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.”

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.

This is my friend Van.

Van is at my pool. Since all of us parents are now COVID-vaccinated, we are feeling more comfortable with outdoor playdates. And our new pool has been a great escape from the heat!

We parents have loved to see each other. Hanging out and listening to music and eating meals together has been so much fun. We’ve missed it so much.

But our new pool poses a risk that wasn’t there before during backyard playdates.

Over the weekend, five children were victim to drownings in our area, and were rushed to the Cook Children’s ER. Some went home. Others did not.

Look at Van’s wrist. He’s wearing a WATER WATCHER band.

This band says that, no matter how many people are in or around the pool, the wearer is in charge of watching the water. The lifeguard, if you will.

The band is traded out every 15-20 minutes. The person who wears it stands guard by the pool with no distractions.

You don’t have to have this fancy band – though it will be available at my office in Forest Park very soon to pick up, and other Cook Children’s PCP offices as well. You can use anything really – a lanyard, a fancy scrunchie, a jangly bracelet.

As long as the responsibility is assigned, and someone is always watching.

Let’s ENJOY these much-missed moments together! We have earned our time together again after last summer’s solitude.

But let’s be SAFE in and around the water – the statistics are sobering in our area lately and now is the time to lifeguard your child!

Water safety advocates urge parents to stay vigilant to protect their children over Memorial Day Weekend and throughout the summer as backyard pool parties start happening again.

People are excited to socialize in person as coronavirus restrictions ease up -- but they must still keep close watch on the kids in the swimming pool. Drownings can occur even with many adults present.

“Everyone is so eager to get back into a normal routine and have those gatherings as COVID-19 decreases,” said Dana Walraven, manager of community health outreach for the Center for Children’s Health, led by Cook Children’s. “We’re just hoping for a heightened sense of awareness. When people are so happy to get back together, there may be distractions.”

In 2019, prior to the pandemic, the number of drowning admissions at Cook Children’s hit 71. Seven of those patients died. By comparison in 2020, there were 48 drownings seen at the medical center, three fatal. Those statics include drownings in bathtubs and open water, such as lakes; the majority, however, occurred in swimming pools.

2020’s decline in drownings came as a happy surprise to those who work to prevent injuries and deaths due to accidents in the water. One possible explanation? Last summer’s social distancing kept many families and friends from meeting up in big groups. Those big gatherings tend to be occasions when everyone assumes someone else is supervising the swimmers.

Sharon Evans, trauma injury prevention coordinator at Cook Children’s, encourages adults to take turns as designated watchers, fully attentive and within arm’s reach of kids in the pool. Designated watchers can spot trouble before it turns into tragedy.

“They don’t talk, they don’t drink, they don’t look at their phones,” Evans said. “You have to have that person in charge of watching. That is your job for 10-15 minutes, then you pass it off.”

Evans said drowning cases typically ramp up starting on Memorial Day. The age group most susceptible to drowning in pools is 1- to 4-year-olds. Precautions should be taken as well for older kids, even if they’re strong swimmers.

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

“It’s not like it is in the movies where they’re thrashing around and yelling for help,” Evans said. “In real life it almost looks like they’re climbing a ladder underwater, and if they can get their head above water, they just get a breath.”

“Lifeguard Your Child,” a drowning prevention campaign created by Cook Children’s, aims to get the message out through a regional collaboration of partners from eight counties across North Texas. The coalition includes school districts, police and fire departments, pool builders and swim lesson providers such as the YMCA. “Lifeguard Your Child’ promotes safety strategies through its website, videos, online classes and social media.

“The biggest piece we’re trying to do is have parents think about water safety and drowning prevention all year long,’’ Walraven said.

Campaign partners came up with new methods to reach their audiences during the COVID lockdown. Those efforts included a shift to greater virtual education. And in spite of the pandemic, “Lifeguard Your Child” reached 6,950 adults and children with educational toolkits between October 2019 and September 2020.

Highlights for drowning prevention include:

• Young children should know to never get in the water unless an adult is within reach and watching. Learn to swim and swim with a buddy.
• Teens should be alert for hazards lurking in murky lake water. No horseplay or risky stunts. Wear U.S.C.G. approved life jackets.
• Caregivers should create barriers to the pool, such as four-sided fencing. Don’t lose track of the kids during the transition from swimming to the next activity (a trip inside to the bathroom, loading the car etc.). Hospital admissions data increasingly show that drownings tend to occur during these unplanned situations “when one child goes back for a toy, or a child wants to jump in one more time,” Walraven said.

