“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 

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.

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.”

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.

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 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.  

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.”

While these popular summer spots are a great way to beat the summer heat, they can pose a danger to anyone not wearing shoes.

“Children often forget that the pavement is hot because they are wet and they aren’t feeling the heat as much, but any dry pavement that is out in the sun is a potential place for children’s feet to get burned quickly,” said Kara Starnes, D.O., medical director of Urgent Care at Cook Children’s.

Dr. Starnes says she’s seen patients who’ve suffered burns on their feet and suggests children wear water shoes while swimming so that if they step on hot pavement, their feet will be protected.

She’s also seen children injured from playing outside at home.

“If your children are like most, they like to run outside to play without a thought about shoes,” Dr. Starnes said. “An option to protect your children’s feet, especially at home, is to place interlocking foam pads down over pavement on patios or other areas where your children commonly play. While these pads do still get hot, it is not typically enough to cause a burn.”

So how do you know when burns are bad enough to seek medical attention? Dr. Starnes advises parents to seek treatment for burns on your child’s feet:

• If there are blisters forming on the bottom of the feet.
• If simple measures such as Tylenol or ibuprofen, aloe to the area or sunburn pain relieving sprays do not relieve symptoms.

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.

According to the Trauma registry, 10 children have died this year already. Two deaths occurred in the month of July to pass the total of eight deaths in 2016. The ages of the children who have died this year range from 17 months old to 13 years of age.

The numbers hit the staff at Cook Children’s especially hard because so much effort continues to be focused on protecting children in and around the water with the “Lifeguard Your Child” campaign.

“It has been a really bad year and it’s not even August,” said Corwin Warmink, M.D., medical director of Emergency Services at Cook Children’s. “For us, in the Emergency Department, it’s just sad because this is something that’s totally preventable. But this is not anything new. We live in Texas and we see this all the time. There are a lot of pools and lakes here. It’s just water and children don’t mix without adult supervision and children wearing their lifejackets.”

This year the experts at Cook Children’s have placed an emphasis on the drownings that occur during non-swim time. Half of the drowning deaths seen at Cook Children’s occurred while the child wasn’t actively swimming, meaning the children gained access during times the family hadn’t planned to be at the pool, pond, lake, etc.

“We’ve talked a lot about how parents need to ‘Lifeguard their child,’ but that doesn’t stop once a child is out of the water,” Sharon Evans, Trauma Injury Prevention Coordinator at Cook Children’s, said. “I think what happens a lot of times is that parents are on high alert while their children are in the water, but then they tend to let their guard down once the day is over and it’s time to leave the pool. Unfortunately, that’s when children are most at risk for going back into the water without anything to prevent them from drowning.”

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.”

Dana Walraven, Community Health Outreach Manager at Cook Children’s, said it’s important for parents to realize that at least 50 percent of the drownings might have been prevented with layers of protection.

The highs this week will be above 100, with temperatures expected to reach 105 degrees. As we head into the scorching heat, it’s important to remember that infants and young children rely on adults to keep them cool, hydrated and safe while outside.

Stay Cool

Too much time out in high temperatures can cause heat-related illnesses such as heat exhaustion and heatstroke.

"As the outside temperature rises, your family's risk of heat stroke rises right along with it," said Corwin Warmink, M.D., medical director of Emergency Service at Cook Children’s. “On 100-degree days, it's best to stay inside. If temperatures exceed 90 degrees, stay in the shade and keep a close eye on the kids."

Take these steps during the summer to prevent heatstroke and heat exhaustion:

• 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 which can trap heat close to the body.
• Schedule outdoor activities carefully: Heatstroke can occur in less than an hour when you are participating in strenuous activity during 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.
• Ventilate: Stay where there’s plenty of air circulating to keep the body cool. If you are without air conditioning, visit a shopping mall or public library. Remember, electric fans may provide comfort, but when the temperatures reach the 90s, they will probably not prevent heat-related illness. A bath or cool shower is a much better way to stay cool.
• Wear Sunscreen: If you got outside, use sunscreen, wear a wide-brimmed hat, sunglasses and put on sunscreen of SPF 15 or higher 30 minutes before going outside. Continue to reapply according to the package directions.

Don’t Leave Your Child Alone In A Car

Over the weekend, a 6-month-old girl in Ohio and 17-month old boy in Florida died after being left inside vehicles. Twenty-four children have died in hot cars in the United States this year, according to noheastroke.org.

