“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 

“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.

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

Even as the summer was winding down, every member of the Emergency Department knew a fatal drowning could still happen at any moment. Tragically, that moment came over the weekend when two sisters were found unresponsive in a Haltom City apartment swimming pool. News agencies report the girls were taken to Cook Children’s where they both died.

“Drownings occur year-round and there is no ‘drowning season,’ especially in Texas,” said Corwin Warmink, M.D., medical director of Emergency Services at Cook Children’s. “You can’t get comfortable and complacent with children and water, no matter the time of year.”

Before this weekend’s pool drownings, three children had died from drowning at Cook Children’s in 2019 – two separate incidents in bathtubs in March and one child in open water in May.

Even in the month of September, the warm Texas weather means kids are getting in the pool. From 2014 to 2018, there have been a total of  16 drownings (13 in a pool and 3 in open water) during the month of September, with two being fatal.

“I worry that with the end of the summer and kids being back in school that people will relax a bit,” said Dana Walraven, community health outreach manager for Cook Children’s. “But we can’t let our guard down even for a little bit. The temperatures are still warm and there’s plenty of time left for kids to be in the water. All the same rules apply to keep our kids safe.”

Hot weather and summer vacation means Texas kids are headed to the water. Sadly, it also means more opportunity for tragedy.

Summer has barely begun and Cook Children's has already seen 24 children at the medical center this year for drowning, with 15 occurring at a swimming pool.

Dana Walraven, community health outreach manager for Cook Children’s, stresses adults supervision of children at all times. She calls the parents who are in charge of lifeguarding the kids a Water Watcher.

So what does it mean to be a “Water Watcher?”

An adult is within arms-reach, no distractions, while children are in and around all water. After 15 minutes, another responsible adult takes over. This allows everyone to enjoy the party while ensuring the kids are being properly watched. It is especially helpful at parties or around the pool or lake. 

Water Watcher tags are available to any person or group who will use them or would like to distribute them. To receive a Water Watcher Tag, email safe.kids@cookchildrens.org. 

Leslie Zvitt works at Cook Children’s as the Senior Epic Business Intelligence Developer and is the mother of two children, ages 12 and 8 years old.

Zvitt makes sure a Water Watcher is on hand for all of her pool parties and makes sure adults are supervising the pool with undistracted attention.

"Our kids love to invite friends over for swim parties, and often times it’s a relief to us, as parents, for the kids to occupy themselves with their friends, while the adults visit and have grown-up discussions," Zvitt said. "However, we still have a very real responsibility to keep them safe from harm; after all, a pool is no substitute for a babysitter. Since I found out about Water Watchers, I’ve been applying some simple guidelines for our pool parties that are really easy to follow, and make all of us safer as a result."

Morgan Miller shared the emotional moment on her Instagram Stories Monday and her post has now gone viral, capturing the nation’s attention.

Hopefully, the post also reminds all parents of young children to take their child to swim lessons.

Drowning is the leading cause of injury death in U.S. children 1 through 4 years of age. It is the third leading cause of unintentional injury death among U.S. children and adolescents 5 through 19 years of age.

At Cook Children’s, last year was the worst on record after 79 children were treated for drowning, with 12 being  fatal.

Nicole Wineriter, a Cook Children’s pediatrician in Keller, began swim lessons for her children when they were older infants, around age 1. Dr. Wineriter says, “I can’t say enough great praises about swim lessons.” At 5, one of her children could swim laps the length of the pool in three different strokes. Another child could swim under water for 10 seconds, traveling 10 feet and climb out of the pool by the age of 2.

“I’m a huge fan of swim lessons, if started at the appropriate time for each child,” Dr. Wineriter said.

The American Academy of Pediatrics (AAP) states that research has found swim lessons are beneficial for children starting at around 1 and may lower drowning rates. The AAP continues that swim lessons are “increasingly available for a wide range of children, including those with various health conditions and disabilities like (autism spectrum disorder) ASD.”

“Learning to swim is a great family activity,” said Linda Quan, M.D., FAAP, co-author of the AAP’s policy statement. “Families can talk with their pediatrician about whether their child is developmentally ready for swim lessons, and then look for a program that has experienced, well-trained instructors. Ideally, programs should teach ‘water competency’ too – the ability to get out of the water if your child ends up in the water unexpectedly.’”

A parent or caregiver’s decision about when to begin swim lessons should be based on a variety of factors, according to the AAP, including comfort being in water, health status, emotional maturity, and physical and cognitive limitations.

Participation in formal swimming lessons can reduce the risk of drowning by 88% among children ages 1 to 4 years old, according to Pediatrics and Adolescent Medicine.

The USA Swimming Foundation found that there’s been a 5-10% improvement among children in overall swimming abilities over the past decade. But there’s still much work that needs to be done.

Nearly 64% of African-American children, 45% of Hispanic children and 40% of Caucasian children have no or low swimming ability, putting them at risk for drowning. A frightening find in the study is that 87% of swimmers with no or low ability planned to go to a swimming facility during the summer and 34% plan to go swimming at least 10 times during the season.

While extremely important, swim lessons are no guarantee that a child will be safe in the water.

“It is important that parents not feel secure that their child is safe in water or safe from drowning after children have participated in swim lessons,” Dr. Wineriter said. “Adequate ‘touch supervision’ is still recommended, meaning an adult should be within an arm’s length at all times.”

Click here to learn more ways to lifeguard your child.

The campaign’s focus has been on parents never taking their eyes off of their children while they are swimming … and that includes all the way to the car or house.

“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.”

From June 1 to Aug. 21, 2017, 54 kids were seen for drowning at Cook Children’s. Three children died during the summer.

Often times the drowning occurred after everyone had gotten out of the pool and the life jacket was taken off him or her. Then the child wanders back into the pool without a life jacket or adult supervision.

Sharon Evans, Trauma Injury Prevention Coordinator at Cook Children’s, says it’s easy to let your guard down once you say the day is over and it’s time to leave the pool. But that’s when children are most at risk for going back into the water without anything to prevent them from drowning.

“It’s important for kids to wear a Coast Guard approved life vest and for parents to be in arms reach of their child,” Evans said. “The mistake that people make is taking that 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 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. 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.”

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.

“If you are somewhere where children are in the pool, insist that an adult be on watch,” said Dana Walraven, community health outreach manager for Cook Children’s, said. “It should be done by a sober adult and that should be his or her only focus during their time watching the kids.”

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.”