In addition to the education component, “Lifeguard Your Child” has distributed 1,296 life jackets this year in drive-through events and through six loaner stations at area lakes. The program recommends only those life jackets approved by the U.S. Coast Guard. Proper fit is essential too.

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

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.

“For us, in the Emergency Department, it’s just sad because this is something that’s totally preventable,” Dr. Warmink said. “It was an unusual summer because of the number of kids who came here because of drowning, but it’s something we see all the time. It’s not a freak occurrence. We live in Texas. There are a lot of pools here. It’s just water and children don’t mix without supervision.”

Dr. Warmink understands that people focus on the number of fatal drownings that occur during a given year. But he says that a near drowning can be devastating for a child.

“Kids come in here and they don’t die, but we know that their outcome is not going to be a good one,” Dr. Warmink said. “People think, ‘He didn’t die, so everything will be great.' But often times, that’s not true. There is a large subset of children who survive, but end up with catastrophic outcomes.”

Time under water = brain

Dr. Warmink describes drowning as the inability to breathe, normally due to submersion in a liquid, usually water.

The outcome, including death, of the person who drowned depends on how long he or she was under water.

“Everything is based on getting oxygen to vital organs,” Dr. Warmink said. “The outcomes of drowning and the adverse effects are based on that lack of oxygen. The most effected parts of a drowning victim are the brain, lungs and the kidneys. The one that is most catastrophic and the one that will kill you is the brain. “

The amount of time children spend under the water while drowning usually determines their outcome. The lack of oxygen destroys brain cells and that causes damage to the brain, ranging from short term (forgetful, clumsy …) to severe (can’t walk to vegetative).

Dr. Warmink says there are several variables that shape how severe the brain damage will be, including how long the person was submerged in the water and how quickly he or she received CPR.

Once a child arrives to the Cook Children’s ER, treatment begins that may include oxygen, X-rays, intubation or medication.

“But a lot of it is supportive care for the children that come in here,” Dr. Warmink said. “We may have to support their lungs because they have been damaged and they have difficulty breathing. Their kidneys could be damaged, so we will do lab work to see what's going on there. But our biggest concern is the brain and honestly, there's not a whole lot we can do. The vast majority of treatment for drowning is supportive. We see what we can do to keep that child alive. That said the earlier you can intervene, the better. One of the things that helps outcomes is early, good CPR. By the time they get to us, it may be too late.

Adult supervision – the hallmark

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.

“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.”

Other layers of protection Dr .Warmink stresses include:

• Fencing around the pool. A fence on all sides of the pool has been shown to reduce fatalities by more than 80 percent.
• Swim lessons for everyone who will be in the pool, including adults.
• Coast-guard approved floating devices. Water wings and “floaties” do not constitute a floatation device.
• Drowning doesn’t look like drowning. Drowning is a silent killer. Kids aren’t kicking and flailing. Dr. Warmink says it’s usually someone looking for their child and they see them at the bottom of a pool.

“As the adult, you have to be actively watching at all times, counting even. OK, there are five kids in this pool. How many heads do i see? Kids will drown right in front of you,” Dr. Warmink said. “It's not a long process of them screaming and crying. It's just one second they are fine and the next second they are under.”

Take it from Dr. Warmink. Unfortunately, he’s had plenty of experience.

Related articles:

• Cook Children's drowning prevention page
• Drowning prevention - 9 ways to protect your kids
• Drowning prevention - watch your kids
• Drownings double from a year ago 
• Be a water watcher. Adult supervisions saves lives.
• Is your baby ready for swim lessons?
• Drowning tragedy - 'I can't believe this happened to me.'
• Swimming with Type 1 diabetes
• The life-saving reason for Water Watchers

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.”

The family, which has requested to remain anonymous, shared their story with Checkup Newsroom in hopes of preventing tragedies to other families.

“It was just a normal day at the pool,” said the girls’ father.

They were at a community pool on a recent July afternoon. The two girls, ages 5 and 6, had been playing in the water for less than 5 minutes when their brother decided he wanted to get out.

“All three were in my line of site. I watched my son get out of the pool. I took my eyes off the water for a matter of seconds to give him a cookie. When I looked at the pool again, I thought they were still playing.”

