Red Nose strongly advises against placing a pillow in the sleep environment of infants and toddlers under the age of two.
We’ve found that pillows are not necessary for young children and actually increase the risk of Sudden Unexpected Death in Infancy (SUDI), including SIDS (Sudden Infant Death Syndrome) and fatal sleep accidents.
Red Nose recommends waiting until the child is over two years old and no longer sleeping in a cot or portable cot before introducing pillows into their sleep environment. However, if you need to use a pillow to support an awake infant during feeding, sitting up, or tummy time, make sure to keep a close eye on them and never leave them unsupervised.
The evidence supporting this recommendation is quite compelling. Multiple studies have shown that using pillows in an infant’s sleep environment significantly raises the risk of SUDI, including SIDS and suffocation-related accidents. Soft bedding like loose blankets or pillows were present in a significant number of SUDI cases. Accidental infant deaths in the United States also revealed that pillows were the most common item associated with suffocation or strangulation.
Why are pillows dangerous for infants? Well, if an infant ends up in a prone position (face down) and their face is in contact with a pillow or soft surface, they can risk rebreathing and suffocating. Some infants may not have the ability to turn their heads effectively while laying on their tummy, making it difficult for them to clear their airway. Even if an infant is positioned on their back but propped up on a pillow, they can still be at risk of rolling or slipping down, leading to their airway becoming blocked
In older infants and toddlers, using pillows has been associated with potential falls if the child tries to climb out of the cot using the pillow as a foothold.
In conclusion, it’s best to avoid using pillows in the sleep environment of infants and children under two years of age. They’re not necessary and can increase the risk of SUDI. It’s important to prioritize infant safety and consider their stage of development when preparing their sleep environment.
Suggested citation: Information Statement: Pillow Use. Red Nose National Scientific Advisory Group. Reviewed May 2023.
Last modified: 16/5/23