Last reviewed by Dr Philippa Kaye: January 2024.

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It's one of the (million and one) things that you've probably never considered until you become a parent: should babies have pillows in their cot or crib, like we do in our bed?

Can my baby have a pillow?

"The answer to this is a straight no," says our expert family GP Dr Philippa Kaye. "You should never let any baby under the age of 12 months sleep with a pillow.

"This is the clear recommendation from both the NHS¹and the Lullaby Trust². And I strongly advise all parents to stick to it, even if you see a pillow that being sold as suitable for babies."

Why shouldn't I let my baby sleep with a pillow?

Simply put, because it's not safe.

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"Pillows use can increase the chance of sudden infant death (SIDS) by up to 2.5 times," said Kate Holmes, Head of Support and Information at the Lullaby Trust, the charity that provides parents with expert advice on safer sleep as part of its mission to raise awareness of SIDS.

"That's because a pillow can, potentially, lead to suffocation – your baby is not yet strong enough to move a pillow away if it gets on top of them. A pillow can also limit the amount of heat your baby is able to release, which can lead to overheating – a risk factor associated with SIDS.

It's much safer for your baby to sleep in a clear, flat space, where nothing can smother or suffocate them
Kate Holmes, The Lullaby Trust

"For safe sleep," says Kate, "all babies need is a firm, flat, waterproof mattress in good condition, and a sleeping bay or firmly tucked-in sheets or blankets.

"Pillows or any other extras, such as toys or quilts, duvets or cot bumpers can increase the risk of an accident."

So at what age can my baby have a pillow? Is it safe after the age of 1?

According to both the NHS and the Lullaby Trust, the safety concerns centre on babies under the age of 12 months. "Generally, it is considered safe to use pillows after the age of 1," says Kate.

Saying that, there is no reason to rush out and buy one on your baby's first birthday, if your child seems quite happy sleeping without one.

And it's worth knowing that the American Academy of Pediatrics³ advises US parents not to use pillows before your child turns 2.

If you do decide to buy a pillow for your toddler, make sure that it's toddler-size (think airline pillow-size, rather a full-size adult pillow) and that it's firm, washable and made of breathable materials. Be especially careful if you're buying online: look for labels that show it's confirm to British Standards for safety and flammability.

Won't a pillow prevent my baby getting a flat head?

Some companies that sell pillows for babies do market them – or have marketed them in the past – as a way to prevent your baby getting a flat head, sometimes called 'flat head syndrome' or plagiocephaly.

The important thing to know here is that it's very common for babies to get a slightly flattened head shape4 as a result of sleeping on their back (which is, of course, the recommend safe-sleeping position) – but that it's not painful and that it nearly always corrects itself over time.4

"We do get calls from many parents asking if they can use pillows as they are worried about their baby getting flat head syndrome," says Kate from The Lullaby Trust. "We tell them it's quite normal for babies to develop a slightly flat head when they sleep on their back, and, in the vast majority of cases, it resolves itself within a few weeks or months."

There are also other, much safer, things you can do to help prevent your baby's head looking flat. Rachel Harrington, a physiotherapist and clinical specialist in paediatric orthopaedics, suggests you:

  • Give your baby plenty of tummy time
  • Cut down on the amount of time your baby spends lying on their back when they are awake; try using a bouncy chair or a baby carrier as alternatives
  • Alternate between pram and baby carrier when you're out and about
  • Swap sides, and maybe even types of hold, regularly if you're breastfeeding, so your baby gets used to using different muscles

"If you are concerned about the shape of your baby's head," says Dr Philippa, "or notice your baby only turns their head to one side, then do see your GP. They might want to run some tests or refer you to a physiotherapist."

About our expert Dr Philippa Kaye

Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.

About our expert Kate Holmes and the Lullaby Trust

Kate Holmes is Head of Support and Information at the Lullaby Trust, the charity that's trying to reduce the number of SIDS deaths, offering parents and carers advice on safe sleep (you can call free on 0808 802 6869) and supporting research in sudden deaths of babies and young children.

About our expert Rachel Harrington

Rachel Harrington is a paediatric physiotherapist, based in London's Harley Street. She has a particular interest in the effect of growth in children and their presenting problems from newborn to final growth. She offers treatment for babies with plagiocephaly, torticollis, hip problems and altered foot posture.

References:

1. Baby and toddler safety. NHS Online
2. Choosing the best mattress and bedding for a baby. The Lullaby Trust
3. Safe and sound: Help young children get a good night's rest. Korioth, T. American Academy of Pediatrics Vol 8 Issue 3 March 2007
4. Flat Head Syndrome in Babies. Kingston Hospital NHS Foundation Trust Pediatic Department

Pic: Getty Images

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Authors

Helen Brown
Helen BrownHead of Content Delivery

Helen is author of the classic advice book Parenting for Dummies and a mum of 3. Before joining MadeForMums, she was Head of Community at Mumsnet and also the Consumer Editor of Mother & Baby.

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