The father said he thought the girls were playing a game to see who could hold their breath the longest. He wasn’t too concerned since both take swim lessons twice a week and spend many hot afternoons in the water. He says he saw one girl jumping up and down, but the other stayed submerged. That’s when he jumped in.

“I grabbed her and started screaming for the lifeguards. Then I realized my oldest daughter was in trouble too.”

More than a dozen lifeguards rushed to their aid, along with a parent who also happened to be a nurse. Both girls were given CPR while another parent took their brother to get a popsicle so he wouldn’t have to see what was going on.

“It happened so fast. The entire episode couldn’t have taken more than 15 or 20 seconds,” said the girls’ father. “It’s not like you see in the movies, there was no splashing, no yelling. There were adults right there that didn’t even know they were in trouble.”

Unfortunately, this is something emergency room physicians and nurses hear all too often at Cook Children’s. Already this summer, 24 children have been admitted to the hospital for drowning and two have died. Over and over again, parents say they didn’t know their child was in danger because they didn’t see or hear anything.

“This is a huge issue in our community, especially in the summertime,” said Dana Walraven, community health outreach manager for Cook Children’s. “Parents may not realize how quickly children can drown, that’s why we teach ‘layers of protection.’”

Layers of protection are safety techniques that have proven to be effective ways to prevent drowning.

They are:

• 100% adult supervision while children are in and around water
• If you are alone with your child, stay with your child. Get in the water with your child and be in arm's reach.
• Swim with U.S. Coast Guard-approved life vests. Don't use floaties filled with air.
• Learn to swim at any age.
• Learn CPR.
• Install a fence on all sides of a backyard pool or spa. Secure the fence with a self-latching gate.
• Use alarms that can be put on children's wrists.
• Update pool/spa drain covers.
• Follow pool rules and signs.
• Install door alarms to alert adults when a child is entering the pool area.

The father who shared his story about his daughters says the depth of the pool played a big part in their close call.

He says he believed the pool was two and a half feet of water, but it actually became deeper in areas.

“My youngest daughter is fearless. She swam into the deeper area without me realizing it. Her older sister saw what was happening and was trying to help.”

He says if he had known the water became deeper, the girls would have been wearing their life vests.

“I’m one of the lucky ones. I got there in time to get them out. The lifeguards did a great job. I could have easily been planning a funeral right now for two little girls.”

Both girls were released from the hospital just one day after the incident. Their father says both are doing great and even had a plan for what they wanted to do once they were able to leave Cook Children’s

“When we left the hospital, the girls (as a family) wanted to go to thank the lifeguards for everything they did for us. My youngest response was "after we thank the lifeguards, can we go swimming?"

Lifeguard Your Child

Did you know that Texas is #1 in the nation for child pool drownings, or that drowning is the leading cause of accidental death for children ages 1 to 4? This year, Cook Children's is asking all parents to #LifeguardYourChild around water. For more information about how to protect your children around water, including where to find swim lessons and what to look for when purchasing a life-saving device, visit our drowning prevention website.

And yet, one in three parents surveyed has left their child at pool for two to three minutes without supervision.

You may have seen movies of someone drowning and splashing in the water and making a big, dramatic scene. But that’s only in the movies.

Drowning is a silent killer. In reality there’s very little splashing, waving or screaming. You likely won’t hear your child drowning until it’s too late.

“Parents should stay in the water and within arms-reach of their child,” said Sharon Evans, Trauma Injury Prevention/Outreach coordinator for Cook Children’s Medical Center. “Don’t rely on a lifeguard, or an older child, to save your child. Be in the water. A drowning can happen too quickly not to be in with a child.”

Watching your children in the pool isn’t a job for kids, even older children.

"Teens can be easily distracted and they may not have the judgement skills to handle the job," said Dana Walraven, Community Health Outreach manager at Cook Children’s. "If there's a problem in the pool, a child may have trouble getting another child out of the pool. And this is not a responsibility for a young person. A drowning, even if not fatal, can scar a child for life if something happened if he or she were in charge. This is definitely a job for a grownup."

Evans said she was alarmed at a recent event she was at when she asked children what they should do if they saw a friend drowning or struggling in the pool. Too many said they would jump in and save the child.

“That’s the last thing we want to happen,” Evans said. “The child may not be strong enough to support the other child or a strong enough swimmer to support both kids. If a kid jumps in to rescue a friend, you can easily have two victims.”

