Should you use a baby pillow for newborns?: Q&A with Stephanie from Peaceful Parenthood

A question that Stephanie Richardson, Pediatric Sleep Counsellor from Peaceful Parenthood, Perinatal Registered Nurse, and Mom gets often is “Is It Safe to Let a Baby Sleep With a Pillow?”. Sleep can seem complicated when it comes to babies - especially when you want to make sure your baby is safe and comfortable. In this blog post, Stephanie answers questions about baby pillows and how safe they really are, blankets for babies, crib safety, and the transition from a crib to a toddler bed. 

Should you use a baby pillow for newborns? 

No, baby pillows are not recommended for newborns. To ensure safe sleep, your newborn baby should be placed down on their back in a crib/bassinet that is clear of obstructions and on a flat surface. That is because research shows that introducing a pillow under a newborn's head can increase their risk of SIDS (sudden infant death syndrome) by up to 50%. This is because propping a newborn’s head up on a pillow leads to improper neck alignment and could reduce airflow entry while sleeping. 

This includes baby sleep positioners which helps newborns sleep on their sides by supporting them on the right and left. The Canadian Paediatric Society and Public Health Agency of Canada's safe sleep guidelines state that all babies should be placed down for both naps and night sleep on their backs and not on their side, so it is best to also avoid these positioners. 

If pillows are unsafe, what is the safest setup for a baby crib?

The Canadian Pediatric Society and Public Health Agency of Canada's safe sleep guidelines recommend babies under the age of one, sleep in a crib free from toys, blankets, bumpers, or pillows to significantly reduce their risk of SIDS. A baby’s crib should contain only a tight fitted sheet over a firm mattress and should be set to a safe age-appropriate height! The area surrounding the crib should be free of hazards including electrical cords, baby monitors, shelves, mirrors, art, or anything that is within reach of the crib.

Want some modern nursery inspiration? Check out our blog post here. 

When is it safe for babies to have pillows? 

Before the age of one, anything introduced into the crib could pose a risk for suffocation. After the age of one, both the child’s brain and mobility should be developed enough to adequately help protect their airways while they sleep. Although the Canadian Pediatric Society does not have an official recommendation on when to start using a pillow with your toddler, what we do know is that it's not safe for babies under the age of one.

Is there a rush to introduce a pillow as soon as your child turns one? No there isn’t!! In my experience, most babies between 12-18 months are still moving around their crib so much that they likely wouldn’t even use a pillow quite yet! There is no need to rush into adding a pillow to the mix especially if it were to just be pushed to the side! Remember, a clear crib is a safe crib. My recommendation to parents is to hold off until their child starts to show signs of desiring a pillow. If a small stuffed toy/snuggly comfort item has been safely introduced into your little one’s sleep environment (after the age of one) and you notice that your baby is naturally using it as a pillow, then that’s a great indication that they’re ready! If they don’t see any signs of desiring the use of a pillow, then it is a-okay to simply wait until the child transitions to a toddler bed to introduce one!  

What is the best type of pillow for a baby/toddler?

When first introducing a pillow to a baby’s sleep environment, it’s of course important to choose a pillow that is safe! Firstly, look for a pillow that is specifically designed with toddlers in mind. Next, I recommend choosing a pillow that is foam filled- as this substance will provide adequate airflow, it will distribute weight evenly, and will help to provide proper neck alignment. The bonus is if you can find a toddler pillow that is two-sided with different height options, allowing your child to grow with their pillow. 

• For babies between the ages 1-2, you’ll want to ensure the pillow's height is no more than 2.5 cm. 
• For babies between 2-3 years old,  you ideally want a pillow that is between 2.5-3.5cm in height. 
• For toddlers 3 years and older, aim for a pillow that is at least 4cm in height. 

How should a parent transition their baby/toddler to a pillow and blanket?

This transition to using a baby/toddler pillow and blanket can take some time! It’s best to always prep your little one beforehand and simply explain to them how to properly use a pillow and how to tuck under their covers.

Using role-play with their stuffed animals before night one can be a fun way to demonstrate. Parents might find that their child continuously kicks their blankets off and pushes their pillow to the side at first- this is totally normal in the beginning since they’re used to a sleep sack/sleep bag that stays on! In time, your child will start to familiarize themselves with their new setup. Continued encouragement will help the child to sleep under their blankets with their head on the pillow. For example, you could try, “You’re a big boy now! You get to sleep with your head on this soft pillow and snuggle up with these blankets, just like Mommy does!”. 

Looking to introduce a blanket for your toddler? Read our guide here.

What is your advice for parents transitioning their toddler from a crib to a toddler bed?

My advice to parents is to keep their babies in their cribs for as long as possible! Unless it is no longer safe to do so, for example, if you have an early climber. Ideally, the older your child is, the better they will understand the transition. As in, when it’s time to sleep, it’s time to sleep and it’s not time to escape down the hallway 22 times.

When preparing for this big transition (as it truly is a big one!), it’s best to avoid doing it at the same time as another significant change. Examples of another significant change can be a big move, starting daycare, or welcoming a new sibling.

Remember that PREP is key. Toddlers tend to handle transitions better if they know what to expect! Have lots of chats with your toddler regarding the details- what the bedtime routine will look like, what their new bed will look like, blankets, pillow etc! These tips will hopefully help your toddler transition easier to their toddler bed. 

Do you have other baby sleep questions?

Stephanie from Peaceful Parenthood works together with parents to find sleep solutions that fit their parenting philosophy because what works for one might not work for another. In her sleep plans, she makes sure that parents feel confident in implementing the strategies and that they still foster a strong connection between themselves and their baby. 

We’re so happy we were able to ask Stephanie questions about baby pillows and their safety. Do you have any other questions about baby sleep or toddler sleep? Let us know below.