When you first put your swaddled-up little one to bed, it may have looked a little strange to see them lying in the middle of their bare mattress. But as the nights turned into weeks and the weeks turned into months, you probably got used to it. At some point, you might start to wonder when you should introduce a pillow. “All kids develop at different rates, and for some, a pillow might still pose a suffocation risk before age 2,” says Po-Chang Hsu, MD, a medical content expert at Sleeping Ocean. “Even then, a safe pillow for a toddler has to be more on the firmer side.” Learn more about what types of pillows are right for toddlers and some safety precautions to keep in mind.

When Is It Safe for My Toddler to Sleep With a Pillow?

Toddlers can sleep with a pillow starting at age 2. Although the risk for sudden infant death syndrome (SIDS) has passed after a baby’s first birthday, pillows are still considered a suffocation risk. This risk is lower by age 2, but a standard adult pillow may not be appropriate. At this age, a pillow needs to be small and firm to be considered safe. “When you do decide your toddler is ready for a pillow, keep in mind that the big fluffy pillows adorning your own bed are probably not the right fit,” notes Harvey Karp, MD, FAAP, a pediatrician and the CEO of Happiest Baby. Remember also that there is no rush to give your toddler a pillow. In fact, the longer they go without it, the better. “The truth is that most little kids sleep fine without pillows,” says Dr. Karp. “I recommend only using a blanket in the crib after the first birthday and waiting to use a pillow until your child transitions from the crib to a bed. This may not be until they reach their third birthday or even later.”

Benefits of Sleeping With a Pillow

If you sleep with a pillow, you probably like it because it supports your spine. Comfort is main benefit of sleeping with a pillow. But little ones who have been used to sleeping without a pillow will most likely roll into a position that feels best without it. You really only need to introduce a pillow to your toddler if it will make them feel cozier in bed.

Safety Precautions

Toddlers can sleep with a pillow after they turn 2. However, there are some important safety precautions to keep in mind when introducing a pillow to your toddler.

Choose a Small and Firm Pillow

There are a few reasons why you should specifically choose a small and firm first pillow for your toddler. First, pillows may still pose a suffocation risk at this age, especially if they are large and fluffy. “A thick pillow may be uncomfortable for your child’s little neck and spine, which are still developing,” explains Dr. Karp. “Instead, look for a small, flat, firm pillow that cradles and supports the head without causing your toddler to strain.”

Watch for Allergies

Pillows may be a cause of allergies in young children. If you are seeing a lot of sneezing or red itchy eyes since introducing a pillow, it might just be to blame. To reduce allergies caused by pillows, replace them after a year or two. Using a hypoallergenic casing over the pillow might also work, but make sure it fits snugly. “Hypoallergenic models are always a safer option,” says Dr. Hsu. “It’s also helpful to get a breathable pillow to aid thermoregulation during sleep. Parents may want to add a natural pillowcase, such as cotton or bamboo, for enhanced breathability.”

The Later, the Better

You don’t have to give your toddler a pillow just because they turn 2. It is generally safest to wait to introduce a pillow as long as you can. “Kids often toss and turn in bed and may end up pressing their faces into the pillow without the ability to roll back,” notes Dr. Hsu. The older and stronger your child grows, the less likely they are to become trapped in a position where the pillow could block their breathing. Pillows may also pose new risks as your baby becomes a toddler. “Giving a pillow to a toddler who still sleeps in the crib can also allow the little one to use the pillow as a boost to climb out,” says Dr. Hsu. “This can lead to injuries.”

A Word From Verywell

Your baby should sleep without a pillow until they are at least 2 years old. Even then, the pillow they use should be small and firm. There is no rush to introduce a pillow, either. Consider waiting until you move your child to a toddler bed or even longer. If a pillow helps your toddler over age 2 sleep more comfortably, you can confidently introduce a toddler-safe pillow. Reach out to your pediatrician if you have any questions or concerns about which pillow to choose or whether your child is ready to sleep with a pillow.