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How Old Should a Baby Be Before Using a Pillow?

By Kathryn Walsh ; Updated June 13, 2017

As you lay your head down on a soft pillow each night, you may fret that your baby is uncomfortable sleeping on a flat mattress. However, sleeping with a pillow is potentially dangerous for young children. Your child may not need a pillow for the first several years of her life. Use your observations about her development and advice from your pediatrician to decide when she's ready.

Pillow Dangers

The primary reason experts warn against placing pillows in a baby's crib is the risk of suffocation. If a baby gets her face pressed into a pillow, she won't have the neck strength to move her head and pull her mouth and nose away. A pillow in an open case poses a risk as well, since a baby could potentially get her head stuck inside the case. Babies are also sensitive to allergens like dust mites, down and feathers, and sleeping on these materials all night can lead to severe allergic reactions.

When to Introduce Pillows

The U.S. Consumer Product Safety Commission, or CPSC, recommends keeping all pillows out of your baby's crib for at least the first 12 months of her life, but pediatric sleep expert Judith Owens recommends keeping pillows away from your baby until she's at least 2 years old. Your baby needs to have the head and neck control to move her face away from a pillow if she can't breathe, so a child who has developmental problems may not be ready for a pillow even after her second birthday. Your pediatrician can help you decide when it's time to introduce pillows. If your child seems perfectly comfortable without a pillow, you can wait until she's in a toddler bed to give her one.

Choosing a Pillow

When your baby is ready to safely sleep with a pillow, don't toss one of your bed pillows into her crib. Buy a new pillow to protect her from germs or dust that have accumulated in your home, and pick a small, firm pillow. It need not be much larger than 12 by 12 inches. Pick a pillow with a sewn-on cover that is labeled as hypoallergenic, rather than one filled with feathers.

Crib Safety

Pillows aren't the only danger when your baby is younger than 12 months old. Check to make sure that your crib model hasn't been recalled for safety concerns. Any fuzzy blankets, quilts or stuffed animals can pose a suffocation threat. Your baby should sleep on her back on top of a mattress with a tight, fitted sheet. Dress her in warm pajamas rather than covering her with a blanket. If you're afraid she'll be cold, the CPSC recommends positioning her with her feet near the end of the crib and tucking the blanket under the end of the mattress so it can't move. After her first birthday, talk to your pediatrician about whether it's safe to introduce more blankets into her crib.

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