. 

“I think parents just see floats like this and think it helps them in the water, and they put their baby in there and think they’re safe and it takes all the responsibility off,” Evans said. “But there is no replacement for an adult watching a child in the water and being within arm’s reach at all times.”

While you’re having fun by the pool this summer, ensure your pool safety plan includes a Water Watcher: an adult who is designated to watch children around the pool at all times. Drowning is silent, so it’s vital to designate a Water Watcher when children are around all bodies of water - swimming pools, kiddie pools, lakes, or the beach. Kids can drown in just 2 inches of water.

Cook Children’s created a wearable Water Watcher tag to ensure that the adult wearing the tag is in charge of watching the children in or near water. Fifteen-minute shifts are recommended for the Water Watchers. During that time, the designated Water Watcher should have no distractions, this means no phone, magazines, books, eating, alcohol or conversing with friends. The only time a phone should be used is during an emergency to call 911. After 15 minutes, pass the tag to the next adult in charge.

Cook Children’s Medical Advisor for Digital Health, Diane Arnaout, M.D., explained the importance of having an assigned adult at all times, especially now that summer is in full swing and social gatherings are held around bodies of water.

“I have a pool myself and we love to have friends over," Dr. Arnaout said. “It’s so easy to talk yourself into thinking your children are being watched when you’re in a group of 12 people because six adults certainly seem like more than two adults watching the kids, so certainly it’s more secure. But the problem is it’s actually less secure.”

Dr. Arnaout also noted that it does not have to be the official Cook Children’s tag, yet the rules remain the same. People can use a rubber band, bracelet or a hair tie as a substitute.

“By using the Water Watcher tags, it basically says the wearer of this does not play on their phone, does not drink, does not talk to other friends at the time - their sole job is to watch children at all times,” Dr. Arnaout said. 

Water Watchers add an extra layer of protection to prevent children from drowning. Swimming lessons are just one layer of protection and do not guarantee safety. Even strong swimmers can drown, so always designate a Water Watcher.

Other extra layers of protection include maintaining barriers to and around the pool, keeping pools clear of toys attractive to little ones when not in use, having a designated water watcher and wearing a life jacket.

A Water Watcher tag can be found in many of Cook Children’s pediatrician offices. Call your pediatrician to get one to use next time you're at the pool. You can also reach out to the Lifeguard Your Child department and one will be mailed.

When wearing the Water Watcher tag, you have one job and one job only - Lifeguard Your Child. 

To get a Water Watcher tag of your own, send an email to safe.kids@cookchildrens.org or follow this link: Water Safety Product Order (jotform.com)

It’s never too early to teach children to be safe around water. After all, if a baby can crawl, they can make their way to a pool or open body of water. Any number of things can lure them there — a floating toy or sheer curiosity as they naturally explore the world around them. Whatever the reason, the result could be deadly. 

The American Academy of Pediatrics says children as young as 1 year old can benefit from water competency training, which is teaching kids to understand the danger water poses, how to avoid it and how to survive should they find themselves in water alone.

“I think the No. 1 thing that water competency gives a young child is confidence,” said Jillian Mitchell, a community health program specialist at Cook Children’s Medical Center. “If a child falls in unexpectedly they are in a situation that might induce panic, but being water-competent is having the confidence to know what to do to survive.”

While most toddlers aren’t coordinated enough to learn traditional swim strokes, they can learn basic survival skills like surfacing, turning onto their backs to float with their head above water and reaching for the wall of the pool.  

Kelsey Strieby calls it aquatic problem-solving. She is a Certified Infant Swimming Resource (ISR) Self-Rescue® instructor and has taught hundreds of children water survival and self-rescue skills. 

“There are two components to this,” Strieby said. “It's the roll-back-to-float program and the swim-float-swim program. But the first priority is being able to float to survive.”

Survival Becomes Second Nature

As an ISR instructor, Strieby teaches infants and children to roll onto their backs and float if they fall into the water. After the child has been walking for a few months, they’ll advance to learn to swim, then roll onto their back and float, and swim again until they can grab the side of the pool. If they are in a larger body of water and cannot get to the side, Strieby teaches kids to survive by floating on their backs until help arrives. 

Her students don’t learn a specific swim stroke or even to tread water, but to use their natural movement, like when they are crawling or walking, to bring themselves to the surface. 

“Self-rescue is taught using muscle memory and each child’s unique muscle movement,” Strieby said. “So the kids actually simulate like they're walking or crawling through the water. We don't teach a specific movement of the hand or leg. We will guide them through how to move effectively in the water and reinforce that moving their arms is great, but how that arm moves or how that leg moves is specific to that child.”

Just like riding a bike, consistency and repetition with these skills promote muscle memory and competence. If the unthinkable happens, those trained responses kick in, giving little ones a chance to survive.

“We want their survival response in water to become second nature,” Mitchell said.

Children with special health, developmental and learning needs benefit from this approach, too, especially if traditional swim lessons are not a good fit for them or learning specific swim strokes is outside of their developmental abilities. Every one of Strieby’s students undergoes a health assessment that is reviewed by a nursing team before beginning lessons, so she can tailor her teaching to their particular needs. 

Choose Wisely

When it comes to finding the right water competency program for your child, Strieby encourages parents to do their research. A quick social media search of infant swim lessons will return all kinds of videos of very young children, even babies, seemingly learning to swim, but Strieby cautions that not all of these approaches are practical or safe. 

“We don't throw babies into the water and let them sink or swim,” she said. “Programs that claim they teach survival and show videos of them chunking children into the water—that should never ever happen in an ISR self-rescue lesson. It should be a guided, safe and gentle approach. I always tell people, if you are going to commit to doing a survival swim program, please do your homework and make sure it's a program with a certified instructor who has had quality training and that the program has safety protocols in place.”

