KNOXVILLE, Tenn. (WVLT) - Drowning is the leading cause of death in children ages one to four, other than birth defects. It is the second leading cause of death in teenagers, according to the American Academy of Pediatrics.

WVLT News anchor Brittany Tarwater has spent the last year working with families across the country who have lost children and loved ones to drowning who all had the same questions: Why isn’t the number one killer of babies a conversation pediatricians are having with parents at every well-child visit? Why aren’t there strict swimming guidelines every parent knows about? Thanks to the relentless efforts by families, especially one in East Tennessee, now there are.

LEVI’S LEGACY

Levi Hughes, 3, drowned two years ago on a summer vacation with his East Tennessee family. Now his parents, Nicole and Johnathan are creating nationwide change within the American Academy of Pediatrics and through Levi’s Legacy to save the lives of other children.

“Levi was our third child and our final one, we were very certain, we had two girls and a boy. He was such a boy too,” said Nicole.

Her son looked forward to their family’s favorite week of the year, an annual beach trip with five other families to Alabama.

“Levi has been as a two-month-old, a one-year-old, a two-year-old and he spent his final days on these beaches with these friends,” she said.

It was the night of their yearly crab hunt, the night the kids looked forward to all year long.

“My husband picked him up and shook him and said, ‘how many crabs are we going to catch tonight?’ And he said, ‘so many dad!’ We were eating dinner and cleaning up and we really weren’t doing anything,” said Hughes. “I went outside on the balcony, I was checking the weather and glanced over the balcony and looked over and he was in the pool and every time - It’s been two years - It’s still a shock.”

Levi was in the pool. In seconds he was gone.

“And I always think the story will end differently but it doesn’t,” she said.

That same day, on the other side of the country, another family went home without their baby. Olympic skier Bode Miller and his wife Morgan’s daughter, 16-month-old Emeline, drowned in their California neighbor’s pool.

Like Levi, Emmy also was not expected to be in the pool. In seconds she was gone.

“Every time I close my eyes at night to go to sleep it replays in my head,” said Morgan. “It happens so fast and under normal, everyday circumstances where life happens the way it has for years and it’s forever changed our families’ lives.”

The same pain that ripped their hearts apart is also bringing these two families together.

The Hughes and the Millers started working together to bring drowning to the front of the national conversation.

“We are failing them, our culture is failing them,” said Nicole. “I wrote this plea to the American Academy of Pediatrics, saying please let me help. It was summer and kids were dying every day.”

The AAP joined the fight with the two families and created new public service announcements to let other parents know about the importance of water safety.

The Hughes and the Millers also teamed up with chair of AAP Council on Injury, Violence and Poison Prevention, Dr. Ben Hoffman, to re-write national safe swimming policies that had not been updated in 10 years.

“It is a public health crisis. We’re talking about 12 kids a week who drown in the US. The standard American school bus holds 70 kids so we’re talking about nine plus school buses over the course of a year. If there was an infectious disease that was killing nine school buses of kids a year we would think of it as a public health crisis and it is. We need to re-frame the way we think of it. It’s just not acceptable for kids to be drowning at these rates,” said Hoffman. “I think the fact that we were able to use their voice to both elevate the problem within the AAP, to be able to get a policy statement done in six months which is like that had never been done before.”

Hughes has said her pediatrician never talked about drowning dangers, and never asked if any of her three children knew how to swim.

The new policy now recommends that conversation happens during checkups, a conversation Sophia Brizeus wishes her daughter’s pediatrician would have had with her.

“I was one of the parents and always thought it couldn’t happen, couldn’t happen to me,” said Brizeus.

It was a Sunday afternoon, at a relative’s house for family dinner.

"I hear the loudest gut-wrenching scream that no one should have to hear," she said.

Her daughter, Soraya, was two weeks away from her second birthday.

“When it happened I was planning her two-year-old birthday party and I ended up planning a funeral. Would you rather have a funeral for your child or pay for swim lessons?”

She said no one had told her that her daughter was more likely to die from drowning than anything else.

"I wish it would have with a conversation, you know, like, what is your water safety plan with your child? Getting them into the swim lesson, when can they start? What do they recommend is the starting point for them to start swim lessons, you know?"

Brizeus said she wants to see the conversation with pediatricians surrounding water safety to be as common as conversations about car seat safety.

