“This is our kid,” read the message I received from a colleague pediatric subspecialist. That is how I, as a primary care pediatrician, initially found out that one of our young patients had died during a tragic drowning accident. I loved this child. He had one of the most attentive, and most caring, families. It was hard to resist thinking about what I could have done differently as his pediatrician to prevent such an unthinkable tragedy.

Young children can be extremely active and fearless, putting them at high risk of injuries or accidents. When I conduct routine physical exams, I provide anticipatory guidance at the end of clinic visits tailored to the children’s developmental milestones. This advice typically includes reminders about water safety and supervision of adventurous young children. I often emphasize facts about childhood drowning.

(1) Drowning is silent. You should not assume that someone who is drowning will be able to shout for help or splash. In fact, over half of childhood drowning deaths occur in children ages 0-4 who may be unaware of what is happening and unable to call for help.

(2) Drowning is quick. A split second is all it takes for someone to go underwater. It can be tempting to want to relax on a hot summer day. Always stay vigilant and regularly check in with children and vulnerable people to ensure that they are safe.

(3) Watching your child in the water is your responsibility. Even if a lifeguard is on duty, there always must be a parent or caregiver assigned to be the “Water Watcher” at any given moment. Lifeguards, while a critical resource around water, must watch dozens of people. It’s easy for one child to get lost or go unnoticed by a lifeguard.

(4) Swim lessons are essential, but skill level varies. A child can become fatigued, or ocean tides can shift. Water is beautiful but very powerful and must be respected. There are free and accessible resources available in our communities, such as Swim Safe Boston, that offer life-saving water safety skills to children of all ages. Health equity must include swimming equity to reduce preventable drowning accidents.

I would be remiss as a pediatrician if I didn’t add another potentially overlooked reality. Children with epilepsy, autism, and cardiac arrhythmias are at higher risk for drowning. According to Autism Speaks, drowning is the leading cause of death for people with autism who wander.

Growing up, I had a family friend with autism who was enamored with the ocean. He was an excellent swimmer and loved spending hours in the ocean. The day he went missing on the beach as a child remains etched in my memory. Panic set in. Word quickly spread up and down the coast that a child with autism was missing. Thankfully, the community came together and with collective effort he was found safe. As a pediatrician, I know we cannot take that type of outcome for granted.

Accidents can happen to anyone, but there are things we can do to minimize the risk of tragedy. According to the Pediatrics Policy Statement “Prevention of Drowning,” parents and caregivers should always have an assigned caregiver who is watching the water at any given moment. Four-sided pool fencing should be installed for residential pools. Lifejackets should be used when in or on watercraft and should be considered for young children and non-swimmers when near bodies of water. Parents and caregivers should strongly consider learning CPR.

I would also advocate for all of us to be aware of our surroundings. If you see someone struggling in the water, say something. Do not assume someone else has also noticed and is taking action. You might be the first and only person to recognize the silent and quick signs of drowning. If you can safely do so, remove the person from the water and initiate life-saving measures. Otherwise, immediately notify the lifeguard on duty or call 911.

At the end of the day, we must all be Water Watchers. These are our kids.

Dr. Jennifer Fiore is a primary care pediatrician at Boston Medical Center and assistant professor of Pediatrics at Boston University Chobanian & Avedisian School of Medicine.