Evans said to make sure your children know the best way they can help if they see someone in trouble in the water is to run and get help. Notify a lifeguard at a pool if one is on duty or find the nearest adult. Have someone get help and call 911 immediately.

So what should you tell your child to do if they see someone drowning?

First, know the signs. The American Red Cross says to watch for these signs a person may be drowning:

• The person is upright (vertical) in the water.
• The person is unable to move forward or tread water.
• The drowning person is pressing his or her arms down at the sides, trying to keep the head above water to breathe.
• The person spends energy just trying to keep his or her head above water.

If a child sees someone showing signs of trouble, he or she should stay out of the water and look for something to grab a hold of to help the person in trouble:

• A pool noodle
• Any flotation device by the pool
• Fishing pole
• Rake
• Canoe paddle
• Boat oar
• Stick
• Tree branch
• Baseball bat

Children who are too small to pull someone in or the person in the water is out of reach, should find objects to throw in to the water including:

• Kickboard
• Empty picnic cooler
• Life jacket
• Ring buoy
• Water jug
• Basketball
• Inner tube

Drowning is the leading cause of unintentional injury-related death in children ages 1 to 4 years old and the second leading cause of unintentional injury-related death for ages 1 to 14.

SafeKids Tarrant County, led by Cook Children’s, offers other sobering facts for parents leading into this swimming season:

• Drowning can still occur even if you know how to swim.
• No one is “drown proof” – no matter their level of swimming ability.
• Falls, entrapments and injuries lead to drowning regardless of swimming level.
• A majority of people overestimate their own and their child’s ability to swim, especially in a panic.
• Drowning is quick and silent.
• Drowning occurs in as little as 2 minutes.
• Irreversible brain damage occurs in as little as 4 minutes.
• Most children who drown are out of sight or missing for less than 5 minutes and usually in the presence of 1 or both parents.
• Most children die who are submerged for as little as 6-10 minutes.
• Children who drown do not scream splash or struggle. They silently slip beneath the water, even with adults and lifeguards present.

That’s scary information, but there are steps you can take to help protect your child and have a safe summer while in the water:

1. Constant visual supervision

• Assign an adult water guardian whose only responsibility is to watch children who are in the water.
• Teach children who can’t swim to stay away from water unless they are with an adult who is within arm’s reach and has eye-to-eye contact on them.

2. Learn to swim

• 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.

3. Keep backyards and bathrooms safe

• Dump all water buckets and empty kiddie pools when they are not in use.
• Install safety latches on toilets
• Never leave children unattended in the bathtub

4. Multiple barriers on all pools and spas

• Install pool fences, self-closing, self-latching gates and door alarms in areas leading to pools and spas.
• Keep a phone by the pool and call 911 in an emergency
• Keep pool area picked up and clear of toys and other items which might attract an unsupervised child.

5. Always check pool/spa first for missing child

• Make sure to look at the bottom of the pool or spa.
• Do not quickly scan the top and move on – children who drown often sink to the bottom and appear as shadows that easily be overlooked.
• Every second counts.

6. Wear life jackets

• Children who cannot swim should always wear a properly sized Coast Guard approved life jacket.
• Do not rely on water wings, floats or other toys to keep children safe.

7. Learn CPR

• Studies show CPR doubles the victim’s chance of survival.
• Use hard/fast compressions in the center of the chest until help arrives.
• Refresh CPR skills yearly, certifications every two years.
• Post CPR guidelines near the pool.

Related Links

• Cookchildrens.org/safety
• Safe Kids’ Water Safety Tips
• Play it Safe on the Water - Texas Parks and Wildlife
• Backyard and Pool: Household Safety Checklist
• Household Safety: Preventing Drowning

Of those drownings, 26 were backyard or community pools.

If you believe swim lessons are nothing more than a fun summer activity, think again. The skills children learn in swim classes could make the difference in life and death.

During swim lessons, kids get used to the water and learn important water safety skills. According to Safe Kids Tarrant County, led by Cook Children's, children who don't know how to swim or who are being supervised by adults who can't swim are eight times more likely to drown or fatally drown.

"Children as young as 2 to 3 years old develop the ability to self-rescue during swim lessons, which means that if they fall into a swimming pool, they can turn around in the water and either float on their back until rescued or use the skills they have learned to swim to the side of the pool," said Tyler Emler, action team chair for drowning prevention for Safe Kids. "The sooner children get in the water, the sooner they become comfortable with swimming. If you wait until children are 6-8 years old to begin swim lessons, they won't have the same comfort level as children who have been in the water since they were younger."

