
When it comes to sleep, there are many considerations to keep in mind to ensure your toddler's safety and comfort. One common question that arises is whether it is suitable for an 18-month-old to sleep with a pillow. While some sources recommend introducing a pillow to a toddler's sleep environment after they transition to a bed, which can happen between 18 months and 3.5 years, others suggest waiting until they are closer to 3 years old. Additionally, it is recommended to choose toddler-specific pillows that are smaller and firmer, providing neck support and promoting healthy spine alignment. However, it is crucial to prioritize safety by reducing the risk of suffocation and other hazards in the sleeping environment.
| Characteristics | Values |
|---|---|
| Recommended age for pillow introduction | 18 months or older |
| Risk factors | Suffocation, SIDS, SUDC |
| Pillow type | Small, thin, firm |
| Pillow material | Hypoallergenic, breathable, untreated, polyester fiberfill, memory foam |
| Other considerations | Child's preference, development of motor skills, allergy risks |
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What You'll Learn

The risk of SIDS and suffocation
Sudden Infant Death Syndrome (SIDS) is the sudden and unexplained death of a baby younger than 1 year old. SIDS is the leading cause of death among infants 1 month to 1 year old, and remains unpredictable despite years of research. Most SIDS deaths are associated with sleep, which is why it's sometimes called "crib death". Even so, the risk of SIDS can be greatly reduced.
According to the Consumer Product Safety Commission, it is recommended that parents wait to introduce pillows to their child's sleep routine until they are at least 18 months old. This is because the risk of sudden unexplained death drops dramatically once a baby turns 1 year old, but it is still a concern in terms of what you place in their crib for a little while longer. Toddlers up to 18 months old may still become overwhelmed by objects in their crib and face suffocation.
Some sources suggest that once your child reaches 18 months, it is generally safe to introduce a pillow to their sleep environment. However, it is important to choose the right pillow. A small, thin, and firm pillow is ideal for toddlers. A firm pillow provides better support for a toddler's neck and promotes proper spinal alignment. Hypoallergenic pillows are also recommended as they can reduce the risk of allergic reactions or rashes.
It is important to note that the transition to a toddler bed or mattress on the floor is also a factor in reducing the risk of SIDS and suffocation. Toddlers who are still sleeping in a crib should not have a pillow, even if they are over 12 months old, as pillows can pose a hazard in a crib. The American Academy of Pediatrics recommends room-sharing without bed-sharing. They suggest that infants sleep in their parents' room on a separate surface, such as a bassinet or crib next to the bed, for at least the first 6 months to lower the risk of SIDS.
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The transition to a toddler bed
Timing the Transition
It is generally recommended to wait until your child is closer to three years old to transition them to a toddler bed. Research suggests that transitioning at this age results in fewer bedtime struggles, longer stretches of night sleep, and decreased night wakings. While the ideal age range for this transition is between 2 to 4 years old, it is important to consider your child's unique development and readiness. Some toddlers may be ready earlier, around 18 months to 2.5 years old, especially if they are regularly climbing out of their cribs. However, younger toddlers may struggle more with the lack of physical boundaries associated with an open bed. Therefore, if sleep issues are present, it is advisable to address them first and establish solid independent sleep skills before transitioning to a toddler bed.
Safety Considerations
When transitioning to a toddler bed, safety should be a top priority. Ensure that your child's room and sleeping environment are safe and secure. Get down to their level and look around for any potential hazards, such as electrical sockets, cords, unsecured furniture, climbable objects, unlocked windows, or access to unsafe areas. Consider using a baby gate at the door or the top of the stairs to create a safe boundary. Additionally, when transitioning to a toddler bed, it is important to reinforce safe sleeping practices. Keep the bed clear of pillows, toys, blankets, and other suffocation hazards, especially if your child is under two years old and still sleeping in a crib. Once they transition to a toddler bed, you can introduce a small, thin, firm pillow designed specifically for toddlers to support their developing necks and reduce the risk of suffocation.
Communicating the Change
Involve your child in the process and communicate the change to them effectively. Talk about the transition as a sign of their growing independence and reinforce your expectations, such as staying in bed after you leave the room. Let them know that you are proud of their ability to follow rules and listen to your instructions. You can also motivate them with positive reinforcement, such as a sticker chart or small rewards for each night they stay in their new bed. This will help create a sense of excitement and encourage them to embrace the change positively.
Gradual Transition
If possible, start by transitioning to a toddler bed for naptime only. This allows your child to get used to the idea of a bed during the day when you are not fast asleep. Once they get comfortable with the concept, you can gradually transition to using the toddler bed at night. Additionally, consider using a toddler bed in a childcare setting or daycare to ease them into the change gradually.
Creating a Safe Sleeping Environment
Whether transitioning to a toddler bed or still using a crib, creating a safe sleeping environment is crucial. Ensure that the crib or bed is away from any objects with ties or strings, such as window blind pulls, curtains, or electrical cords. Keep the crib mattress in the lowest position or consider removing the crib side to make it more challenging for your toddler to climb out. You can also push the crib into the corner of the room to block potential climbing sides. These simple adjustments can help extend the use of the crib and delay the transition to a toddler bed until your child is developmentally ready.
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Hypoallergenic pillows
The general consensus is that it is safe for an 18-month-old toddler to sleep with a pillow, provided it is small, firm, and hypoallergenic.
