Water Play, the Safe Way: Tips From a Pediatrician

Summer is almost here, promising days full of splashing in the pool and little toes digging in the sand. While water brings joy and life, it’s essential to remember the risks it carries. Stanford Medicine Children’s Health pediatrician Nadereh Varamini, MD, offers essential water safety tips to make summer water play safer for your child.

The importance of water safety

According to Dr. Varamini, drowning is the leading cause of injury-related death among children between the ages of 1 and 4, and it is the third-leading cause of unintentional injury-related death among children under 19 years of age. But the good news is, many of these deaths are preventable.

“It’s so tragic for families to lose a child,” she emphasizes. “That’s why it’s so important to prevent this type of injury.”

Water safety basics

The number one thing parents and caregivers can do to protect a child is to keep them within reach. Young children need vigilant supervision when they are near water.

“Just be present constantly and keep the children within arm’s reach of an adult, especially when they are under age 4. It only takes a second for a child to drown. It’s the amount of time that you look at your text, or if you’re fishing, you look at your fishing pole, or putting sunblock on another kid or on yourself,” Dr. Varamini advises.

“Caregivers need to give full attention to children. Not looking at a text, not looking at a book—just focusing on the children and truly being ready to catch them at every moment in case they’re going toward water.”

Dr. Varamini also recommends teaching children how to swim and simple water safety from an early age.

“We need to encourage learning how to swim from a young age,” she stresses. “It’s very important that they be water competent, learning swimming skills, learning how to help others at every age. It’s very important to be proactive about it.”

Water safety at home and in the pool

“For families with pools, limiting access to the water can reduce the risk of drowning by 80% if we have four-foot-tall fencing around the pools or bodies of water at home, which is impressive,” Dr. Varamini explains. “A fence can prevent kids that are under age 4 from reaching the water. The fence should have a self-closing or self-latching gate.”

Smaller amounts of water in the house, such as in tubs, buckets, kiddie pools, and even toilets, can be drowning dangers, particularly for children under age 1.

Older kids and teens, even those who can swim, aren’t immune to the dangers of the water. “For teenagers, the influence of alcohol and drugs is important to keep in mind,” Dr. Varamini notes. “Even if you’re the best swimmer, if you’re a lifeguard, I want you to have a buddy that can swim with you—someone that can hear you and call for help if you need help.”

Dr. Varamini shares additional tips for pool play:

Avoid roughhousing and running around the pool.

If there is no lifeguard present, there should be an adult present to monitor children.

Wear brightly colored swimsuits that are visible under water—neon colors like lime green, hot pink, and orange can help locate a child who is submerged.

No holding other people’s heads underwater.

Every adult and teenager should know CPR.

Open water safety

Enjoying water out in nature, be it the beach or rivers and lakes, brings different safety concerns in addition to what you need to be aware of at home.

“When you’re at the beach, you need to consider ocean rip currents,” Dr. Varamini cautions. “You need to educate kids on it, how to recognize it, and how to escape it. It’s the same for river currents. And definitely always constant adult supervision is important.”

Other things Dr. Varamini recommends when enjoying natural bodies of water:

Check with the weather report for storms or rough water.

Stay where there are lifeguards posted wherever possible.

Avoid swimming in murky water where you cannot see the depth.

Watch out for underwater hazards such as vegetation or animals.

Wear a Coast Guard–approved personal flotation device.

What to do if a child is drowning

If a near-drowning (non-fatal drowning incident) happens, Dr. Varamini urges caregivers to call for help immediately. She says that in addition, “they need to start CPR. It is very important for every adult and every teenager to learn how to do CPR and to conduct it correctly. I encourage parents and caregivers to take CPR and first aid courses. We need to use medical visits as opportunities to discuss water safety and preventive measures tailored to the child’s age and activities.”

Getting immediate medical help is essential, Dr. Varamini says, even if the child seems OK, walking and talking, as complications can develop within one to 24 hours after the event. It is crucial to monitor the child closely for the following:

Secondary drowning signs: Water irritates the lungs, causing inflammation, or fluid builds up hours later. Watch for the following signs: cough, chest pain, shortness of breath, fatigue or lethargy, bluish lips, or pale skin.

Brain injury from low oxygen signs: Confusion, change in behavior, memory issues, trouble walking or staying alert.

Aspiration pneumonia signs: Fever, cough, difficulty breathing.

Always seek emergency medical evaluation, monitor closely, and go to the emergency room if any of the above symptoms emerge.

Water safety is a multidimensional concern involving awareness, education, supervision, and community efforts to ensure that environments such as beaches, pools, and home water areas are safe for everyone, especially children.

Implementing these safety measures can significantly reduce the risk of drowning and ensure a safer environment for children around water.