Pillow Use

Red Nose does not recommend placing a pillow in baby’s sleep environment.

  • Pillows are not necessary for baby and increase baby’s risk of sudden unexpected death in infancy including SIDS and fatal sleep accidents
  • Red Nose recommends delaying offering a pillow until baby is over two years of age and is no longer sleeping in a cot or portable cot

Pillows are not necessary for baby while baby is sleeping unobserved. Red Nose is aware of research showing that the use of a pillow in baby’s sleep environment increases the risk of Sudden Unexpected Death in Infancy (SUDI), including Sudden Infant Death Syndrome (SIDS) and fatal sleep accidents1-8. They may cover the baby’s face and obstruct breathing or cause overheating. Older babies in a cot can be at an increased risk of a sleeping accident by using pillows as a step to climb up and fall out of the cot.

Case reports have also shown an increased risk of SUDI with pillow use9-11. The Coroners Prevention Unit (Vic) examined a total of 72 infant deaths occurring in a sleeping context in Victoria from 2008 to 201012. A statistically significant association was identified for infants less than four months and the presence of a pillow with deaths occurring in a co-sleeping context13.

Some physiotherapists and chiropractors have recommended the use of a pillow to relieve the flattening a baby’s head, a relatively common condition, known as positional plagiocephaly14. This is not suitable while baby sleeps unobserved. If baby’s medical practitioner recommends the use of a pillow during unobserved sleep, it is recommended the medical practitioner puts this advice in writing.

For the majority of children, positional plagiocephaly is a preventable condition, responding well to simple repositioning techniques and by minimising pressure on the head when baby is awake. These simple measures are described in the Red Nose information statement on baby’s head shape.

Red Nose does not recommend placing a pillow where baby sleeps unobserved. It is safer to wait until the child starts to sleep in a bed before introducing a pillow. The Australian government states it is safer not to use a pillow at all for children under two15.

The Red Nose Safe Sleeping program is based on scientific evidence and was developed by Australian SUDI researchers, paediatricians, pathologists, and child health experts with input from overseas experts in the field.

For further information phone us on 1300 998 698.

Suggested citation:

Red Nose. National Scientific Advisory Group (NSAG). 2013. Information Statement: Pillow use. Melbourne, Red Nose. This information statement is a revision of the information statement first posted in March, 2013.

View the references for this article here.

Last modified: 19/1/17