
When it comes to toddler sleep, one of the biggest concerns for parents is whether their little one should be using a pillow. The answer depends on a few factors, including the child's age, development, and sleeping environment. While some sources suggest that toddlers can safely use pillows once they transition to a bed, others recommend waiting until they are at least 18 months old, and ideally 2 years old, to reduce the risk of suffocation. To ensure safe sleep for toddlers, it is recommended to use small, thin, firm pillows made from breathable and hypoallergenic materials.
| Characteristics | Values |
|---|---|
| Safe age to introduce pillows | Most sources recommend waiting until the toddler is at least 18 months old, some suggest waiting until they are 2 years old or have transitioned to a bed. |
| Pillow type | A small, firm pillow made of breathable, hypoallergenic material is recommended. |
| Benefits | Better spine alignment, prevents shoulder pain from using the arm as a headrest, promotes comfort. |
| Risks | Poses a suffocation risk, can be used as a step to climb out of the crib.. |
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What You'll Learn

Safe age to introduce pillows
The recommended age for introducing pillows to a toddler's sleep environment is when they are over 2 years old. Sleeping with a pillow before the age of 2 could put your child at risk of positional asphyxia, blocking their airway and resulting in suffocation. The American Academy of Pediatrics (AAP) recommends no pillows for children under 2 years of age. This guideline is based on factors such as the reduced risk of Sudden Infant Death Syndrome (SIDS) and the development of motor skills that allow toddlers to maintain open airways while sleeping.
However, some parents introduce pillows earlier, and the decision is dependent on the parents and their medical provider. Some signs that your toddler may be ready for a pillow include showing interest in or asking for a pillow, and demonstrating the ability to move pillows or blankets away from their face during sleep. If you are considering introducing a pillow, it is recommended to speak to your pediatrician.
When choosing a pillow for your toddler, it is important to select one that is specifically designed for toddlers. Toddler pillows are smaller, firmer, and made of breathable materials to regulate temperature. A firm pillow is better for toddlers as it provides support for their developing necks and promotes better spine alignment. The pillow should be small enough so that the toddler cannot use it as a step stool to climb out of their crib.
To create a safe sleeping environment for your toddler, make sure their crib or bed is away from any objects with ties or strings, such as window blind pulls, curtains, or electrical cords. Also, ensure that there are no items within reach that your toddler could pull into their crib or bed, such as picture frames, mobiles, or other hazards.
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Pillow size and material
The size of the pillow is an important factor to consider when introducing a pillow to a toddler's sleep environment. It is recommended to choose a pillow that is small and thin, specifically one that is smaller than a standard pillow. This helps to reduce the risk of suffocation and ensure the pillow is not used as a step to climb out of the crib.
The pillow should be firm rather than soft, providing support for the toddler's neck and spine, which are still developing. A thick or soft pillow may be uncomfortable and cause the toddler to strain their neck. A small, flat, firm pillow that cradles the head is ideal.
In terms of material, breathable fabrics are essential to reduce the risk of suffocation. Hypoallergenic and untreated materials are preferred to reduce the chances of allergic reactions or rashes. It is best to avoid feather pillows, as they can trigger allergies and pose a smothering risk.
Pillows designed specifically for toddlers are available on the market and are typically constructed with the preferred materials and size in mind.
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Suffocation risk
The suffocation risk posed by pillows depends on the age of the toddler and the type of pillow. Pillows can be a suffocation hazard for toddlers under the age of two, so it is generally recommended to wait until they are older before introducing pillows to their sleep environment.
The Consumer Product Safety Commission and other experts recommend waiting until a child is at least 18 months old before allowing them to sleep with a pillow. This is because younger toddlers may still be overwhelmed by objects in their crib and face a higher risk of suffocation. The American Academy of Pediatrics also advises against letting toddlers under two years old use pillows.
The risk of suffocation is greater with soft pillows, as a child's head can sink into them, increasing the risk of their airway becoming blocked. Firm pillows are better for toddlers as they provide better support for their still-developing necks and spines. Pillows made from hypoallergenic materials are also preferable as they reduce the risk of allergic reactions or rashes.