Strieby’s lessons do include simulations of situations in which a child may fall into the water. They even practice survival skills in diapers as well as summer, fall and winter clothing because many drownings occur when kids are fully clothed and not expected to be near water. In 2021, over 60% of patients brought to Cook Children’s following a drowning incident were from accidents that occurred during an unplanned swim time.

Respect the Danger

Water competency and rescue skills also teach kids to have a healthy fear of water as they are introduced to the natural consequences of going into the water alone, like not being able to breathe and the hard work it takes to stay afloat. 

“Kids who learn to self-rescue learn that if they fall into that water and mom is not right there, they are going to be responsible for their own lives and getting their own air,” Strieby said. “As silly as it sounds, this creates a healthy boundary for many kids, because they don't want to have to do that hard work. They don’t want to have to use their skills unnecessarily.”

The majority of Strieby’s students are under the age of 4, but she does teach self-rescue to children up to six years of age. Once they master survival and self-rescue skills, some kids go on to traditional lessons with other programs to learn specific swim strokes. Either way, children who learn water competency and rescue skills from an early age are better equipped to survive a water-related accident. 

Even so, Mitchell cautions that swim and self-rescue lessons are not a replacement for the layers of protection needed to prevent children from drowning. Maintaining barriers to and around the pool, keeping pools clear of toys attractive to little ones when not in use, having a designated water watcher and wearing a life jacket are all important components of water safety, whether a child does or does not know how to swim. 

Violet Gomez admits she didn’t know much about water safety and drowning prevention when she had her first child nine years ago. It wasn’t until after the birth of her second child that she began to take the dangers of water seriously, thanks to a Cook Children’s Health Care System program she joined called the Water Safety Club.

“I never knew safety precautions and the steps to introduce my first son to water,” Gomez said. “I would just say, ‘Oh, he'll be fine.’ I would never really take him to a pool. So I really didn’t know what kind of safety steps I would have to take.”

The Water Safety Club is a drowning prevention program of Safe Kids North Texas - Fort Worth, led by Cook Children’s. It’s open to all and free to join. 

Now a mother of four, Gomez was introduced to the Water Safety Club through her kids’ Head Start program with Child Care Associates, a community partner of Safe Kids North Texas - Fort Worth. During a Head Start meeting that Gomez attended, a Safe Kids North Texas - Fort Worth representative talked about the club, the importance of water safety and how to prevent drowning.

After the presentation, Gomez signed up to learn more about how to keep her kids safe in and around water. She shared what she learned with her children and says they are now as aware of water dangers as their mother.

“For me, it's helped so much, and it's helped my son because he didn’t know at a younger age,” Gomez said. “I learned myself to be able to teach them what safety steps they have to do before even going in the water. I have learned how to introduce them to the pool.”

The club exists to generate awareness and ongoing conversations about water safety and how to prevent drowning.

“We want to make sure children are educated, and that parents are talking to their kids about having a healthy fear and an awareness of the water,” said Jillian Mitchell, a community health specialist at Cook Children’s. “Because if we're not talking about it, then kids don't understand what's OK and what's not OK”

Drownings are the No. 1 cause of death in children ages 1 to 4. Already this year, more than 50 children have been treated at Cook Children’s for drowning injuries. This is a significantly higher number than in recent past years during the same time period.

“Not all drowning incidents are fatal, but non-fatal incidents can also be devastating,” Mitchell said. “That's why we want to have these conversations over and over to help build awareness.”

Community partnerships, like the one with Child Care Associates, help spread the message of the Water Safety Club and provide membership access. Currently, there are about 2,000 members and some from as far away as Alabama.

In addition to education and information, Water Safety Club members also gain access to free or reduced-cost safety resources such as life jackets, bathtub kneelers, swim goggles, water safety lessons and CPR instruction. For her membership, Gomez received free life jackets for her children.

“Whenever we have gone to any pool I tell them to make sure you put your life jacket on first,” Gomez said. “They're like, ‘Can I go in the water? I'm just gonna put my legs in there.’ I'm like, ‘Nope. If your legs are in, you have to put on your life jacket because you don't know what can happen.’”

Gomez says she’ll continue to teach her children what she learns as a club member. She also encourages her family members and friends to join.

“I find it amazing because they've learned so much, and I want them to continue to learn so much,” she said. ‘I have invited other moms, friends of my daughter and my sons. I'm like, ‘Hey, you should learn more about this program. It helps you know what to do in case something happens or how to prepare before even taking your children to the pool.’”

Joining the Water Safety Club is easy. Click here to become a member, to view current membership incentives, to identify community partners, and to learn more about how to lifeguard your child. 

The Fourth of July is a time for celebration and getting together with family and friends. Cook Children’s experts are sharing safety tips and information to remember as people gather this weekend. Keep in mind that drowning is the leading threat for children, especially during the Fourth of July holiday.

In the emergency room, drowning patients are seen the most frequently and drownings most often lead to fatal outcomes, said Corwin Warmink, M.D., medical director of Cook Children’s Emergency Department.

“Keep a close eye on your child any time there is water nearby,” Dr. Warmink said. “People are often in large groups and let down their guard thinking that someone else is watching the kids in or around the water. They should identify an official Water Watcher who is responsible for keeping track of everyone.”

DROWNINGS

In June 2022, there were 19 drownings treated at Cook Children’s, none were fatal. Seventeen of those children were 5 years old and under.

• In June 2021, there were 22 drownings, one was fatal.
• In June 2020, there were 8 drownings.
• In June 2019, there were 13 drownings.
• In June 2018, there were 16 drownings. Three were fatal.

While most patients survived these incidents, drowning injuries can result in severe effects, especially on a child’s brain development.

Many of the drownings so far in 2022 have occurred during unplanned swim time. This is when parents didn’t expect their child to be in or around the water.