Since 1998, 767 children have died nationally as a result of being left in a car. Texas leads the nation in children dying from pediatric vehicular heatstroke with 16 deaths since 1998.

For the Trauma department at Cook Children’s, statistics are much more than numbers. They represent very real, too often tragic consequences.

“Every time we hear of a child dying in a hot car, it’s heartbreaking for all of us,” said Sharon Evans, Trauma Injury Prevention coordinator at Cook Children’s. “It’s especially devastating because these deaths are preventable."

For More Information On This Topic:

• Tips for Preventing Heat-Related Illness - CDC
• Heat Exhaustion and Heat Stroke
• Child Safety Center
• Vehicle/Car Safety
• Drowning Prevention

There were only five juvenile drowning deaths in all of 2017, according to Tarrant County Public Health spokesman Kelly Hanes.

Read the full story 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.

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.

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

Things were so bad that Fort Worth Mayor Betsy Price called a press conference pleading for city-wide support of drowning prevention measures and asking parents to supervise their kids at all times. 

And yet, it's happening again. Cook Children's has seen 15 near drownings and two fatal drownings already in the month of June. 

At the press conference a year ago, Denise Doherty, an RN and director of Emergency Services at Cook Children's, said her staff was "drained and heart broken" from the number of children and patients affected by this "very preventable tragedy."

"It has to stop," Doherty said. "Can you imagine being a parent, sitting in the ED waiting room, praying that the life of someone you love so dearly is spared, especially since it was something that didn't have to happen? No parent wants to be saddled with that guilt. I think it's also appropriate for me to say that no one is immune, and yes, it can happen to you. Cook Children's has witnessed this in a very intimate way, even our own medical community has experienced this heartbreak."

But the good news is that we can prevent our kids from drowning. Here are 9 tips that if we all truly followed, could make for a safe summer for our kids:

1. Get in the water. Be in arms reach of your child. Don't let your child out of your sight and be there to grab your children out of the water at any sign of trouble.

2. 100 percent adult supervision at all times. Be active in the pool with the children or watch like a lifeguard. Don't take your eyes off of your child. If you aren't in the water, be sure to watch your kids at all times. Don't spend time on your smartphone, talking to friends or walking away for even a moment. Do have a phone nearby in case of an emergency. But that's the only time anyone should be using one.

3. Watch them until they are safe and inside. Monitoring your kids includes accounting for everyone who had been in the water all the way to the house or apartment. Once you are inside, count again and make sure all the kids are safe and inside.

4. Be a water watcher. If you are at a party with a group of children, take 15-minute shifts watching the kids. Count heads above water and look for any that are motionless on the bottom of the pool. Give your undivided while you are the water watcher. Stay sober and be alert. You can't have a more important responsibility.

5. Life jackets. Not just any flotation device will do. Make sure your life jacket is U.S. Coast Guard approved. Check the tag to say so. Remember that life jackets aren't just for the lake, but for the swimming pool too.

6. Swim lessons. Mom and dad, you need to know how to swim. If you don't know, take lessons with your child. Make sure your child knows how to swim too. If they are in the pool, they need to know how to get to safety. But this is only a layer of protection and doesn't take away from the fact that you need to be in arm's reach.

7. Know CPR. Local CPR lessons are given in your area. A quick Google search should help you find a class.

8. Use pool and child alarms to alert you if your child gets in the water without you.

9. Isolate your pool from the rest of your backyard with a permanent, four-sided fence with self-latching gates to prevent kids from accessing the pool area without an adult.

Previous articles on this topic:

• Is your baby ready for swim lessons?
• This life-saving tip could prevent your child from drowning
• Life After Drowning
• 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
• Cook Children's drowning prevention page

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.

Planning and gear is necessary when setting off for a day of water fun, but for kids with diabetes it can sometimes feel like an Everest expedition. Their checklist can include any or all of the items below:

●Blood glucose meter

●Supplies to check blood sugar

●A cooler or ice packs to keep insulin cool

●Insulin

●Insulin injection supplies

●Insulin pump supplies

●Snacks for low blood sugars

Children and their families with Type 1 diabetes deal with additional risks on top of the typical worries that all families deal with. Some diabetes specific risks include:

●Low blood sugar

●Dehydration

●High blood sugars

●Ketones

The wisdom and experience of a parent of a child with Type 1 diabetes adds more practical value. I discovered this article on swimming with Type 1 diabetes.

