Rohit Shenoi, MD, breakdowns new AAP policy statement on drowning prevention

Drowning remains a leading cause of unintentional injury death among children in the United States, prompting the American Academy of Pediatrics (AAP) to issue updated recommendations emphasizing multiple layers of prevention and expanded access to water safety resources.^1,2

The revised policy statement, “Prevention of Drowning,” published in Pediatrics, outlines evidence-based strategies for clinicians, families, and communities aimed at reducing pediatric drowning risk. The guidance stresses that no single intervention is sufficient on its own and instead supports a comprehensive approach that includes supervision, swim instruction, pool barriers, life jacket use, and emergency preparedness.

“Drowning is the leading cause of death, unintentional injury death in children in the United States,” Rohit P. Shenoi, MD, FAAP, lead author of the policy statement and pediatric emergency physician at Texas Children’s Hospital and Baylor College of Medicine, said in an interview. “For several years, there were declining fatal drowning rates in children, but there's been an uptick in those rates recently.”

The policy statement notes that toddlers remain at the highest risk of drowning because they may gain unsupervised access to water quickly and quietly. Adolescents also remain vulnerable because of risk-taking behaviors and overestimation of swimming ability.

According to Shenoi, the updated recommendations are designed to reinforce the importance of “multiple levels of prevention.”

“No single method of drowning prevention is effective in preventing all drowning,” Shenoi said. “What this policy statement emphasizes [is] the need for multiple levels of prevention.”

Among the key recommendations is close, constant, attentive, and capable adult supervision whenever children are in or around water. The AAP also continues to recommend 4-sided isolation fencing around pools with self-closing and self-latching gates that separate the pool from the home.

Shenoi emphasized that water competency extends beyond basic swim instruction.

“The need for water competency…includes swimming skills, but also a knowledge of risk awareness, the safe behaviors in and around water,” he said.

The guidance also supports the use of properly fitted, US Coast Guard–approved life jackets for boating activities and for children who are weak swimmers. Adults are encouraged to model life jacket use.

“And then adults should model life jacket use as well,” Shenoi said.

The policy additionally highlights the importance of rapid rescue and resuscitation efforts during drowning emergencies.

“When drowning occurs, seconds matter,” Shenoi said. “So, there's really a need for early rescue and the emergency response, which includes resuscitation to save life.”

The updated recommendations also address longstanding racial, ethnic, geographic, and socioeconomic disparities in drowning deaths. Shenoi noted that Black children, Native Hawaiian and Pacific Islander children, and children living in rural communities continue to experience disproportionately high drowning mortality rates.

“What we've noticed is that the disparities in fatal drowning rates affecting certain racial and ethnic groups…are disproportionately affected in terms of fatal drowning rates,” Shenoi said.

According to the policy statement, barriers contributing to these disparities may include limited access to swim lessons, fewer aquatic facilities, financial constraints, shortages of lifeguards in underserved communities, and historical inequities that restricted access to swimming programs.

In response, the AAP recommends culturally affirming policies that expand access to aquatic activities and water safety education.

“What the AAP recommends is culturally affirming policies that encourage participation of people from diverse backgrounds in aquatic activities, expand the access of swim classes and aquatic venues, disseminate affordable and culturally appropriate water safety information and resources in multiple languages,” Shenoi said.

The guidance also includes recommendations for children with autism spectrum disorder, who may face an elevated drowning risk. Shenoi said adaptive aquatic classes can help support water safety skills for these children.

“One special note is for children with autism, too,” Shenoi said. “There's a need to have them enrolled in adaptive aquatic classes.”

The AAP continues to recommend that swim lessons may begin after a child’s first birthday when developmentally appropriate.

“The reason for this is that they have the motor skills in which they can be taught how to harness that and learn to swim,” Shenoi said. “Swim lessons should be an enjoyable activity too, and parents are participating as well.”

References

1. Shenoi RP, McCallin T, Farrell C, Yusuf S, Kendi S, Gilchrist J, Quan L, and the Council on Injury, Violence, and Poison Prevention. Prevention of Drowning: Policy Statement. Pediatrics. 2026. doi:10.1542/peds.2026-077410.

2. AAP. American Academy of Pediatrics Updates Recommendations on Drowning Prevention. AAP. Press release. May 18, 2206. Accessed May 18, 2026.