Which swim class is best?

When choosing swim lessons for your child, visit local health clubs and recreational centers to meet with swim instructors and educate yourself on the classes offered. 

According to Emler, the most successful classes teach a love for water while also building necessary swimming and water safety skills.

While swim classes should have accommodations in place to assist children who don't acclimate to the water or who aren't reaching swim class goals, Emler notes that parents can help their child's progress by spending family time in the pool and stopping any pressure a child may feel to master skills more quickly. 

Young children who take swim classes in late spring or early summer should return for indoor winter refresher courses every year until they reach 6 or 7 years old. This way, coordination and muscle memory has a chance to develop, allowing children to maintain skills for longer periods of time.

For more information

Learn more about drowning prevention and water safety here. This page gives helpful information on keeping your kids safe during swim season, including proper fit for life jackets, pool safety videos and fences/alarms information.

Water sports are great because it allows one to exercise at a high intensity, there is not that much stress on the back and legs. It is great for a whole body work out and allows someone, in one hour, to be able to burn as many calories as in a one-hour run.

Typically, one doesn’t think of swimming as a sport that leads to many injuries. Swimming is an overhead sport and the human body is not made to handle a lot of overhead activities. Swimming too much can lead to overuse injuries. The main ones are shoulders pain and occasionally knee pain.

The training for competitive swimmers has changed in recent years. Training now requires swimming a lot of laps. All this swimming leads to more overuse injuries, like the ones we see in baseball pitchers and runners. Shoulder pain is the major problem swimmers will “swim” into because using the same muscles over and over can lead to the muscles in the chest and back being unequally strong. These muscles not being equal can lead to bad swimming form which will then lead to shoulder pain. Swimming strokes that can lead to shoulder pain are freestyle, back stroke and butterfly. Swimmers that participate in breast stroke are as at risk as other strokes for shoulder pain, but can also develop knee pain. This comes from the knee cap shifting and rubbing on other parts of the knee joint leading to knee pain.

It is important for coaches and parents to know how to keep their young swimmers safe, what to look for, and what questions to ask their kids to ensure that they are staying safe and not injuring themselves.

KNOW WHAT’S BEST FOR YOUR YOUNG SWIMMER:

Parents and coaches can help their swimmers by being an extra pairs of eyes, because the young athletes don’t know any better.

Rest: Athletes participating in overhead activities should not participate in these activities for at least three months out of the year. This means that it is good for parents to encourage their child to try different sports, specifically ones that don’t involve overhead activities.

Warmup: Ensure that your swimmer is warmed up properly. It is never good to get into a pool cold. The type of warm up is important too. Make sure that the warm ups are active and not passive stretches. There are a lot of traditional stretches that swimmers do to warm up their arms. These warm ups target parts of the shoulders that keep the joint stable. It is important to warm up and actively stretch the muscles themselves and not the shoulder joint.

Hydration: Lastly, make sure to drink a lot of water. Being in a pool dehydrates the body on top of the sweating that occurs while working out.

THINGS TO AVOID:

• Incorrect swimming form
• Excessive training without rest days
• Swimming the same stroke every time

WHAT TO WATCH FOR:

• GREEN LIGHT- Good: Muscle soreness is OK if it last 2-3 days
• RED LIGHT- Bad: If soreness last more than 2-3 days, or gets worse, and/or is sharp

(If it is a red light item one should seek help from a medical professional)

NOW WHAT:

Young Kids AGE: 5-9

• Training should not exceed 60 minutes and no more than three times a week.
• Learn how to properly perform the basics of the strokes.

Older Kids AGE: 10-16

• Training should not exceed 120 minutes and no more than 6 times a week.
• Learning how to decrease wasted energy with strokes.

PROPER WARM UP:

• 5 minutes of light swimming
• 15 minutes of active stretching
• 10 minutes of stroke and breathing exercises in the pool

At Cook Children’s, our SPORTS physical therapists are trained in proper rehabilitation of overuse injuries and work to restore full function and safely guide return to athletic activities. If your child has a history of injuries from swimming or you are concerned about risk of future injury, talk to your pediatrician about a referral to physical therapy.

Learn more here:

• USA Swimming
• Ovoiding overuse injuries
• Swimming Injury Prevention