I reached out via Twitter to the mom and author of the article. As the mother of two girls with Type 1 diabetes, she had a lot of good, practical advice, which I endorse and would give to my own patients.

I know it helps to here from other moms. Here are some of the thoughts and tips that she shared about her now older girls.

Importance of swim lessons

My girls passed all of their swim lessons and have reached the level that will safely take them into adulthood ... I still tend to hold the book and scan the water until both are safely drying off on my blanket. Once a mom, well, always a mom.

“Managing” blood sugars

Despite this natural maturity and necessary growth, our family is still cautious with Type 1 diabetes and swimming. We know that blood sugar management during exercise can be tricky on a good day, let alone, on a day of intense swimming, where every single muscle is engaged and active.

Here is a list of strategies that we use to help keep teenager independence while staying healthy with Type 1 diabetes.

1.Check blood sugar before you go into the water.

2.Blood sugar MUST be above 100 mg/dl.

3.If not, BEFORE swimming, eat a small protein and carb snack and do not bolus. Our girls like re-sealable chocolate milk jugs, cheese and crackers or small peanut butter and jelly sandwiches.

4.Swim with a buddy and never alone.

5.Every hour, get out of the water and check blood glucose.

6.If blood sugar is rising, which often happens due to adrenaline during exercise, reconnect the pump and take ½ of the recommended bolus amount. This also helps to avoid ketones from lack of insulin.

7.Stay hydrated. Even if you feel like you are not thirsty, drink 8 ounces of water each time you are checking your blood sugar.

8.Always bring money. If you find yourself eating through snacks, be prepared to purchase carb-laden food from the snack machine or beach shack. This happens more often than not, so I stress this often!

9.Be prepared for lows that might happen an hour or two after leaving the water. With T1d, it’s not just the first event (swimming), but the second, third and fourth events that need proper planning. For that reason, always tuck in more glucose, more meter strips and extra supplies than you think you might need. Chances are, you will need it!

I hope this article was helpful and makes for a better water safety experience.

My gratitude to naturallysweetsisters.com for sharing.

It could save their lives.

“For children’s safety, parents should make sure their kids are in U.S. Coast Guard (USCG) approved life jackets,” said Dana Walraven, Cook Children’s Community Health Outreach manager and Safe Kids Tarrant County coordinator. “Not just any flotation device will do. Parents need to check the tag or the inside of the life jacket to make sure it truly is something that will save the child’s life if he or she is in danger of drowning. The USCG life jackets provide buoyancy to keep the child floating and his or her head above the water.”

Walraven asks parents to make sure of the following:

Look for the USCG tag or that it is embroidered somewhere in the life jacket. It is the only way parents can be guaranteed that they have a proper flotation device to protect their children.

Walraven said she’s noticed at the popular go-to shopping centers where entire walls are covered with pool tools and flotation devices, but a closer look shows that none of the gear is U.S. Coast Guard approved.

“Unfortunately, it seems there are more and more equipment to choose from that’s not safe for kids to be using in the water,” Walraven said. “The labels are clearly written. It’s so important for parents to look closely at the labels.”

Learn more about ways to protect your children from drowning with the following resources:

• 9 Ways to Protect Children from Drowning
• Water safety and drowning prevention
• Life After Drowning
• The life-saving reasons for Water Watchers
• Drowning prevention – watch your kids
• Drowning tragedy - 'I can't believe this happened to me'

More importantly, who is not watching them drown?

The month of May has been designated as National Water Safety Month because the warmer weather marks the beginning of summer and drowning season across the United States.

Already this year, one child died at Cook Children's from a fatal drowning and eight more kids have been treated for non-fatal drownings. Last year, Cook Children’s staff saw eight drowning deaths and another 61 children treated for near-drownings.

Most of the drownings occurred during the summer months of June and July with 39 total drowning and 5 deaths.

The numbers have to go down and this month Cook Children’s begins its new campaign: “Lifeguard Your Child.”

“We hope this campaign sends a clear message to parents and adults when they are at the pool or lake,” Sharon Evans, Trauma Injury Prevention coordinator at Cook Children’s. “Adult supervision is critical to the safety of a child in the water and is the difference between life and death for many kids.

We’re asking parents and adults watching children in the water to go in with the mindset of a lifeguard.”

Ideally, Evans suggests adults get in the water and be in arms reach of their child. “Don’t let your child out of your sight and be there to grab children out of the water at any sign of trouble,” Evans said.

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.

