Protecting Kids from Drowning: A Pediatric Water Safety Guide

School’s out. Summer’s in full swing. The icy pops are frozen, the inflatable flamingos are back in action—unfortunately, so is the seasonal uptick in water-related injuries. From bathtubs to the ocean, any place with standing water deserves a pause, a conversation, and a prevention plan. 

From primary care and pediatrics to urgent care and the ED, clinicians are often the first line of defense. Here’s how we can talk to families about water safety and help prevent drowning.

Water Safety: Preventing Drowning in Children

Drowning is the leading cause of unintentional injury-related death in children, with children ages 0-4 at the highest risk according to several sources (ACEP 2025, CDC 2024, AAP 2019, Johnson MB & Lawson KA). In 2017, nearly 1000 children under the age of 20 died from drowning-related incidents (AAP 2019). According to the CDC, for every child who dies from drowning, another seven receive emergency care for submersion injuries or non-fatal drowning.

Children from lower socioeconomic backgrounds, as well as racial and ethnic minority groups, experience disproportionately higher drowning rates. This disparity has been linked to decreased access to swim lessons and safe water environments (AAP 2019, CDC 2024).

Drowning can happen anywhere, often in seconds and without warning. And it doesn’t take much—just a few inches of standing water is enough. While the risks are different across ages, the threat is real at every stage:

(CDC 2024)

Most victims of nonfatal drowning have no long-term effects or neurological deficits unless submersion time is extended (>6 minutes) (AAP 2019). Some possible complications of nonfatal drowning include acute respiratory distress syndrome (ARDS), anoxic brain injury, permanent brain damage and disability, hypothermia, and secondary infections, such as aspiration pneumonia.

Water Safety Tips to Share with Every Family

This summer, when completing any summer wellness visits or school participation physicals, take the opportunity to discuss water safety with your patients and their families. The American Academy of Pediatrics recommends a multi-layered approach to protect children from drowning. Here is a list of prevention strategies to include when discussing water safety and drowning prevention in our pediatric patients:

Adult Supervision Above All Else 

This is non-negotiable. Kids under 5 need touch supervision—a non-distracted adult within arm’s reach at all times. Even if there’s a lifeguard.

At group events (pool parties, beach days), assign a “water watcher”—a responsible adult who wears something visual (like a life vest jacket or neon hat), avoids distractions (no phones, books, or alcohol), and keeps eyes on the water. Set a timer to switch every 15–30 minutes so everyone gets a break without losing vigilance.

Fence Pools on Four Sides

Home swimming pools should be surrounded on all four sides by a fence with a self-closing, self-latching gate that is completely separate from the house. This type of fence, compared to a 3-sided fence which does not separate the house from the pool, has been shown to reduce the risk of a child drowning by 83%. It is recommended that the fence be at least four feet high and the latch be 54 inches from the ground. 

Early and Formal Swim Instruction 

Swim lessons alone do not prevent drowning in young children, but formal instruction—especially between the ages 1 and 4—can reduce the risk of drowning by up to 88% (National Drowning Prevention Alliance, ACEP 2025, Brenner RA, et al.). 

Programs like Step Into Swim are great resources for families seeking affordable swim programs.

Use of Appropriately Fitted Portable Floatation Devices (PFD) 

For children who can’t swim (or are still learning), appropriately sized and US Coast Guard-approved PFDs should be worn at all times when they are in or around water. PFDs should be worn 100% of the time a child is in a boat, whether it is moving or not. 

Caregiver CPR Training

All adults, caregivers, and pool owners should complete basic CPR training. In the event of a water emergency, Basic Life Support and rescue breathing skills can be lifesaving and improve outcomes in the critical minutes before EMS arrival.

Swimwear Color Matters 

Although the majority of childhood drownings occur when the child is not swimming, swimsuit color can help you identify your child while watching them swim. Bright, high-contrast swimsuits—like neon orange, yellow, or hot pink—are easier to see both above and below the water. While it won’t prevent drowning, it can help spot a submerged child faster. This viral photo from Step Into Swim has been popular on social media platforms in recent years. 

How Clinicians Can Help

Small changes during routine visits can go a long way toward drowning prevention:

• ▪️Ask about water access: Do they have a home pool? Is it fenced? Have the kids started swim lessons?

• ▪️Share resources: Help families find local swim programs or CPR classes—especially free or low-cost options.

• ▪️Normalize the conversation: Water safety is part of overall wellness. Make it as routine as bike helmets and seatbelts.

As clinicians, our guidance can have a lasting impact. By counseling caregivers effectively on water safety, we can help prevent drowning tragedies and ensure a joyful summer for the families we serve.