Such was the case with four-year-old Elianna Grace, who was splashing around in her backyard pool in Bradenton, Florida earlier this month. After she accidentally swallowed water while playing a game in the pool—something her mother described as a “freak accident”—Elianna immediately threw up, but seemed to recover fine shortly after, according to ABC News. Just two days later, Elianna was struck by a fever that wasn’t letting up. Her mother took her to urgent care, where her heart rate spiked, oxygen levels dropped, and skin turned purple. From there, the two went straight to the emergency room. Remembering the 4-year-old boy from Texas who died last summer after inhaling water during a Memorial Day weekend trip, Elianna’s mother broke down crying, suspecting the same thing was happening to Elianna. “At that point, I had no clue how it was going to end,” she told ABC News. “I was so, so, so terrified.” Elianna was, in fact, experiencing “dry drowning” or “secondary drowning.” She was treated for aspiration pneumonia, a condition in which there is swelling or an infection of the lungs or large airways. She spent four days in the hospital, relying on an oxygen tank to breathe, and is slowly recovering. Here’s what you should know about dry and secondary drowning, how to spot the conditions, and what you can do keep your kids safe this summer.

What are dry drowning and secondary drowning?

Dry drowning and secondary drowning are often used interchangeably, and even have similar symptoms, but they are different conditions. Dry drowning occurs after you inhale water through your nose or mouth, spurring a spasm and blocking your airway, which prevents proper breathing, according to the American Osteopathic Association (AOA). Secondary drowning, which is also known as delayed drowning, involves ingesting water as well. Unlike dry drowning, though, the water makes its way to your lungs, which causes inflammation or swelling and impairs breathing over time, the AOA says.

What are the symptoms of dry and secondary drowning?

If your child accidentally swallows a large amount of water, he or she may experience trouble breathing, coughing, sleepiness or a drop in energy, irritability, chest pain, or vomiting. If you notice these warn signings, go to the hospital and have doc look into it. In the case of dry drowning, these symptoms will likely occur soon after the water is swallowed. In secondary drowning, the symptoms often don’t appear until a few hours—or even days—after the incident.

How can you prevent dry drowning and secondary drowning?

Just like any other kind of drowning, you can take a few steps to keep your kids safe from dry or secondary drowning while they swim. In addition to being alert while your child is in the water, have them take swim lessons as early as possible to learn proper water safety, the AOA recommends. Never let them swim alone and always make sure there are lifeguards around. The good news is, these conditions are both rare, so as long as you keep an eye on your kids while they’re in the pool and take note of any unusual symptoms, you should be able to enjoy the water with little worry this summer.