Drowning remains the leading cause of death for children ages 1 to 4 and recent trends are moving in the wrong direction, according to Dr. Alicia Bazzano, director of pediatric emergency services at MedStar Montgomery Medical Center.
Bazzano said drowning deaths among young children increased significantly between 2019 and 2022, prompting the .
“About 500 more children died during that period, and drowning deaths among children ages 1 to 4 were approximately 28% higher in 2022 than in 2019,” Bazzano said.
The updated recommendations emphasize that swim lessons alone are not enough to prevent drowning. Instead, the academy is urging families to use multiple layers of protection, including water competency, close supervision, life jackets and barriers around pools.
Water competency includes swimming skills, understanding water hazards and knowing how to respond in an emergency, Bazzano said.
“The strongest evidence-based protection for young children is a four-sided fence that completely separates a pool from the house and yard,” she said.
Bazzano also stressed the importance of assigning a dedicated “water watcher” whenever children are near water.
“Most childhood drownings aren’t happening because parents don’t care,” she said. “Toddlers are fast, water is quiet and adults can get distracted.”
She noted that drowning risks extend beyond swimming pools. Children can drown in ponds, drainage ditches, bathtubs, oceans and even large buckets of water.
Bazzano said the rise in drowning deaths overlaps with the COVID-19 pandemic, when many families lost access to swim lessons, public pools and lifeguards. But she said the larger issue is ensuring all children have access to water safety education and safe places to swim.
The updated guidance also addresses racial disparities in water safety. Bazzano said many nonwhite children, including African American children, have fewer opportunities to access swim lessons, water safety education and aquatic facilities.
“If we want to reduce drowning, we have to make those opportunities available to all children,” she said.
Community programs can help close those gaps, Bazzano added, pointing to local pools, community organizations and programs for children with disabilities, including Special Olympics.
To underscore how quickly drownings can happen, Bazzano shared a personal story involving her own family.
When her daughter was 2 years old, she fell into a pool during a gathering while her father, also a pediatrician, was watching nearby.
“There was no noise,” Bazzano said. “He saw her little scared face looking up at him as she was falling into the water.”
He immediately jumped in, fully clothed, and pulled her out.
“Had he not been watching closely, that could have ended very differently,” she said.
Bazzano urged families to enjoy the water this summer but to do so safely.
“Get outside, swim, play in the water and make great memories,” she said. “Just use layers of protection and prepare so that you can enjoy it safely. I’d much rather see you at the pool than see your child in my ER.”
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