Additionally, it is important to ensure that the pillow is not too big. A small, thin pillow is recommended for toddlers to prevent them from using it as a step to climb out of their crib or bed.
Overall, while the risk of suffocation is reduced after a toddler transitions to a bed, it is still important to choose an appropriately sized and firm pillow to minimise any potential hazards.
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Crib safety
When it comes to crib safety for toddlers, there are several factors to consider. Firstly, it is recommended to use a crib manufactured after 2011 to ensure it meets the most current safety requirements. Check for any safety recalls on the Consumer Product Safety Commission (CPSC) website. The crib should be assembled correctly, with no missing, loose, or broken hardware, screws, brackets, or slats, as this can pose an entrapment or suffocation risk. The slats should be no more than 2 3/8 inches (about 6 centimeters) apart, with no decorative cutouts, sharp edges, or drop sides. Ensure the crib sheet is specifically designed for crib use and fits snugly over a firm, tight-fitting mattress of the same size as the crib, leaving no gaps that could trap a child's arms, legs, or body.
Additionally, create a safe sleeping environment by keeping the crib clear of hazards. Avoid placing pillows, quilts, comforters, stuffed toys, loose blankets, or other soft objects in the crib, as they can pose a suffocation risk for toddlers under two years old. Small, thin pillows may be introduced for toddlers over two, but ensure they are not used as a step to climb out of the crib. Keep the crib away from objects with ties or strings, such as window blinds, curtains, or electrical cords, and ensure that the toddler cannot pull hazardous items into the crib.
It is also important to consider the toddler's development and sleeping position. After the first birthday, stomach sleeping is no longer a concern, and toddlers can sleep on their back, stomach, or side. Once they reach 18 months, a thin blanket or small stuffed animal may be introduced, but ensure they cannot be used to climb out of the crib.
Lastly, it is recommended to learn cardiopulmonary resuscitation (CPR) and the Heimlich maneuver, and to follow the “Back to Sleep” campaign's guidance to place toddlers on their backs to sleep, reducing the risk of Sudden Infant Death Syndrome (SIDS).
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Benefits of pillows
While toddlers can sleep without pillows, there are some benefits to using them. The recommended age for using a pillow is 2 years old, as there is a risk of suffocation for younger toddlers. However, once they are old enough, pillows can provide several advantages for toddlers.
Firstly, pillows promote better spine alignment. A pillow that is appropriately sized for a toddler can aid in keeping their spine in the proper position for healthy development. This also helps prevent neck pain. Before introducing a pillow, a toddler may use their arm as a prop for their head as they sleep, which can lead to shoulder pain.
Secondly, a pillow can provide comfort. While toddlers can sleep without pillows, some may find them comforting. However, it is important to choose the right type of pillow. A thick or fluffy pillow may be uncomfortable for a toddler's neck and spine, so a small, flat, firm pillow is recommended. Hypoallergenic pillows can also help reduce allergic reactions or rashes.
Thirdly, a pillow can help keep a toddler safe in a bed. While pillows can pose a risk of suffocation in a crib, as toddlers may use them to climb out, this risk is reduced in a bed. A pillow can provide a sense of familiarity and comfort as a toddler transitions to a bed.
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Frequently asked questions
It is generally recommended to wait until your toddler is at least 18 months old, and ideally 2 years old, before introducing a pillow. The risk of suffocation is greatly reduced after this age.
A small, flat, firm pillow is best for toddlers. Avoid adult-sized pillows, as these can be unsafe and uncomfortable for small children. Look for pillows made from breathable, hypoallergenic fabrics and materials.
Yes, a pillow can promote better spine alignment and prevent neck and shoulder pain.
In addition to the risk of suffocation, toddlers could use pillows to climb out of their cribs. Make sure the pillow is not big enough for your toddler to use as a step stool.
Toddlers can sleep fine without pillows. If your toddler seems comfortable without a pillow, there may be no need to introduce one.











































