Pillow Use in Children – At what age should I introduce a pillow for my child?

From time to time, I get asked at what age parents should introduce a pillow for their toddler. This question is one in which there may be a number of different factors at play. Perhaps the child has asked for a pillow or maybe the parent believes the child should have one at a certain age. Either way I haven’t come across official guidelines on this topic, so I set out to find out what we do know and what is out there in the public domain.

Most new parents know that pillows should not be introduced from birth for 2 main reasons:

1. There is an increased risk of Sudden Infant Death Syndrome (SIDS) in children under the age of 1 year (1). Having a pillow in the cot with an infant puts them at risk of suffocation or breathing in chemicals that may be inherent in the pillow. (1,2)
2. An infant has not yet developed a cervical lordosis (other wise known as the forward neck curve). There is simply no need for a pillow as it may interefere with normal development

However, as your infant becomes a toddler you may be considering moving them into a big bed.

Dr Maria Medeles, a paediatrician specialising in sleep apnoea from the John Hopkins Hospital suggests that a child can usually safely be introduced to pillow usage from the age of 2 (3). The Child Safety Experts website (5) advocate that age of 2-3 years old is the best age to transition to a thin but firm pillow and the consumer product safety commission recommends not introducing a toddler to pillow use before 18 months.

Another sign of readiness for using a pillow might be when a child frequently uses a soft toy or blanket to rest their head on (3).

Considerations for choosing your child’s new pillow: (6)

A child shouldn’t have an adult sized pillow. Consider the thickness / thinness of it.

Does your child have allergies? Know what the filling is. E.g. one made from feather my be more likely to cause issues (4).

Soft is good, but too soft and you may as well not have a pillow. You want to avoid a pillow that will leave a big indent in it.

A child’s pillow should be low profile. There should be no muscle strain. There is rarely a need for a contoured pillow in a toddler.

A machine washable pillow is a great idea, especially if you have a dribbler! Otherwise buy a pillow protector and extra pillowcases.

Whatever and whenever you decide for your child’s sleep health and hygiene, make sure that you do your research before purchasing a pillow.

References

1. Goldberg N.,  Rodriguez-Prado, Y., Tillery, R., Chua, C. (2018). Sudden Infant Death Syndrome: A Review Pediatric Annals  2018 Mar 1;47(3):e118-e123
2. Moon, R.Y. and Task Force on Sudden Infant Death Syndrome. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment
3. https://www.healthline.com/health/childrens-health/when-can-toddler-have-pillow#age
4. https://www.care.com/c/stories/4695/5-potential-dangers-of-a-toddler-pillow-and/
5. https://www.childsafetyexperts.com/baby/age-for-toddlers-pillow
6. https://mumsgrapevine.com.au