“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.

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. 

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