“Because, I’m always here in my mind I feel like the one thing I always remember is the seat, always, don’t, don’t turn the baby around till they’re two and every time I left laughing when they would always say to me. ‘Remember don’t face around yet,’ like, ‘okay.’ So, I wish water safety is part of that.”

Pediatricians talking to parents about water safety and suggesting swim lessons begin at one year old are now part of the national recommendations. It’s not required, but it is suggested that doctors adopt the policy.

A year after losing Levi, the Hughes welcome baby Willow into their family. When she turned 8 months old she started swim lessons to learn to roll to float on her back and breathe.

“It was just so empowering. It was awesome. Of course it was just the gut punch that if she is this capable at 8 months what could he have done at three and that he had to be the sacrifice for her to have to learn this.” said Nicole.

Within weeks of Levi’s death, his parents started Levi’s Legacy, spreading the word about water safety to encourage families to appoint a water guardian even when children are not swimming, but have access to water.

COVID-19 SUMMER

Drowning is already the leading killer of children and this year experts worry there is an even higher risk. The COVID-19 pandemic is bringing with it extra threats for which parents should be prepared.

Chair of AAP Council on Injury, Violence and Poison Prevention, Dr. Ben Hoffman, said Florida’s drowning rates have already increased compared to 2019.

"It's 100 percent, compared to last year. Kids are going to be exposed to that water a lot more often. So, I'm really worried about this summer," he said.

With more people staying home during the pandemic, Dr. Hoffman said daily routines are shifting and families are spending more time at home. Market research firm the NPD Group has reported swimming pool sales are up 161 percent compared to 2019, meaning more kids have access to water.

“For families that have standing water on their property, whether it’s in-ground pools and above ground, or a creek or a lake. You know, kids are going to be around those more often I think parent’s and caregiver’s ability to provide that constant capable supervision is going to be complicated just because it’s so constant and unrelenting need for that supervision. So, I think the issue of providing barriers to access to water is going to be more important than it’s ever been before,” said Hoffman.

Andrea Montoya was in the process of installing a fence around her Florida backyard pool in May, but because of the pandemic, she said the company told her they couldn’t come. The next week, her 14-month-old son, Sylas, escaped their home through the doggy door and drowned.

“Nobody should wait a single day to install a pool fence if your home has a pool. It’s the only barrier between your home and that pool. We had reached out to a company a week before the accident because he was just starting to walk but they weren’t able to come by on time because of the pandemic and it took us losing sight of him momentarily in our own home to lose him forever. Every second could mean their life,” said Montoya.

Montoya started The Sylas Project to raise awareness of water safety and provide scholarships for swim lessons.

A SILENT KILLER

Drowning doesn’t happen like most people imagine. There is rarely splashing and yelling for help. It’s silent and can happen in a matter of seconds. The Centers for Disease Control and Prevention reports an average of ten people die from drowning every day — a quarter of them are children. Most child drownings happen like Deborah Blizzard’s two-year-old granddaughter Brooklynn, in a backyard pool.

“It was the worst day. I was at work. My daughter, Holly and her came home and they were out playing. Brooklynn wanted to go swimming,” said Blizzard.

Brooklynn didn’t know how to swim. She was told to wait until after a nap to go in the water. Brooklynn unlocked two deadbolts while her mother was sleeping to get to the pool.

“She was underneath the float,” she said.

Brooklynn died that day in 2018.

“We miss her so much. But I know she’s watching us.”

Blizzard started Swim for Brook to bring awareness to water safety.

LAYERS OF PROTECTION

Like Brooklynn, the AAP reports nearly 70 percent of drownings happen when children aren’t expected to be in the water.

“And so, for parents to make sure that not only is the water, you know that if the child is around the water that they can’t get in, but that kids can’t get to the water outside of the house where they’re not supposed to be. It can never be one thing to drown a child because that’s impossible so it has to be multiple. It has to be everything basically,” said Hoffman.

Nothing can drown-proof a child, but there are layers of protection the AAP recommends to be proactive:

Always wear a life jacket on the open water, but don’t rely on flotation devices for protection.

Check for four-sided fences around pools with latches that lock high enough to be out of reach of children.

Pool alarms are required by law in Tennessee in pools built since 2011. There are alarms to monitor movement that stay in the pool and alarms that go off when a door opens.