Drownings can happen silently and quickly. A submerged person might not attract attention or appear to be in danger.

Drownings can occur even with many adults present. When there are children around water, always designate a Water Watcher, an adult who is in charge of watching all children without any distractions.

Drownings on July 3 and 4:

• 2018: one drowning on July 3 and two on July 4
• 2019: four drownings on July 3
• 2020: one drowning on July 4
• 2021: one drowning on July 3 and one drowning on July 4

None of these drownings listed above were fatal, but parents and caregivers must remain vigilant.

Parents can also put barriers in place to help prevent a child from accessing the water or make it more difficult to access when an adult is not present. Barriers – such as locks, alarms and fencing – can help keep unsupervised young children from getting into swimming pools.

For more information and resource, including Water Watcher tags, visit: LifeguardYourChild.org

HEAT SAFETY

There are other threats during the Fourth of July holiday that can lead to severe injuries.

“Boating, jet ski and watercraft accidents are very frequent and often very tragic injuries. Burns from fireworks and cookouts are also very common,” Dr. Warmink said. “Snake bites and other bites are also common because a lot of people are outdoors along with very severe sunburns and heat exhaustion.” 

With the highs in the upper 90s and triple-digits, be sure to keep these heat safety tips in mind.

“Sunscreen is important and it should be reapplied every few hours. Drinking plenty of water and hydrating drinks throughout the day,” Dr. Warmink said.

Wear appropriate clothing: Choose lightweight, light-colored, loose-fitting clothes. Wear a hat to shield yourself from the sun, until you feel yourself getting warm. Then remove any items covering your head that can trap heat close to the body.

Schedule outdoor activities carefully: Heatstroke can occur in less than an hour when you are participating in a strenuous activity on a hot day. Try to limit outdoor activity to when it’s coolest, like morning and evening hours. Rest often in shady areas so your child’s body has a chance to recover.

Hydrate: Drink plenty of water during the day, especially if you are engaged in any strenuous activity. Be sure to drink water or a sports drink before, during and after any strenuous activity.

Wear sunscreen: If you got outside, use sunscreen, wear a wide-brimmed hat, and sunglasses, and put on sunscreen of SPF 15 or higher 30 minutes before going outside. Continue to reapply according to the package directions.

FIREWORKS

Severe injuries from fireworks can be harmful and painful to a child. Even sparklers can heat up to more than 1,200 degrees and are dangerous for young children.

“Kids should not shoot off fireworks and they should be shot off in a ‘kid-free’ zone," Dr. Warmink said. "Keep kids away from grills and bonfires also.”

ATV SAFETY

Though often thrilling for children, off-road motorized vehicles — including all-terrain vehicles (ATVs), ATV mules, go-karts, and even golf carts — can be extremely dangerous for them to ride, especially if they don’t use safety measures once they get on board.

To prevent such injuries among children, the American Academy of Pediatrics (AAP) recommends children under 16 do not drive or ride as passengers in two- and four-wheeled off-road vehicles.

ATV Safety:

• Always wear protective gear such as:
• o Helmet
• o Eye Protection
• o Boots, gloves, long pants, jacket
• Do not ride an ATV at night
• Take an ATV safety course
• Never ride on public roads
• Perform ATV safety checks

The display is located in front of Cook Children’s Medical Center, located at 801 7^th Ave. It is on the north lawn, directly across from the N.E.S.T. Clinic on Cooper Street.

This is a record number of drownings for this time period at Cook Children’s. We installed the display ahead of Memorial Day Weekend in hopes of preventing future drownings as this is typically one of the worst weekends for drowning patients at Cook Children’s.  

Drowning is the leading cause of accidental death in children ages 1 to 4 and the second leading cause of accidental death in kids ages 1 to 14. It’s also 100% preventable.

Keeping kids safe in and around water is all about layers of protection — locking and alarming doors and gates leading to bodies of water, having a physical barrier over or around a pool, adult supervision near water, wearing a life jacket and learning to swim. Together, these layers save lives.

A child that knows how to swim or what to do should they fall into the water can potentially rescue themselves or keep their head above water until help arrives. It’s important to know that even strong swimmers can drown, so adult supervision during planned swim time is key.

Kathryn Lammers has been a professional swim instructor for 20 years. She is the owner of The Swim Lesson People and the chair of Safe Kids North Texas - Fort Worth, a childhood injury prevention coalition of the Center for Children’s Health, led by Cook Children’s. We asked Lammers to break down the importance of swim lessons and what parents need to know to find the best fit for their child.

Why are formal swim lessons with a certified instructor important?

There's a lot that goes into swim lessons. It’s more than just learning a swim stroke. We teach rescue and safety skills like back floats, turning around and swimming back to the wall, safe entry and exit of the pool, and waiting for permission to go into the water. One of the things that we really work on is kids coming out to us in the pool. So they have to sit, stop, wait, and then turn around and ask the parents, “May I get in the water?“ Asking for permission is our step one. Then we go into how to safely get in and out of the pool. Or, if they fall in, how to climb back up and exit to safety. We also teach them how to float until mom or dad sees them. Formal swim lessons cover a big grouping of water safety and competency skills.

What age should kids start swim lessons?

We really encourage water acclimation and safety as early as possible. Kids are able to learn safety skills like rolling over and floating on their back as soon as they're crawling and walking. But, every child is different. The American Academy of Pediatrics recommends that parents keep their child’s emotional and physical maturity, comfort level in the water, and developmental abilities and limitations in mind when considering when to start them in lessons. When in doubt, talk to a certified swim instructor for guidance.

Do kids age out or get too old for swim lessons?

It’s never too late to learn to swim, even for adults. In fact, parents who do not know how to swim are more likely to have children that grow up with a fear of the water. Taking lessons together would be a healthy bonding experience for the whole family. You’re never too old to learn and practice water safety.

