Drowning looks nothing like how many Hollywood movies and TV shows portray it. That misconception matters even more now, because after decades of decline, child drowning deaths are rising again in the United States.

What drowning looks like

“Drowning is very, very quiet,” says Dr. Meghan Martin, a pediatric ER doctor at Johns Hopkins All Children’s Hospital in Florida. You might also know her as Dr. Beachgem10 on social media.

She’s seen hundreds of children who’ve survived and died in drowning incidents and she explains, “There's not a lot of splashing or thrashing or screaming or yelling. They slip in and under the water, and that's the only sound.”

Dr. Martin adds, “In just seconds, a kid can slip away and they're underwater and it's done."

Why are more kids drowning?

Drowning is the leading cause of death for children between the ages of 1 and 4, according to the Centers for Disease Control and Prevention. 

Unintentional child drowning deaths in the U.S. fell from around 2,000 a year in the 1980s to below 1,000 a year by the early 2000s, thanks in part to public awareness campaigns, expanded access to swimming lessons, and adoption of pool fencing laws. Between 2000 and 2019, health officials saw a 38% drop.

But then the trend reversed, with the number of child drowning deaths rising from 756 in 2019 to 865 in 2024, the most recent year for which complete data is available. The bulk of them were children younger than 5. 

What happened?

The COVID-19 pandemic interrupted swimming lessons and lifeguard training programs, and contributed to a national lifeguard shortage. Meanwhile, some data suggests an increase in swimming pool construction and increases in unsupervised swimming, said Tessa Clemens, the CDC Foundation’s senior director for drowning prevention initiatives.

Some possible good news: Preliminary U.S. data for last year suggests child drownings declined. But it's not clear whether that's the start of a trend, and the deaths still remain higher compared to before the COVID-19 pandemic, Clemens said.

When everyone’s watching, no one’s watching

Dr. Martin says there should be one designated person to watch kids when they’re in a pool: “When everyone is watching, no one is watching.”

It's a warning the Leonard family knows all too well. Stew Leonard’s son was 21 months old when he drowned during a family vacation on the island of St. Martin in 1989.

More than a dozen adults and kids had gathered at a birthday party for Stewie's older sister, who was turning 3. Stew Leonard was outside hanging balloons and his wife was inside baking a cake.

“I saw Stewie outside and I assumed that he (Leonard) was watching him,” said his wife, Kim, noting that other relatives also were in the area of the pool.

“We never communicated with each other; ‘You’ve got him?’” said Kim Leonard, now 65. 

“There were a couple of balloons floating in the water,” Leonard, 71, recalled. “And you know after a few minutes, sort of everybody was like, ‘Where’s Stewie?’ Unfortunately I was the one who found him. He was face down in the pool.”

His death led the couple to start a foundation that pays for children’s swimming lessons and promotes drowning prevention.

Layers of protection

Long before children jump into the water, you need to have layers of protection in place:

• Door alarms and self-locking door locks with number pads
• Self-closing pool fences and pool covers
• Pool alarms (newer AI devices can spot kids in the water)
• Floaties: this is a big one — floaties are not a safety net. They can build a false sense of security. Also, because they keep kids vertical, they’re in the wrong position and can drown more easily if the floaties come off.
• Designate one adult as the "water watcher" — one person, no phone, sole job is watching the kids.

Dr. Martin’s biggest piece of advice? “If the child is old enough to be in the water, they are old enough to participate in swim lessons, or swim safety to some degree.”

Every adult should also learn CPR in case the worst happens: "When drowning occurs, seconds matter. Quick rescue and resuscitation can mean the difference between life, death and lifelong disability, " says Dr. Rohit Shenoi, the lead author of a recent American Academy of Pediatrics warning.

Stew Leonard adds, "I love ballet. I love karate. I love tennis lessons… But the only thing you can do to save their life is put them in swimming lessons."

The Associated Press contributed to this report.