Read more about the Knox County pool code here.

Don’t store toys in the pool, they can tempt young children to jump in.

Swim lessons are proven to make children nearly 90 percent less likely to drown.

Nothing replaces supervision. Designate a water guardian who knows CPR (sign up for CPR training here). That person should never, even for a moment, leave children unattended around water.

ADDIE’S STORY

Emily and Jordan Friske said it was CPR that saved their daughter’s life.

“I just kept going this is not happening to us, this isn’t happening to us.”

Emily replays the moment in her mind. Just moments before were like any other day.

“I have the girls and just finishing up lunch and Jordan came home and he, you know, kind of, was going around the house just doing regular your work at home, type things,” she said.

The couple has two young girls, Adelaide, 2, and Josefina,1. Until they close on their new house, they’re staying with her parents, who have a backyard pool.

“Josefina crawls around to kind of her side of the couch and by the back door and I noticed the back door was open,” said Emily.

Addie was in the pool.

“I dropped everything I have the baby in my hand still I run out to the pool area, and I see her floating in the shallow end, and she’s not struggling, she’s not breathing she’s not responsive, she’s blue. She’s on her side and she’s laying she’s just kind of like dangling. And so I screamed her name, I screamed, ‘Adelaide!’ And I jumped in the pool, but I held the baby up, you know above water, and I pulled Adelaide out with my other arm.”

Emily, a former emergency medical technician (EMT), started CPR. She and Jordan took turns for 12 minutes doing CPR and calling for help.

Doctors at the hospital worked to revive her. They said Addie went without a pulse for more than 20 minutes.

Until, finally.

“We got a pulse back, and she’s breathing, and we just fell to the ground and we thanked God,” said Emily.

Doctors told Emily and Jordan it was CPR that saved their daughter’s life.

“We routinely would watch CPR, videos. We see them on Instagram and YouTube. But just to keep them in the back of our brains almost like if you ever do need it is muscle memory your brain knows exactly what to do. So, our doctor had said, when I was able to go into the trauma room with Addie, she goes, ‘I heard you were the one that did CPR on her.’ And I know through tears I said, ‘yeah, that was, that was me and my husband were the first ones there.’ And she held my hand and said ‘had she not gotten CPR so quickly, and so effectively. We would be looking at a different outcome,” said Emily.

Now, the couple is using their story to urge other families to learn CPR.

“CPR is what saved our daughter’s life,” said Emily. “And it’s what gave us her back.”

Emily and Jordan said Addie is back to her old self and they know she’s one of the lucky ones.

East Tennessee Children’s Hospital has said it usually treats 50 kids per year for serious, but not deadly, drowning events. Non-fatal drownings can cause severe brain damage that can lead to long term problems, learning disabilities and even permanent loss of basic functions.

Not just swimming pools, all it takes is a few inches of water and a matter of seconds.

“An inch of water in a bathtub for an infant is, is absolutely a threat. I personally have seen kids who have drowned in buckets, toilets, little plastic wading pools in the back yard. I’ve seen kids drown in bathtubs when the parents got up to answer a phone call. A child in water, a child around water is always a risk,” said Dr. Hoffman. “All it takes is a little bit of water, and a face, and drowning can happen.”

WHAT PRODUCTS ARE SAFE?

Knowing the truth about safe swimming products will provide an extra layer to keeping children protected in the water. Blow-up swim wings and inflatable rings are not United States Coast Guard approved safety devices. Dr. Hoffman said a good rule of thumb is if it can be blown up with a mouth, it is a toy.

“Anything that inflates anything that’s blow up. We can’t consider it anything more than a toy. And so, you know, the blow-up floaties and those sorts of things. Those are not safety devices, those are toys and we would urge parents, not to use those as if they were protective because there are just too many risks associated with them. They can lose air, they’re just not built they’re really not built for that. Anything that a family would use should be Coast Guard approved,” he said.

Even some foam products aren’t proper safety devices. If a product is U.S. Coast Guard approved, you’ll see a mark indicating it is approved. Dr. Hoffman said to make sure all products are worn correctly to best protect your child and remember nothing replaces supervision.

TEENS AT RISK

While most young children and babies drown in pools, teenagers are most at risk in our open water. The American Academy of Pediatrics has claimed drowning as the second leading cause of death in teenagers behind only car crashes.