What should parents look for in a program or swim instructor?

You want to make sure that your instructor is insured. You also want to see what kind of certifications and training they have. There are quite a few certifications out there, including the Red Cross, Starfish Aquatics Institute, Swim Lessons University, Infant Survival Rescue, YMCA and Infant Aquatics. Make sure they have at least one certification, if not multiple. Make sure they are CPR and first aid certified so that, in the event of an emergency, they have some sort of training to respond. Also, talk with your friends and people in your community for feedback and reviews on programs and instructors they have used.

How often should kids take lessons?

Year-round is always a better option versus a few weeks of intensive lessons. If you think about it, a runner training for a marathon does not train for just two weeks before their race. They train all year. It’s the same concept with swim lessons. Having those year-round touches, even if it's just a once-a-week refresher or a once-a-week building course, are better for retaining skills. As kids grow and develop, we can change and alter our skills with them. Whereas, when we throw a one-week or two-week intensive training at them, it gets them a lot of information really quickly, but they tend to lose those skills if they aren’t practicing them regularly. If you have a pool in your backyard and your kids are swimming every day, a two-week intensive program might work well, but that’s not going to work if kids don’t swim for a month or more after that two-week session. It really depends on the kids, the family and the schedule. My personal preference has always been classes once a week all year round.

What’s better — group or private lessons?

In a private lesson, you can get more tailored to what your child needs, and they get more instructional time. As for group classes, some kids learn by playing with friends and having that peer support. Again, it really becomes a personal decision based on the needs of your child. Sometimes we start with private lessons and move to groups. That way we learn our basic skills and get to a point where mom and dad feel comfortable with our swim ability, and then we go into a group class to further our skills.

What are some misconceptions about swim lessons?

Parents often believe if they put their child in swim lessons, they become a competent swimmer in just a few lessons, and that they don't have to watch them when they are in the water. We can’t emphasize enough that even strong swimmers can drown, so adults should stay within reach of swimmers without distraction.

Everybody talks about the statistic that kids in swim lessons are less likely to drown. It’s not that they're less likely to drown, it's that they're less likely to have a fatal drowning incident. Your child learning to swim is just one of the layers to protect them around water. It needs to be coupled with a gate or barrier to the pool, watching the water when your child is swimming and the proper use of life jackets.

Another misconception is that kids who take swim lessons are capable of swimming in any pool, be it indoors or outdoors. Outdoor pools are much colder than indoor pools where many learn to swim. Our indoor pool is 92 degrees. It's like a giant bathtub, but then you go outside on a 100-degree day and jump into a pool that's 75 or 80 degrees and it instantly takes your breath away. As an adult, we can cope with that and adjust quickly, but kids don't understand or know how to regulate that. It’s a shock to their system. So they jump in a cold pool and that initial shock sets them back a little. They’re more concerned at that point with self-preservation than calmly doing what they’ve been taught to do to stay above water.

Open bodies of water are a whole new kind of challenge. Backyard pool drownings happen most with younger kids. As kids get older, they start to become victims to open-water drownings, like in a lake or ocean. They're used to playing in pools where they can touch, or they can swim but don't have to swim long distances. Then they go to a lake, pond or the ocean and have new obstacles to deal with like murky water, currents, changing water depths, rip tides, and debris that may entrap a swimmer. You might have a 12-year-old who's comfortable in a swimming pool and 4 to 5 feet of water, but then you take them to the lake and, all of a sudden, they come off the bank and it's 10-feet-deep, or they jump into the water and hit their head on something.

What options are available to those who can’t afford to pay for formal swim lessons?

Fort Worth Drowning Prevention Coalition does a great job with water safety and swim lessons for a nominal fee. The YMCA typically has scholarship programs, as do many privately-owned swim lesson companies, so that we can make lessons affordable to those who need financial assistance. Hope Floats Foundation raises money and awards scholarships, either partial or full, for swim lessons for children living in poverty. Safe Kids North Texas - Fort Worth has the Water Safety Club. As a member of this club you get free water safety lessons at multiple locations throughout North Texas.

If your child or teen recently hit a growth spurt, last summer’s life jacket might not fit now.

So before your family heads to the lake, make sure everyone has a life jacket that fits properly, based on the weight of the person wearing it. Check the weight limits on the label – and try it on before getting in the water.  One of the keys to drowning prevention depends on the appropriate size life jacket.

A small model designed for a 50-pound swimmer isn’t guaranteed to hold up someone who weighs more. A too-big life jacket, meanwhile, won’t keep a child’s head above water.  

“Proper fit can’t be emphasized enough,” said Kyle Lewis, project manager and program coordinator for the Brazos River Authority at Lake Granbury, southwest of Fort Worth. “A jacket should fit the child snug. In my opinion, you should not get more than two or three fingers under the shoulder straps.”

Lewis travels to area schools to talk about water and boating safety. In his demonstrations, he puts an oversized life jacket on a student and holds onto the shoulder portion while the student steps off a chair. The life jacket pops up when the student goes down.

“If the life jacket fits, the child’s chin and ears will not slip through,” according to the U.S. Coast Guard (USCG). “A device that ‘rides up’ around your face, or worse, falls off in rough water is dangerous. The floatation needs to stay snug around your body and lift you out of the water with your airway clear.”  

Safe Kids North Texas, a community coalition based in Fort Worth and led by Cook Children’s, aims to raise awareness about water safety in lakes, swimming pools, bathtubs and any other place where children have access to water. Safe Kids partners with regional cities and agencies such as the Brazos River Authority to provide education and resources through the nationally recognized Lifeguard Your Child campaign. 

It's an urgent message: Drownings are the leading cause of accidental death in children ages 1-4, and the second top cause of accidental death for children under age 14. The U.S. Centers for Disease Control reports that for every child who dies by drowning, another eight receive emergency care for non-fatal drowning injuries, which can include brain damage. 

