After 4-year-old Frankie Delgado died days after inhaling water at Houston’s Texas City Dike in 2017, his parents shared what happened with news outlets. Almost a year later his story saved another child’s life.

When Lacey Grace’s daughter, Elianna, inhaled pool water and started having odd symptoms, Grace remembered Frankie's story and thought Elianna might be experiencing the same thing, secondary drowning. Grace took her daughter to the emergency room and doctors put Elianna on antibiotics to treat the infections caused from water in her lungs.

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Drowning, secondary drowning and dry drowning
With such high-profile stories about near-deaths and deaths from delayed drownings, the water can feel like a scary place. What’s secondary drowning? How’s it different than dry drowning? Should you rush to the emergency room every time your child swallows water?

Probably not.

"Kids swallow water all the time and that is not something that is going to cause an aspiration event," Dr. Kristin Stukus, assistant professor of pediatrics in the division of emergency medicine at Nationwide Children's Hospital in Columbus, told TODAY. "When I get concerned is when there is a submersion event for longer than 30 seconds."

The experts want people to know that drowning remains a bigger risk.

“Drowning is one of the leading causes of death among children, especially in kids under 12 and especially in males,” Dr. James Callahan, associate medical director of the division of Emergency Medicine at Children’s Hospital of Philadelphia, told TODAY.

As for secondary and dry drowning, they are less common but can be dangerous.

“Seven to 10 deaths might be related to (delayed drowning),” Callahan said. “These delayed events are tragic. But it is less than one to two percent than all of the drowning injuries.”

Dry drowning and secondary drowning are often used interchangeably but they are different.

“These are all submersion injuries,” Callahan explained.

He recommends that parents seek help for their children after a water incident if they:

  • Throw up
  • Cough persistently
  • Struggle to breathe
  • Act lethargic

Dry drowning
Dry drowning occurs when people inhale water and the vocal cords spasm and close, trapping the water in the mouth or nose, which causes asphyxiation.

“If you get enough water in quickly the muscle in the top of the airway close,” Callahan said.

When this happens people look like they are choking and turn blue.

Secondary drowning
People who experience secondary drowning also inhale water but it gets into the lungs. At first, it might not be apparent and people experiencing this often worsen over time. Parents will notice rapid, labored breathing over 24 hours.

“They have significant coughing that persists and it seems to be fairly fast breathing or breathing that looks labored,” Callahan said.

They’ll also seem lethargic and “off.”

“A child that seemed OK and was in the water and active and playful and has an event and suddenly is sleepy that can be because they are having trouble getting oxygen,” Callahan said.

How to keep kids safe in water
One way to prevent drowning is by teaching children how to swim. Callahan recommends that parents learn CPR, encourage their children to wear life vests and only swim in safe areas. Having good supervision, such as a designated watcher, can make sure that a child doesn’t dip below the water.

"Drowning is a not a loud noisy event. It is kids slipping below the surface," Stukus said. "I can treat infection, I cannot treat (lack of) oxygen to the brain ... watch your kids at all times."