Use these safety techniques and layers of protection 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 U.S. Coast Guard approved life jacket use for non-swimmers.

· Enroll children in swimming lessons.

· Parents and caregivers should undergo CPR training.

In large pools, it’s ideal to split up in groups and take sections of the pool.

“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.”

For more information about this topic, visit cookchildrens.org.

"If it can accelerate your body, it can injure you," said Corwin Warmink, M.D., medical director of the Emergency Department at Cook Children's. "Vehicular accidents, including boats, ATVs, cars, scooters and bikes are all too common on holiday weekends during the summer."

Another danger Dr. Warmink is concerned about this weekend: broken bones. No one wants to spend Labor Day weekend in the hospital. But Dr. Warmink says many families do, thanks to trampolines and monkey bars.

One of the scariest threats we see all too often is drowning. And yes, it can happen to you. In August alone, 14 children were admitted to Cook Children's Medical Center for drowning-related injuries. Two of those children died.

"We've seen many cases where children took their life preservers off and jumped back into 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."

One of the best ways to protect your child around the pool or lake is to become a Water Watcher. This means adults take turns supervising the water with undistracted attention. You can find more information about the program here, including 5 seldom used tips that could save a child's life.

And Labor Day may mark the unofficial end of summer, but that does not mean an end to the heat. According to Dr. Warmink, heat-related illness also tops the list of Labor Day dangers. "Heat exhaustion, heat stroke, hot cars and sunburns are among the common injuries we see over the Labor Day weekend," said Dr. Warmink. "Parents should make sure their kids drink plenty of water and wear sunscreen, and of course, never leave a child alone in a car."

With your help, we can cut the number of Emergency Department admissions this holiday weekend and ensure a safe celebration for everyone.

That was the overall message from Fort Worth, Texas Mayor Betsy Price and representatives from the city of Fort Worth, including Cook Children's, at a press conference to address city-wide support of drowning prevention measures.

Mayor Price said that the message of the day was that tragedy in the water only takes seconds and that drowning is a silent killer. "Children drown without a sound," she said.

The press conference called for awareness and a city-wide call-to-action to protect our children through education, prevention and response. Along with the Mayor and Cook Children's, representatives from the Fort Worth Drowning Prevention Coalition, the Fort Worth YMCA, the Fort Worth Firefighter Charities, the Fort Worth Fire Department and MedStar were all in attendance.

The event included a poignant speech from Denise Doherty, an RN and director of Emergency Services at Cook Children's. Doherty said her staff is "drained and heart broken" from the number of children and patients affected by this "very preventable tragedy."

In the past two months, Cook Children's has seen nearly a child a day for drownings. The month of July began with two drowning deaths and Cook Children's Trauma Department seeing 19 total drownings from July 1 to July 22, compared to 11 drownings and two fatalities last year for the entire month of July. June saw more than double the amount of non-fatal drownings from a year ago with 26. 

Parents have been urged to watch their kids. Now the message has a new sense of urgency - you must protect your children. 

"We've seen more than enough children die this year," Doherty said. "It has to stop. Can you imagine being a parent, sitting in the ED waiting room, praying that the life of someone you love so dearly is spared, especially since it was something that didn't have to happen? No parent wants to be saddled with that guilt. I think it's also appropriate for me to say that no one is immune, and yes, it can happen to you. Cook Children's has witnessed this in a very intimate way, even our own medical community has experienced this heartbreak."

Doherty added," Today, we're making a plea. It's not only time to watch your kids near the water, but it's time to protect them."

So what does it mean to truly protect your kids? Help us spread the word with these tips:

1. Get in the water. Be in arms reach of your child. Don't let your child out of your sight and be there to grab your children out of the water at any sign of trouble.

2. 100 percent adult supervision at all times. Be active in the pool with the children or watch like a lifeguard. Don't take your eyes off of your child. If you aren't in the water, be sure to watch your kids at all times. Don't spend time on your smartphone, talking to friends or walking away for even a moment. Do have a phone nearby in case of an emergency. But that's the only time anyone should be using one.

3. Watch them until they are safe and inside. Monitoring your kids includes accounting for everyone who had been in the water all the way to the house or apartment. Once you are inside, count again and make sure all the kids are safe and inside.

4. Be a water watcher. If you are at a party with a group of children, take 15-minute shifts watching the kids. Count heads above water and look for any that are motionless on the bottom of the pool. Give your undivided while you are the water watcher. Stay sober and be alert. You can't have a more important responsibility.