“We have seen several boating accidents where the child was severely injured, but thankfully they had a life vest on so they stayed afloat until help could get to them,” said Sharon Evans, who collects data in her role as trauma injury prevention coordinator at Cook Children’s.

Three of the 82 non-fatal drownings treated at Cook Children’s Medical Center in 2021 occurred in open water. Eight drownings seen at Cook Children’s were fatal last year. Evans said most of the 2021 drownings happened in swimming pools in backyards, apartments, hotels or community locations.  As of early May, there have been 20 total drownings in 2022, three of them fatal.

Lewis and his crew plan to distribute about 250 free life jackets at giveaway events at Lake Granbury during the month of May. Safe Kids and the Brazos River Authority are providing life jackets, which come in four sizes: infant, 35-50 pounds, 50-90 pounds and adult small. Lake rangers will be on hand to help ensure the right fit.

If you’re purchasing a new life jacket, check to verify the label says “USCG approved.” Through testing, the Coast Guard designates what qualifies as a life-saving device. Not all styles on the market meet the USCG regulations.

Dana Walraven, manager for Community Health Outreach at Cook Children’s, recommends first, finding “USGC approved" on the label, and then letting your child or teen pick a color and style they’ll be excited to wear.

Previously used life jackets should be carefully inspected for wear and tear. Look for broken buckles and zippers, frayed straps, or rips in the flotation casing. Don’t use a damaged life jacket. The Coast Guard also advises:

• Life jackets are especially important where currents or murky conditions create hazards.  They provide buoyancy for non-swimmers who wind up in the water unexpectedly, or for swimmers who become fatigued or hurt. Life jackets save lives.
• If a toe is in the lake, a life jacket goes on. That goes for confident swimmers and teens too. Statistics show an elevated drowning risk for teenagers due to peer pressure, alcohol use and other factors.
• Life jackets are not babysitters. An adult must always be present and watch when a child is in or near the water.
• Think of arm floaties, rafts and inflatable items as toys. “Arm floaties are not considered a lifesaving device, and the label will state that,” Walraven said. “They can easily become deflated and offer no head or trunk support to keep a child afloat.”

Children should continue to wear life jackets until they are away from the water’s edge or the dock. Walraven said children can easily get out of sight during distracted transition time, and adults might not hear a child falling off a dock or getting back into the water.

In 19 years of working in water safety, Lewis has unfortunately investigated several drownings, but none in the past two years at Lake Granbury. He credits improved public awareness by safety advocates, including the Lifeguard Your Child campaign.

Lewis points out that children under age 13 are required by law to wear USCG-approved life jackets while on a boat. One life jacket must be accessible for every boat passenger older than 12. He urges teenagers and adults to wear them because life jackets provide a layer of protection much like a seatbelt in a car.   

Lewis said parents should remain vigilant even when their child is wearing a life jacket. The child might remove the life jacket, drift too far from shore, or be injured by an underwater object.  A family gathering at the lake can turn into a tragedy in an instant, he said.  

“Parents cannot take their eyes off their kids in the water. Drowning is sudden and it’s silent. It’s not like you see on TV where they’re splashing and yelling for help.”

Life Jacket Loaner Stations

Cook Children’s has worked collaboratively with partners, and currently stocks 31 loaner life jacket stations in North Texas, allowing lake visitors to borrow life jackets for the day. Five more loaner stations are planned to open at Lavon Lake in June. Each loaner station supplies five sizes of USCG-approved life jackets -- two in each size -- for use by children and adults.

Jillian Mitchell, drowning prevention specialist at Cook Children’s, said the program continues to grow thanks to partners like Linbeck Construction, which teamed up with Cook Children’s to build 17 of the loaner stations. Partnerships are essential to the success of the program, Mitchell said.

“Without their dedication and passion for water safety, we would not be able to grow as we have,” she said. “Cook Children’s loaner jackets are restocked every year. By making life jackets accessible and paired with education on the station, we believe it makes an impactful difference that saves lives in area lakes, ponds and rivers.”

Lifeguard Your Child shares these videos from the Texas Parks and Wildlife Department to illustrate the proper fit for life jackets:   

• English: https://youtu.be/h55hX8Jimcs
• Spanish: https://youtu.be/bpyoiBEp9jI

This is an alarming increase compared to January through May 1 in 2021, 2020, 2019, 2018 and 2017, according to Cook Children's data.

This year, 11 drownings have occurred in swimming pools, one occurred in a hot tub, and five drownings were in bathtubs. Children ranged in age from 11 months old to 9 years old.

While most patients survived these incidents, drowning injuries can result in severe effects.

Many of the drownings in 2022 happened during unplanned swim time. This is when parents didn’t expect their child to be in or around the water. 

Parents can put barriers in place to help prevent a child from accessing the water or make it more difficult to access when an adult is not present. Barriers – such as locks, alarms and fencing – can help keep unsupervised young children from getting into swimming pools.

In 2021, more than 60% of drownings treated at Cook Children's were during unplanned swimming time.

Lifeguard Your Child

Cook Children’s initiated a drowning prevention campaign called Lifeguard Your Child in 2015 in response to a high number of drowning injuries treated in the Emergency Department and medical center that year. The Lifeguard Your Child campaign is spread through the Safe Kids North Texas Coalition, which is based in Fort Worth and led by Cook Children’s.

The campaign’s strategies include Cook Children’s Loaner Life Jacket Stations at many lake entry points across the region. Families can go to the stations to find U.S. Coast Guard-approved life jackets in a variety of sizes with easy tips for a proper fit.