The transition from a crib to a bed is a significant milestone for toddlers and usually occurs between 18 months and 3.5 years of age. Once your child reaches this age, they can sleep safely on their back, stomach, or side. It is also generally considered safe to introduce a thin blanket and a small pillow to their sleep environment.
However, it is important to note that the risk of sudden infant death syndrome (SIDS) and its cousin, sudden unexplained death in childhood (SUDC), are still relevant concerns for toddlers over one year old. Therefore, creating a safe sleeping space is crucial. Ensure that your toddler's bed is clear of any objects with ties or strings, such as window blind pulls, curtains, or electrical cords. Additionally, keep blankets, pillows, and stuffed animals small enough so that your toddler cannot use them to climb out of their bed or crib.
- KeaBabies Toddler Pillow: This pillow is made from organic cotton and is highly rated by parents for its comfort and spinal support. It is washable and durable, making it an excellent choice for everyday use.
- Little Sleepy Head Toddler Pillow: This pillow is designed to provide better neck support with its ergonomic design. It is made from 100% cotton and comes with a snug-fit envelope pillowcase. The pillow is hypoallergenic and machine washable, making it a practical choice.
- A Little Pillow Company's Hypoallergenic Toddler Pillow: This pillow is made from 100% plant-based, USDA Certified Organic cotton. It features an adjustable loft, allowing you to customize the height, firmness, and softness by adding or removing filling. This pillow is also machine washable.
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The right size and type of pillow
The Consumer Product Safety Commission (CPSC) and the American Academy of Pediatrics (AAP) recommend that babies sleep in an empty crib without any pillows for at least the first 12 months of their lives. This is because pillows can pose a choking or strangling hazard, and the risk of sudden infant death syndrome (SIDS) is higher during this period.
However, once your child reaches 18 months of age and transitions to a toddler bed, you can consider introducing a small, thin, and firm pillow designed specifically for toddlers. Toddler pillows are typically smaller than standard adult pillows, measuring around 13 by 18 inches. They are designed for smaller heads and provide better support for the developing necks and spines of toddlers.
It is important to choose a pillow with hypoallergenic and untreated materials to reduce the risk of allergic reactions or rashes. Additionally, ensure that the pillowcase is breathable and fits snugly to avoid any loose material that your child could get caught in.
Some signs that may indicate your toddler is ready for a pillow include propping their head up on a rolled-up blanket or toy, or laying their head on a pillow when sitting on a couch or another bed. Ultimately, the decision to introduce a pillow should be made based on your child's comfort and development, and it is always recommended to consult with a pediatrician for professional advice.
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The need for a pillow
The transition from a crib to a bed is a significant milestone in a toddler's life, and it is natural for parents to wonder when their child is ready for this change. While there is no one-size-fits-all answer, there are some general guidelines and safety considerations to keep in mind.
The Consumer Product Safety Commission recommends that toddlers should start using pillows when they are 18 months old. This recommendation is based on reducing the risk of sudden infant death syndrome (SIDS) and its variant, sudden unexplained death in childhood (SUDC). SIDS is generally associated with babies up to 12 months old, while SUDC applies to toddlers over one year old. The risk of SUDC drops significantly after a child's first birthday, but it is still a concern for a little while longer. Introducing pillows too early can increase the risk of suffocation, as toddlers may become overwhelmed by objects in their crib and face difficulty breathing.
Some experts suggest that the transition to a bed and the introduction of a pillow can happen when a child turns two years old. The American Academy of Pediatrics (AAP) recommends that pillows should only be introduced after a child's second birthday. This guideline is based on minimizing the risk of SIDS and allowing for the development of motor skills that enable toddlers to maintain open airways while sleeping.
However, it is important to remember that every child is unique, and parents should trust their instincts and prioritize their toddler's safety and comfort. Some toddlers may show signs of readiness for a pillow before they turn two, such as demonstrating an interest in or asking for a pillow, or showing the ability to move pillows or blankets away from their face during sleep.
When selecting a pillow for a toddler, it is crucial to choose one specifically designed for them. These pillows are typically smaller and firmer than adult pillows, providing adequate support without overcrowding the sleep space. Hypoallergenic materials, such as polyester fiberfill or memory foam, are preferred to prevent allergic reactions or rashes.
Additionally, parents can promote better spine alignment and pain prevention by providing a pillow that supports their toddler's neck and spine development. A pillow can help maintain the proper spinal position and prevent shoulder pain from using an arm as a headrest during sleep.
In summary, while the transition to a bed and the introduction of a pillow is a gradual process, it is essential to prioritize safety and comfort. Parents should wait until their toddler shows signs of readiness and choose age-appropriate bedding to ensure a peaceful night's rest for their little ones.
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Frequently asked questions
Generally, it is recommended that children under the age of two do not use pillows. However, some sources say that once a child turns 18 months old, it is considered safe to introduce a pillow. It is advised that you wait until your child is 24 months old to reduce the risk of suffocation.
Pillows can pose a suffocation risk for infants and young toddlers. They can cover a baby's face or cause them to overheat, increasing the risk of sudden infant death syndrome (SIDS).
If you decide to introduce a pillow to your 18-month-old, it is recommended to choose a small, firm, and thin pillow that is specifically designed for toddlers. Hypoallergenic pillows with breathable materials can reduce the risk of allergic reactions.






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