5. Life jackets. Not just any flotation device will do. Make sure your life jacket is U.S. Coast Guard approved. Check the tag to say so.

6. Swim lessons. Mom and dad, you need to know how to swim. If you don't know, take lessons with your child. Make sure your child knows how to swim too. If they are in the pool, they need to know how to get to safety. But this is only a layer of protection and doesn't take away from the fact that you need to be in arm's reach.

7. Know CPR. Local CPR lessons are given in your area. A quick Google search should help you find a class.

8. Use pool and child alarms to alert you if your child gets in the water without you.

9. Isolate your pool from the rest of your backyard with a permanent, four-sided fence with self-latching gates to prevent kids from accessing the pool area without an adult.

Previous articles on this topic:

• 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
• Cook Children's drowning prevention page

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.

• 2 deaths to begin the month of July
• 26 non-fatal drownings from June 1 to July 1, 2015
• 43 non-fatal drownings from Oct. 1, 2014 to July 1, 2015
• 4 fatal drownings during that same time frame

And now we head into the July 4^th weekend where people will be throwing pool parties at their house or apartment or going out to area lakes … and at many of those parties there will be drinking.

So what’s left to say? Sharon Evans, Trauma/Injury Prevention outreach coordinator at Cook Children’s, admits to being tired, frustrated, sad and even a little angry that no matter how much the message is delivered, kids drown.

“I feel like a broken recording at this point,” Evans said. “But I don’t know what else to do. We have to keep telling people. We have to keep getting the word out. Tell your friends. Tell your neighbors. Tell your other family members. Kids are dying.”

And then Evans collects herself to deliver the message again.

“I don’t think people know how quickly it happens,” Evans said. “It’s just seconds and it’s a silent killer. Kids died silently. You can’t just let your kids go. Water is dangerous. It scares me because now we are headed toward the July Fourth weekend.”

If nothing else, Evans wants to make sure everyone reading this gets this point.

“It can happen to you,” Evans said. “I can say it, but I don’t think people really realize it. It can happen to you. Don’t take your eyes off of your child. You have to hold on to his or her hand sometimes. The most important thing is to be there for your child. And my God, whatever you do, you can’t let your kid go swimming or to the water alone. You have to have adult supervision.”

Evans speaks strong, but you can hear the pain and heartbreak in her voice. She’s seen a lot of this in her career and twice the amount of drownings over the last month as she saw last year. And what troubles her the most is that she knows no matter how much she speaks about drowning prevention, she will see more again.

“I wish I had a better line, a better solution,” Evans said. “I don’t know what else to say. I just know it’s preventable, if we take the right precautions.”

Click to read the following information for those precautions:

• 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.'
• Cook Children's drowning prevention page

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.

Since Oct. 1, 2014 to present, 40 drownings have been seen here and three of them have been fatal.

Those numbers are chilling and once again place an emphasis on water safety in the area.

Dana Walraven, community health outreach manager for Cook Children’s, wants to make sure that parents are prepared for warm weather and children in the water. She said the safety begins with making sure a grownup is watching the kids in the water at all times.

“Active adult supervision and layers of protection such as door alarms and a fence can lower the risk for your child,” Walraven said. “The majority of these water-related incidents happen in the child’s own backyard pools and to children 4 years old and younger. Drowning prevention around the pool starts 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.

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. Walraven says she knows it is difficult to supervise children 100 percent of the time. She said the levels of protection provide barriers in case the child should slip out of supervision.

Safe Kids Tarrant County, led by Cook Children’s, also offers Water Watcher tags to anyone or group who will use or distribute them. These are especially helpful at parties around the pool or lake to help designate adults that are watching the water. After 15 minutes, the tag is given to another responsible adult – letting everyone enjoy the party while ensuring that the kids are being properly watched. To receive a Water Watcher Tag, call 682-885-4244.

In large pools, it’s ideal to split up in groups and take sections of the pool.

“If you are somewhere where children are in the pool, insist that an adult be on watch,” Walraven said. “It should be done by a sober adult and that should be his or her only focus during their time watching the kids.”

Aside from supervision, four-sided isolation fencing with self-closing/self-latching gates is the best protection for your child and pets. It could prevent 50-90 percent of childhood drowning and near-drowning incidents. This type of fencing goes beyond the yard, to fencing in the pool itself, preventing direct access from the house.