Safety tips for home swimming pools: 
• Restrict access by installing door locks high out of children’s reach. Door and window alarms can signal if someone leaves the house. 
• Install four-sided fencing around pools with a self-latching gate that only opens out. The fence should be at least 4 feet (preferably 5 feet) high. 
• Remove all toys and floats from the pool area so children are not tempted to get close to the water. 
• For above-ground pools, make sure the ladder is removed and not accessible when it’s not swimming time. 
• Consider a pool surface alarm to alert if anyone/anything falls into the water. 

Safety tips for the bathtub: 
• An adult must stay at the side of the tub in reach of the child. 
• Pay attention. This is not the time for multitasking. 
• Ignore distractions like the doorbell or phone calls. 
• Drain the tub after each use. 
For more information about drowning prevention, go to www.lifeguardyourchild.org. 

he drownings were unrelated and all took place at home pools after the children escaped adult supervision, with two of the toddlers getting outside through doggie doors. 

“This recent burst of drownings is incredibly worrisome,” said Sharon Evans, trauma injury prevention coordinator at Cook Children’s. “Now is the time for parents, grandparents and caregivers to reassess the ‘layers of protection’ they have at home. Make sure that pool gates still close and self-latch correctly, locks on outside doors are up high and out of reach of children and certainly don’t let your guard down!”

Sadly, 2021 surpassed recent years for the number of drowning injuries seen at Cook Children’s, with 82 children admitted to our hospital. Seven were fatal and four resulted in life-altering diagnoses. The data includes drowning in bathtubs and open water, such as lakes; the majority, however, occurred in swimming pools.

While the fall season is here and temperatures in Texas begin to cool down, this is a reminder that a child can drown at any time of the year and in any place where there is water. 

"Home safety checks are helpful for families with busy households and small children," said Dana Walraven, manager of community health outreach for the Center for Children’s Health. "Go through each room of your home to identify all points that would allow access to potential danger zones both indoors and outdoors."

Pool season in Texas tends to run through November, and even into the winter months with heated pools and hot tubs. Water safety advocates urge pool owners to put multiple safety measures in place to help prevent pediatric drownings. 

Safety tips include:

• Prevent access when adults are not watching:
  • Doors with locks out of reaching of children, safety alarms for both pools and children, doorknob covers on doors accessing water, etc.
• Install four-sided fencing around home pools with a self-closing/self-latching gate that only opens out.
• Reroute any doggie doors that have direct access to the pool area.
• Install pool and spa covers that are sturdy enough to support the weight of a child or multiple children.
• Schedule water safety and swim lessons.
• Take family CPR lessons.
• Create and follow pool rules.

For more information about steps to prevent drowning, go to www.lifeguardyourchild.org.

Last year’s Memorial Day weekend was a tragic one at Cook Children’s.

Over the four-day holiday weekend in 2018, nine children were admitted to the medical center for drowning. Two of those children died. Last year marked the first time drowning fatalities were recorded at Cook Children’s in May since at least 2012 (when the Trauma department began gathering statistics). All the drownings occurred at a pool, but the locations happened at apartments, hotels and at family homes.

“Last year was a brutal one for all of us,” said Corwin Warmink, M.D., medical director of Emergency Services. “Every year, we are asking parents to ‘Lifeguard Your Child’ and every year, we see the same drowning tragedies with multiple families torn apart.”

Dr. Warmink calls drowning a “preventable tragedy.” In nearly nine out of 10 child drowning–related deaths, the parent or caregiver said the child had been with them in the house or pool within five minutes of the accident.

He says drowning happens in a matter of seconds, can be subtle and silent, and generally occur when adults and family members are nearby.

“People need to actively supervise their children when they are in or even near water. This means designating a specific person whose responsibility it is to watch the water without distraction,” Dr. Warmink said. “We strongly encourage parents to be in arm's length of their child while in water. And that’s not just in pools or at the lake. That includes bathtubs or any other container with water. A child can drown in even a few inches of water.”

Teaching your children the dangers of water, having them learn to swim and parents learning CPR are also worthwhile ways to prevent drowning, Dr. Warmink said.

Sharon Evans, Trauma/Injury Prevention Outreach Coordinator at Cook Children’s, warns parents against letting their guard down once the child leaves the pool or lake. That moment when a parent relaxes can place the child at risk.

“It’s important for kids to wear a Coast Guard approved life vest and for parents to be in arm’s reach of their child,” Evans said. “The mistake that people make is taking the life vest off once they are out of the water. I tell parents to keep the life vest on until they are actually putting their child in the car or they are in their home with the door shut and locked.”

Evans said if children go to the bathroom, a parent should go with them and hold the life vest. Once they have washed their hands, place the life vest back on before they leave the bathroom and head back to the water.

The safety experts at Cook Children’s say kids can’t afford anything less than 100 percent adult supervision at the pool at all times. That means not taking your eyes off of a child while he or she is in the water.

For many of us, that starts with putting away perhaps the greatest competition for a grownup's attention - their phone.

“We understand the need for a phone at the pool, in case of emergencies, but those phones need to be put away until you leave the swimming area,” said Dana Walraven, Community Health Outreach manager at Cook Children’s and Safe Kids Tarrant County Coordinator. “Parents should only be spending time watching their kids and not on the phone.”

For more information visit the following:

• Pool Safety
• Open Water
• Bath Time
• Prevention Resources

Last week, Cook Children’s medical staff treated four children for drowning-related accidents with ages ranging from 18 months to 6 years old. The near drownings took place at a variety of locations, including a recreation center, a community center, a home pool and a bathtub.

For the month, seven kids, ranging from 6 weeks to 6 years, were seen for drowning at the medical center. Two children died after drowning in bathtubs.

“The events of this month is a tragic reminder that we don’t have a drowning season in Texas,” said Ben Olsson, M.D., a Pediatric Intensive Care Unit physician at Cook Children’s. “Drownings don’t just take place in the summer at a pool or a lake. The most important thing for parents to remember is that when you are somewhere near water, you can’t take your eyes off your child. That’s the common theme, regardless if it’s a pool, lake or bathtub. Children need adult supervision. We say it all the time at Cook Children’s, lifeguard your child. Don’t take your eyes off of your child when they are around or in the water.”

