In the latest installment of our conversations with Fort Worth newsmakers, Candle Johnson, a certified pediatric nurse practitioner at Cook Children’s Renaissance Neighborhood Clinic in south Fort Worth, discusses safe sleep for babies one year and younger. 

This conversation has been edited for length and clarity. For a longer version, please listen to the audio file attached to this article.

Alexis Allison: So Candle, Cook Children’s recently released a report about infant deaths related to unsafe sleep. First, can you tell us what unsafe sleep is? Also, what did the report find?

Candle Johnson: Over the last year, Cook started to follow the death tolls for unsafe sleep and it was actually higher than fatal gunshot wounds and drownings. In the last year, it was 30 infant deaths from unsafe sleep.

Unsafe sleep (occurs) with co-sleeping with either two parents, or one parent or a caregiver, in a bed with them, finding them to have been rolled over on or wedged between a pillow or wedged between the bed and a nightstand or have suffocated by some device or a blanket or stuffed animal or something being in the bed at the time when they were found unresponsive.

Allison: Which babies are at risk for this?

Johnson: Anyone from one year and under, starting from the day that they’re born. It is important for the families to understand that these babies should sleep in a crib or bassinet alone, without any blankets, pillows or stuffed animals. It makes for a safe environment for them when it comes to sleep.

Allison: Big picture — why is this happening? 

Johnson: A lot of times when things are swept under the rug in families, we tend not to focus on them. We focus more on, like, ‘Oh, make sure you have a car seat,’ feeding, but we’re not paying attention to sleep. I feel that, in that first year of life, there’s a lot of learned behavior that needs to be addressed. Maybe great Grandma slept that way with their mom, or their mom slept that way with them. And there’s a myth: ‘This won’t happen to me.’ Or, it’s easier for me to do this at night because I’m so exhausted. Another form of this: ‘I feel safer when my baby is with me in the bed next to me because I’m able to attend to them a lot faster.’

Want to learn more about safe baby sleep? 

The Center for Children’s Health at Cook Children’s offers resources, including Zoom training, about safe sleep.

Allison: What are some of the other circumstances that can lead to these deaths that you’ve encountered?

Johnson: So a lot of times too it’s just a knowledge base. When they leave the hospital, they are informed about not co-sleeping, but it’s very brief. And they’re getting so much other information. It is a lot when you go through delivery — it’s almost like a blur. 

The other thing is cultural. We are noticing that it is a higher level of deaths in the Black community. Second leading is Hispanic. And a lot of times, they may not have a lot of trust in the medical system. So feeling that we are just telling them this to spend more money. ‘I have a bed so we can sleep here. And this hasn’t happened to any of my other children or any of anyone that I know. So it may not happen to me.’ Or, ‘A crib and a bassinet is too much for me to afford.’ 

Allison: So if you encounter a family who says, ‘We don’t have as much trust in the medical establishment,’ or ‘This has been done in my family and no one’s gotten hurt,’ how do you address that with them?

Johnson: So I tried to address it with them by first sympathizing with what they’re saying, but also giving them information on why this is important. I then go in and say that I’m a parent, too. I think that really resonates well with them to know that who they are speaking with has a child of their own. 

I explain to them that we do understand some of the misconceptions/false beliefs is that it couldn’t happen to them, but really, no one is exempt. 

And I always want to be proactive rather than reactive. So I can give you all the tools, all the knowledge, to know what’s important so we don’t ever have to go through the tragedy. 

Allison: Is there anything else that you’d like to add anything else that you think we need to know?

Johnson: Unsafe sleep habits are preventable. And our job as parents is to keep our children safe. Our whole life, we’re going to be battling on keeping our children safe. I don’t want to battle keeping our children safe on the first year of life. 

Because of unsafe sleep habits, I think I want to give our children a chance to thrive. As a provider, we really love your children. We actually take them on as ours because, when you come in to see your (primary care physician), we pretty much raise them from newborn to 18. So they become a part of our family. 

And our goal is to give you all the tools, all the knowledge, everything to be a successful parent. And when we are pleading with you to get a crib or to get a bassinet and to make sure that your baby is in a crib or bassinet with no blankets, no stuffed animals, no pillows, actually sleeping in a onesie or sleep sack … We are asking that because we don’t want to see the fatalities that we’ve seen over the last year. 

Alexis Allison is the health reporter at the Fort Worth Report. Contact her at or via Twitter.

Her position is supported by a grant from Texas Health Resources. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

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Alexis AllisonHealth Reporter

Alexis Allison covers health for the Fort Worth Report. When she can, she'll slip in an illustration or two. Allison is a former high school English teacher and hopes her journalism is likewise educational....