“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.

February isn’t over and already four children have been treated for near-drowning accidents at Cook Children’s Emergency Department. All of these incidents occured in swimming pools.

“So often we think of the summer months as the time when we see drownings,” said Sharon Evans, Trauma Injury Prevention coordinator at Cook Children’s. “But as long as a child is around water, the threat is real for a child to drown. In Texas, we have 70 or 80 degree days during the winter and kids are outside playing around pools. If you have a pool, parents should be outside with their child. If not, the results can be tragic.”

The threat of drowning is a continuing concern well before summer begins. By the end of April 2016, 12 children were admitted for drowning injuries (9 in a pool) at Cook Children's, including two that were fatal (one pool death, one pond).

Even non-fatal, or near, drownings can be devastating for a child. Corwin Warmink, M.D., medical director of the Cook Children’s Emergency Department, says there’s a large amount of children who survive a drowning, but end up with catastrophic outcomes. The most effected parts of a near-drowning victim are the brain, lungs and kidneys. “The one that is most catastrophic and the one that will kill you is the brain,” Dr. Warmink said.

As a parent, Dr. Warmink stresses supervision of his own children in the pool. He calls it a hallmark of making sure children are safe. Half of all drownings occur within 25 feet of an adult.

“Children should never be in water without adults watching them,” he said. “If you have a toddler, that child shouldn't be in water without what we call touch supervision. You need to be in hand'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.”

The most important step a parent can make in making sure their child is safe around water is simply being present without distractions. Drowning is silent and quick, so a grownup should be watching children near water at all times and never leave, even for a brief moment.

“Active adult supervision and layers of protection such as door alarms and a fence can lower the risk for your child,” Dana Walraven, Community Outreach manager said. “The majority of these water-related incidents happen in the child’s own backyard pools and to children 4 years old and younger. Preventing pool drownings begins with adult supervision.”

Children are protected by layers of protection by using these safety techniques whenever children are around the pool:

• Always have adult supervision present when children are swimming or around pools.
• A fence with a locking gate should surround the pool.
• Install door alarms to alert adults when a child is entering the pool area.
• Require life jacket use for non-swimmers.
• Enroll children in swimming lessons.
• Parents and caregivers should undergo CPR training.

Other Resources:

• NRH Water Safety 365 Drowning Prevention Coalition
• Grownups be smart: Put down the phone at the pool
• 9 Ways to Protect Children From Drowning
• What Your Children Should Do If They See Someone Drowning
• Is Your Baby Ready For Swim Lessons?