Drowning is the leading cause of accidental death for children ages 1 to 4, and the second leading cause of death for kids 1-14 in Texas.

Cook Children’s experts recommend the following tips to protect kids from drowning:

1. Wear life vests with U.S. Coast Guard-approved labels. If your child’s lifejacket doesn’t say “US Coast Guard Approved” or “USCG Approved,” you can assume it’s not safe. Always check the label. Any items filled with air (arm floaties, rafts, etc.) are considered toys and not a life-saving device. And as your child grows, the lifejacket needs to meet their new weight. Get a new lifejacket if there are rips and tears or fraying of the straps.

2. Take family CPR lessons. Learning CPR can be the difference between life and death while waiting for emergency personnel to arrive. Check your local Red Cross and YMCA for classes.

3. Insist on adult, non-distracted Water Watchers. Children drown silently, so designate a Water Watcher to watch children in and around all water. A Water Watcher Tag is used to designate responsible adults to watch the water when you have a party at the pool, lake or beach. At social gatherings, 10-15 minute shifts are recommended for Water Watchers. During that time, Water Watchers should not be distracted by conversations, cell phones, reading, etc. Always check the pool first for missing kids. Send an email to safe.kids@cookchildrens.org to request your Water Watcher tags.

4. Invest in swim lessons. Drownings and near drownings are eight times more likely to happen to children who don’t know how to swim or are being supervised by adults who don’t know how to swim. Check out this list of swim lesson providers in the Tarrant County area. If you are not in Tarrant County, contact your local YMCA, Red Cross or parks and recreation center for information in your area.

5. Update pool drains and cleaning systems. Children should stay away from pool drains and other cleaning equipment as they have powerful suction that can pull them down to the bottom of the pool. Swimsuit straps, hair and other items can easily get caught. There are certain safety drain covers that can prevent this from happening.

Click here to learn more ways to lifeguard your child.

As one of the worst drowning seasons in Cook Children's history continues, Dr. Olsson is trying again. 

Dr. Olsson said it has been a "rough season" on his staff and it can be frustrating because so much effort has been placed on awareness, they will continue to do all they can to educate families in hope of preventing another drowning.

"There are tragedies we see that can be life changing for families and a drowning is one of those," Dr. Olsson said. "What’s difficult for us as staff is that these are usually healthy kids leading up to this. It’s a very quick change in a family’s life from that point on."

Twelve children have died from swimming-related drowning causes this year at Cook Children's, the most in at least six years.  

After going through the Emergency Department, many of the children who are treated at Cook Children's spend time in the Pediatric Intensive Care Unit. The PICU team says the impact of a drowning lasts long after the child is no longer at the medical center.

"Drownings are tough for us because you have children who the day before or hours before were playing or they  had their pictures taken," said Rachel Hayes, a registered nurse in the PICU. "Their parents were celebrating, maybe going out for dinner or going out to barbecue in the backyard. So it’s knowing that those children had a beautifully healthy life and suddenly at the drop of a hat (she snaps her fingers) their lives are changed forever. The family’s life is changed forever. The neighbors’ lives are changed forever. So I think that’s part of what it makes it so challenging is just that we can relate to these kids as our children."

Dr. Olsson said the staff is specially trained to give the children who enter the PICU the best possible care, but it never stops being difficult for the caregiver.

"Dealing with the families and their emotions and walking with them is a struggle for us sometimes," Dr. Olsson said. "And there’s always the battle of us transposing that on ourselves and our own family and our own children,  thinking of those situations and what it would be like to be in those situations. And often times we do. Often times  as much as we approach it in a professional way, we are human and we have emotions and feelings. Sometimes we have to cry with the families and sometimes we have to cry with each other and support each other in that. Our Pastoral Care department helps us in those situations."

"Even if you do come to terms with, 'OK we dealt with that one. I’m at peace with that one.' Then the next week another kid comes in with same story," Hayes said. "The same thing happens. So you don’t get to let go of it in that aspect. Yeah, definitely, it’s very emotional and it sticks with you."

And while much is made of the drowning deaths, the staff in the PICU stress that just because a child makes it out alive, it doesn't guarantee the best of results.

"There’s a heartbreak to it that nothing else can come close to and it's heart-wrenching because it's 100 percent preventable," said Cammie Bonahoon, a registered nurse in the PICU. "The child may have come back out of that pool alive, with a pulse and with blood pressure, but they aren’t going to be the same child that went into that pool."

The ages of the children ranged from 1 year to 9 years old. The drownings all occurred in pools.

“Unfortunately, we had a busy weekend with drownings and we aren’t even at Memorial Day,” said Sharon Evans, Trauma Injury Prevention Outreach coordinator at Cook Children’s.

Last year, eight kids were seen at Cook Children’s for drowning during the entire month of May and none were fatal.

As we head into the summer, Cook Children’s is once again asking parents to “Lifeguard Your Child.”

The focus is on parents never taking their eyes off their children while they are swimming, and that includes until they are safely in the house or car.

“We’ve seen many cases where children removed their life vests and jumped back in the water,” said Magdalena Santillan, Trauma Injury Prevention specialist at Cook Children’s. “Often, parents are getting ready to leave the pool and don’t realize their kids have jumped back in.”

Evans warns parents against letting their guard down once the child leaves the pool or lake. That moment when a parent relaxes can place the child at risk. 

“It’s important for kids to wear a Coast Guard approved life vest and for parents to be in arm’s reach of their child,” Evans said. “The mistakes that people make is taking the life vest off once they are out of the water. I tell parents to keep the life vest on until they are actually putting their child in the car or they are in their home with the door shut and locked.”