Last summer Alexis Shirley, 13, died when she drowned at Peery’s Mill Dam in Townsend. Her mother, Renee Ritchie, said she slipped on a rock and the current of the dam pulled her under.

“Your world can literally turn upside down in a matter of minutes. You think you’re going to have a fun day and then the next thing you know your whole world is completely different,” she said.

Ritchie convinced the state to put up warning signs in the area for swimmers.

“Maybe someone will listen. Maybe their outcome will change,” she said.

Tennessee Wildlife Resources Agency reported in 2019 there were 13 people who died on Tennessee Waterways, 70 percent are from drowning.

“It’s not the same as being in the pool as it in in the open water you have a lifeguard most of the time and you don’t have the currents and temperature changes and the obstacles that can be in the open water,” said Knox County Rescue Squad Deputy Chief John Whited.

Connor Gage was 15-years-old when he drowned after jumping off a dock at a friend’s birthday party.

“That was the day our very happy family of four turned into a very broken family of three,” said Connor’s mother, Dana Gage.

She said he was an athlete and a strong swimmer who had grown up on lakes in Texas. He was not wearing a life jacket when he jumped in. It was eight years ago. Dana started The LV Project in Connor’s name to encourage everyone on the open water to wear a personal flotation device.

“I just feel like the day we lost him, you know, it’s not the end like it’s my job now to tell moms to tell families. This could be you know you never think it’s going to happen to you, but drowning rates triple at age 15 and open water, and the rates remain elevated throughout adulthood. It’s our teenagers and our adults who were losing, and in lakes, because and most of those are in swimming not in boating accidents. So, you know, just like you buckle up in the car, you got to buckle up at the lake and people don’t really realize that,” said Gage.

A PUBLIC HEALTH CRISIS

The American Academy of Pediatrics has called drowning a public health crisis, but there are some people who are more likely to die from drowning than others.

“We see that there is a huge racial disparity,” said Dr. Hoffman.

Drowning does not discriminate, but there are some who are at a higher risk. According to the CDC Blacks and Hispanics are five times more likely to drown than whites.

64% of African Americans have little to no swimming ability

45% of Hispanics have little to no swimming ability

40% of Caucasians have little to no swimming ability

80% of drowning victims are males

USA Swimming also notes that parents who do not know how to swim are far less likely to teach their children how to swim.

“Swimming Pool deaths tend to happen more for white kids and for the 15 to 19-year-olds that tend to be males and especially African American males and that’s really related to the often to the, to the lack of swim lessons and trying to highlight this idea that swim lessons should be considered part of anybody’s toolkit that being able to protect yourself from the water. Water competence is really an essential life skill,” said Hoffman.

Because of the pandemic experts are worried fewer children are learning how to swim in a safe environment. The Boys and Girls Club of the Tennessee Valley typically offers free swim lessons as part of its summer camp. The Emerald Youth Foundation usually offers reduced cost lessons during the summer. Both have been canceled this summer.

SAFE SWIMMING FOR LIFE

There are options in East Tennessee for swim lessons from private businesses and non-profit organizations.

“What will be with them for the rest of their lives and that is the ability to swim. It goes so beyond the ability to save your toddler, but gosh that should be enough,” said Nicole Hughes whose son, Levi, drowned in 2018.

ISR LESSONS

Infant Swimming Resource (ISR) is also referred to as survival or self-rescue swim lessons. ISR typically begins lessons when a child is as young as six months old, submerges a child underwater and teaches a repetitive movement of flipping over to float on their back and wait for rescue. Once the child has mastered the movement, they are tested wearing clothes and shoes to be prepared for a situation where they are not expected to be swimming. It typically takes six weeks of daily lessons for a young child to learn this technique.

TRADITIONAL LESSONS

Traditional swim lessons can begin for children as young as six months old. Children learn fundamental survival skills like rolling to float on their backs and fronts at a pace that challenges the child while gaining confidence in the water. They also learn key skills like holding their breath underwater, blowing bubbles and kicking. These lessons teach proper swimming techniques that lead to learning strokes.

Continuous lessons make a child 88 percent less likely to drown, according to USA Swimming. The American Academy of Pediatrics recommends children begin swim lessons at one year old.

The USA Swimming Foundation provides grants to support swim lessons across the country.

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