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Safety & Prevention

Water Safety for Children with Special Health Care Needs

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​By Hailey Nelson, MD, FAAP, IBCLC

When the weather warms up, families often head to the pool, lake, or beach to cool off and have fun. Water play can be a wonderful way for kids to exercise, relax and socialize. But for children with special health care needs, a few extra precautions can make all the difference in keeping everyone safe.

Below are important water safety tips for children with medical conditions or developmental differences—because all kids deserve a safe splash this summer!

Start with universal water safety

Whether your child has special health care needs or not, these tips are essential for everyone:

  • Use U.S. Coast Guard-approved life jackets near open water (even for strong swimmers).These life jackets have been thoroughly tested and must meet strict safety and performance standards.

  • Provide constant, close adult supervision—no distractions!

  • The adult "water watcher" should put their cell phone down so they can focus on monitoring young swimmers.

  • Encourage swim lessons as early as your child is ready (adapted programs are available!).

Children with g-tubes (feeding tubes)

Yes, your child can still enjoy the pool if they have a gastronomy tube (g-tube)—but here's what to know:

  • Wait at least 4 months after tube placement to swim, and always check with your child's doctor first.

  • Stick to clean, chlorinated pools. Avoid lakes, rivers or oceans due to higher bacterial levels that could lead to infection.

  • Cover the stoma (tube site) with waterproof dressing (like Tegaderm) during water play.

  • After swimming, gently clean and dry the site​​​ and follow your usual tube care routine.

Children with epilepsy

Water safety becomes even more important if your child has a seizure disorder. Here are a few tips to keep them safe in the water:

  • Always assign a "water watcher" whose only job is to supervise swimmers—no phones or chatting!

  • Provide"touch supervision"—stay within arm's reach of your child at all times.

  • Swim where there are lifeguards, or someone trained to respond if a seizure occurs in water.

Children with a tracheostomy

A tracheostomy or "trach" helps your child breathe—but it also creates a direct path for water to enter the lungs. That's why:

  • Avoid submerging a child with a trach in any body of water.

  • Get creative with water play: Try splash pads, water tables, misting fans, or squirt toys instead.

  • Supervision is essential, even for shallow or sensory play areas.

Children with autism spectrum disorder

Children on the autism spectrum may be drawn to water—and not always recognize the dangers. Here's how to help:

  • Make sure pools are fenced on all 4 sides with a self-latching gate. The fence should completely separate the pool from the house and the rest of the yard.

  • Keep pool doors and gates locked and alarmed if possible.

  • Supervise constantly, even if your child can swim.

  • Swim lessons tailored to children with autism can help build skills and awareness of water safety.

  • Use visual schedules or social stories to help your child prepare and understand pool rules.

Children with cerebral palsy

Water can be especially therapeutic for kids with cerebral palsy:

  • The weightless feeling of floating can relieve tight muscles and reduce discomfort.

  • Use adaptive flotation devices as needed for safety and comfort.

  • Consider programs like adaptive swim therapy, which combine physical therapy with water fun!

Remember

Taking just a few extra steps to plan for your child's unique needs can turn a day at the pool into a safe and joyful experience for the whole family.

Water safety is for everyone—especially our most vulnerable kids. Talk to your pediatrician about the best water play options for your child, and dive into summer with confidence!

Stay safe and be well.

More information


About Dr. Nelson

Hailey Nelson, MD, FAAP, IBCLC, is a complex care pediatrician at Valley Children’s Hospital in Madera, California. Dr. Nelson enjoys working with children of all ages and abilities and is especially passionate about providing the best possible care to medically fragile children and their families. She is also a licensed breastfeeding consultant, certified by the International Board of Lactation Consultants to support nursing mothers and their babies.

Last Updated
5/22/2025
Source
American Academy of Pediatrics Council on Injury, Violence & Poison Prevention & Council on Children With Disabilities (Copyright © 2025)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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