Evans said if children go to the bathroom, a parent should go with them and hold the life vest. Once they have washed their hands, place the life vest back on before they leave the bathroom and head back to the water.

Corwin Warmink, M.D., medical director of Emergency Services at Cook Children’s, calls drowning a “preventable tragedy.” In nearly nine out of 10 child drowning–related deaths, the parent or caregiver said the child had been with them in the house or pool within five minutes of the accident.

“Children should never be in water without adults watching them,” said Corwin Warmink, M.D., medical director of Emergency Services at Cook Children’s. “If you have a toddler, that child shouldn't be in water without what we call touch supervision. You need to be in arm's length and it's not just pools. That includes bathtubs or any other container with water. I've seen kids drown in buckets. A child can drown in any water, even a few inches deep. Supervision isn't, 'Hey there’s six of us cooking hamburgers and text messaging.' It means there’s someone who has the designated job to watch the children in the water.”

The safety experts at Cook Children’s say kids can’t afford anything less than 100 percent adult supervision at the pool at all times. That means not taking your eyes off of a child while he or she is in the water.

For many of us, that starts with putting away perhaps the greatest competition for a grownup's attention - their phone.

“We understand the need for a phone at the pool, in case of emergencies, but those phones need to be put away until you leave the swimming area,” said Dana Walraven, Community Health Outreach manager at Cook Children’s and Safe Kids Tarrant County Coordinator. “Parents should only be spending time watching their kids and not on the phone.”

Drowning prevention around the pool begins with adult supervision, but there are other steps parents can take at home to help protect their children from drowning.

Learn More About Water Safety and Drowning Prevention, by clicking here.

These stories can be scary for parents, but how much are your kids really at risk?

Few of the emergency and pediatric intensive care unit physicians at Cook Children’s have seen a case of dry downing. Cook Children’s Trauma registry shows only one case of dry drowning in the past decade.

Dry and secondary drownings typically happen to children who struggle while swimming and take in a large amount of water.

Dry drowning never reaches the lungs, but the child takes in enough water to cause the child’s vocal chords to spasm or close up after he or she has left the water. The airways shut off and it’s hard for the child to breathe.

In secondary drowning, the water goes past the child’s airways and into the lungs, where it builds up and causes the child to have difficulty breathing.

Normally, dry drowning happens immediately after the drowning incident. Secondary drowning can take up to 1-24 hours after the drowning incident.

“I think this goes along with what we have been saying about all drowning prevention,” said Linda Thompson, M.D., a PICU pediatrician at Cook Children's. “Parents should keep a watchful eye on their children. They should never allow their kids to swim alone and they should not take their eyes off of them playing around any size of water from pools to plastic tubs or bathtubs.”

Symptoms range from trouble breathing, chest pain, lethargy and irritability.

Parents shouldn’t wait if their child has any of these symptoms or they are concerned about the large amount of water their child has swallowed. See a physician immediately.

Tips to prevent dry drowning or similar to other tips while you “Lifeguard Your Child”:

• Watch to make sure your child has not inhaled a large amount of water.
• Pools or other swimming should be closely monitored. Only swim where there is an adult present, watching the kids.
• Children should learn to swim as early as possible.
• Never let children swim alone.
• Talk to your kids about not dunking another child’s head in the water.

The Centers for Disease Control and Prevention defines drowning as “the process of experiencing respiratory impairment from submersion/immersion in liquid” and the CDC does not distinguish between “wet” and “dry” drownings.

While dry drowning has gotten recent attention, “wet” drownings still remain the biggest threat to children. Through June 8, 2017, 20 children had been treated at Cook Children’s for drowning, including one death.

A little over a year since her death, one of Elise’s swim coaches, Tracey Anne Boyd, 49, has been indicted on a charge of abandonment and endangering of a child by criminal negligence, according to court records as reported on by the Star-Telegram.

The indictment says Boyd did not “watch or observe Elise Cerami while [Cerami] was swimming.”

“The charge against Tracey Boyd describes her conduct and we believe that the district attorney will devote the full resources of their office to the case against Boyd,” Lori Cerami, Elise’s mother, wrote in an email to Checkup Newsroom. “While the court system proceeds with the grand jury’s indictment, our efforts will continue in water safety and drowning prevention.”

Since Elise’s death, the Cerami family have become tireless advocates for drowning prevention. Both Lori and Bryce, Elise’s younger brother, participate in Cook Children’s Lifeguard Your Child campaign to stress the importance of adult supervision of children in the water at all times.

The family started the Swim4Elise Foundation as a way to educate young people on water safety through the Elise Cerami Memorial for camp and college swim scholarships. In collaborating with Swim4Elise volunteers, the foundation also developed to include Run4Elise, the 100 Lifeguard Challenge and Drowning Prevention Education for local daycare centers.

“Though the grief and loss are overwhelming, we are doing our best to make a positive change in water safety and our hearts go out to other families who have also lost a child to drowning,” Lori Cerami wrote.

Elise was a competitive swimmer for more than seven years and practiced as much as four hours on a given day. Although Elise’s death was ruled an accidental drowning by the Tarrant County medical examiner, Lori says one of the challenges her family has faced in heightening the message of water safety has been the rational by others that Elise must have been ill.

“Hence, parents and swimmers cannot relate to her story as their child is healthy, so this could never happen to them,” Lori wrote. “Unfortunately, this message creates a barrier, causing the community to disregard the important message of water safety and drowning prevention. Elise was a healthy kid, passing every annual physical with the same Cook Children’s physician over her lifetime. Though it is unimaginable, to believe this could happen to healthy kids, who can swim, we want the community to understand that drowning is completely silent. The best way to prevent drowning is to have active water watchers, regardless of the person’s swimming ability.”