Door and gate alarms give another signal that a child may have access to the pool area without supervision. The tendency is to disconnect it – especially at parties where people are going in and out. But these are also the times when small children are the most vulnerable for injury because of the confusion.

Learning CPR can save a child’s life by restoring breathing and circulation until advance life support can be given by health care providers.

Swim programs for children should teach good water safety behaviors in and around the pool but should not be seen as the sole way to decrease the risk of drowning.

Use a U.S. Coast Guard approved lifejacket with children who can’t swim. It should fit snugly when the child is buckled in and should not go beyond the top of the ears when lifted at the shoulders. Many air-filled, float-type toys are thought to be lifesavers but are not.

Check your pool and spa for cracked or broken drain covers on a regular basis. The suction around the drain can catch hair or clothing, pinning the child underwater. Anti-entrapment drain covers are available for as low as $40 and serve as another level of protection.

Since beach balls, noodles and other toys are attractive to curious young children – put them away when not at the pool.

For more information

Cook Children's has many resources on drowning prevention, beginning here. Click the links below with downloadable information in both Spanish and English, as well as videos. 

• Drowning prevention tips - English
• Drowning prevention tips - Spanish
• Water safety resources
• Drowning prevention education (English and Spanish)

Videos:

• Pool safety video step 1: Supervision
• Pool safety video step 2: Fencing
• Pool safety video step 3: Pool and spa covers
• Pool safety video step 4: Alarms
• Pool safety video step 5: Safety drain covers
• Pool safety video step 6: Swimming lessons
• Pool safety video step 7: Learning CPR
• Safe Kids Tarrant County Drowning Prevention Tips
• Safe Kids Tarrant County sugerencias de prevención de ahogamientos 

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

The answer is complicated.

Yes, it's very important for toddlers ages 1-3 to interact with other kids their age and challenge their balance, strength and coordination. Sports are a great way to promote these skills and literature shows that athletes who play sports at a younger age are more likely to be active adults than their peers who don't participate in sports.

However, organized sports  may not be the best solution for children 3 and under, and aren't the only way to teach our children these skills. The list below describes activities for toddlers and some benefits of these activities for their development.

Swimming: Helps strengthen the arms and legs, as well as improve coordination since the child has to use both arms and both legs at the same time. Learning swimming at an early age helps promote good water safety habits later in life. You can practice swimming in a "parent and me" swimming class. 

Dance: Improves balance, coordination, strength and flexibility. You can practice in a class setting or by having a "dance party" or playing a game of "freeze dance" at home.

Biking: Between ages 2 and 3, kids should be able to begin riding a tricycle. For young kids, there are tricycles that offer a parent guide bar to help kids move and steer. You can practice biking in your neighborhood or on trails.

Soccer: Most teams start between ages 3-5; however, kicking a ball in the backyard with your toddler is a great way to help them learn to run, develop core strength and balance on one foot for a short period of time.

Basketball: Helps kids develop hand-eye coordination when dribbling and shooting and improve running and jumping skills, as well. You can play with an adjustable hoop in the driveway, or sing up for a community team (which will generally begin between ages 3-5).

T-Ball: Teaches running, balll skills and coordination skills. Using larger balls for young children will help them be successful with catching and throwing.

Yoga: Helps improve flexibility, which is very important since toddlers are growing quickly and develop tight musles quickly. Yoga can also improve strength (especially in the core muscles) and balance. Several toddler yoga videos can be found online, and classes are available throught out the DFW area.

Gymnastics: Another way to gain strength, balance and flexibility, gymnastics is a sport that children can begin learning as early as 18 months old. Many gyms have special toddler and preschool classes, as well as "parent and me" classes.

Yard games: The old staples of "tag" and "hide and seek" are great for teaching turn taking and problem solving, as well as practicing and running and climbing. Taking your child to a local playground also offers a wide variety of ways to practice climbing stairs, running, swinging, balance, etc. 

With all of these, safety is a primary concern. Toddlers are at high risk of injury when practicing new things. Contact your pediatrician if you feel like your child is having difficulty learning new skills and they may refer you for evaluation by a physical therapist to evaluate your child and help them learn these new skills.

About the author

Jodi Burgett PT, DPT, CPST, is the clinical coordinator of Neurodevelopmental Physical Therapy at Cook Children's. Physical therapy at Cook Children's focuses on large motor and functional skils to enhance development, restore function and prevent disability from pediatric conditions, illness or injury. Cook Children's has Rehabilition Services in locations in Fort Worth, Hurst and most recently in Mansfield.