Parents search for "crib pillows" for two very different reasons. Some want to buy a pillow for their baby's crib. Others want to know when it is safe to introduce one. The answer to the first is clear: do not put a pillow in a crib with an infant. The answer to the second is more nuanced, involving age, development, and the type of pillow you choose. This article covers both, starting with the safety facts that every parent needs to know.
Quick Answer
The American Academy of Pediatrics and the Canadian Paediatric Society both recommend keeping pillows, blankets, stuffed animals, and all soft objects out of the crib until at least age one. Many paediatric sleep experts extend this recommendation to age two. The risk is suffocation. Infants lack the motor control and strength to move away from soft objects that cover their face during sleep. Once a child has transitioned out of a crib (or is at least 18-24 months with strong head and neck control), a small, firm toddler pillow can be introduced. The pillow should be thin (2-3 inches), firm enough that it does not envelop the face when pressed, and appropriately sized for a toddler (roughly 13 x 18 inches). Standard adult pillows are too large, too soft, and too thick for toddlers. Never use a crib bumper, positioning pillow, or decorative pillow in a crib regardless of age.
Why Pillows Are Dangerous in Cribs
Infants under 12 months have limited ability to turn their heads, push objects away, or reposition themselves if bedding covers their face. A pillow in a crib creates a suffocation risk because the infant's face can press into the soft surface, blocking the nose and mouth. This risk is one of the primary factors in sleep-related infant deaths, which the AAP's safe sleep guidelines specifically address.
The guidelines are straightforward: a firm, flat mattress with a fitted sheet. Nothing else. No pillows, no blankets, no bumpers, no stuffed animals, no positioning devices. This applies regardless of how adorable the nursery bedding set looks on the store shelf. Those coordinated crib pillow and blanket sets are designed for decoration after nap time, not for sleeping.
Between ages one and two, the suffocation risk decreases as the child develops stronger motor control. However, most paediatric sleep experts still recommend waiting until at least 18 months, and many prefer age two, before introducing any pillow. The additional caution accounts for variability in motor development across children. A child who can reliably roll, sit up, and push objects away is safer with a pillow than one who has not yet reached those milestones consistently.
When and How to Introduce a Toddler Pillow
The transition from no pillow to a pillow typically happens when the child moves from a crib to a toddler bed, or when they are consistently two years old, whichever comes later. Signs that a child is ready include reliably sleeping through the night without needing repositioning, demonstrating strong head and neck control during waking hours, and showing interest in using a pillow (some toddlers start bunching up blankets or stuffed animals under their head).
A toddler's first pillow should be small (approximately 13 x 18 inches), thin (2-3 inches of loft), and firm enough that pressing your hand into it does not create a deep impression that could conform around a face. Polyester fill and memory foam toddler pillows both work if the firmness is appropriate. Avoid down or feather fill for toddlers because down pillows conform too closely to facial contours and create more suffocation risk than firmer alternatives.
It is difficult to say exactly when each individual child is ready, because motor development varies. If you are uncertain, discuss timing with your child's paediatrician, who can assess developmental readiness specific to your child rather than relying on general age guidelines.
Sleep Science
Adults need pillows to maintain cervical spine alignment because our shoulder width creates a gap between the head and mattress in side sleeping. Toddlers have proportionally larger heads relative to their bodies and narrower shoulders, which means the head-to-mattress gap is smaller. Many toddlers sleep comfortably without a pillow until age three or four. Introducing a pillow too early or using one that is too thick can actually push the toddler's head into poor alignment, creating the opposite of the intended effect. A flat mattress surface often provides better sleep posture for young children than any pillow. If your toddler sleeps well without a pillow, there is no developmental reason to add one.
What to Avoid
Crib bumpers, whether padded, mesh, or "breathable," have been banned for sale in the United States since 2022 and are discouraged by the Canadian Paediatric Society. The risk of entrapment and suffocation outweighs any perceived benefit of preventing limb entanglement in crib slats. Modern crib slat spacing standards already prevent head entrapment, making bumpers unnecessary.
Positioning pillows, wedges, and sleep positioners marketed to prevent flat head syndrome (plagiocephaly) or reflux are not recommended for unsupervised sleep. The FDA has warned against their use due to suffocation risk. If your infant has reflux or positional head flattening, discuss solutions with your paediatrician rather than purchasing sleep positioning products.
Decorative pillow sets sold as "crib bedding" are designed for appearance, not sleep. Use them during supervised awake time or for nursery decoration only. Remove all soft items before placing the infant in the crib for sleep, including naps.
For Brantford Residents
When your child is ready for a proper mattress transition, whether from crib to toddler bed or toddler bed to twin, our showroom at 441 1/2 West Street carries Restonic ComfortCare twin mattresses starting at $875 with 690 individually wrapped coils and CertiPUR-US certi
fied foam. Brad can explain which firmness level suits a growing child's developing spine and how to choose age-appropriate bedding layers that keep your child comfortable without compromising safety. Call (519) 770-0001 or visit: Mon-Wed 10-6, Thu-Fri 10-7, Sat 10-5, Sun 12-4.
Frequently Asked Questions
Can I put a pillow in my baby's crib?
No. The AAP and Canadian Paediatric Society recommend no pillows, blankets, or soft objects in a crib for infants under 12 months. Many experts extend this to 18-24 months. The risk is suffocation. A firm mattress with a fitted sheet is the only safe sleep surface for infants.
When can a toddler start using a pillow?
Most paediatric sleep experts recommend waiting until at least age 2, or when the child transitions to a toddler bed. The child should have strong head and neck control and be able to reliably reposition themselves during sleep. When in doubt, ask your paediatrician.
What kind of pillow is safe for a toddler?
Small (13 x 18 inches), thin (2-3 inches loft), and firm enough that it does not conform around the face when pressed. Polyester fill or firm memory foam works. Avoid down or feather fills for toddlers due to their conforming nature. Standard adult pillows are too large and too soft.
Are crib bumpers safe?
No. Crib bumpers have been banned for sale in the US since 2022 and are discouraged by the Canadian Paediatric Society. The suffocation and entrapment risk outweighs any benefit. Modern crib slat spacing standards already prevent head entanglement.
Where can I find safe children's mattresses in Brantford?
Mattress Miracle at 441 1/2 West Street carries CertiPUR-US certified twin mattresses suitable for children. Brad helps match firmness to a child's developmental stage. Call (519) 770-0001 or visit: Mon-Wed 10-6, Thu-Fri 10-7, Sat 10-5, Sun 12-4.
Visit Mattress Miracle Brantford
Safe sleep surfaces matter at every age. Visit our showroom at 441 1/2 West Street, Brantford, Ontario to find mattresses that support your child's growing body with certified safe materials. White glove delivery available to Hamilton, Kitchener, Toronto, and across Southern Ontario. Call 519-770-0001 or stop by: Mon-Wed 10-6, Thu-Fri 10-7, Sat 10-5, Sun 12-4.
Sources
- Moon RY, Carlin RF, Hand I. Sleep-Related Infant Deaths: Updated 2022 Recommendations. Pediatrics. 2022;150(1):e2022057990. DOI: 10.1542/peds.2022-057990
- Lambert AB, et al. Sleep-Related Infant Suffocation Deaths Attributable to Soft Bedding. Pediatrics. 2019;143(5):e20183408. DOI: 10.1542/peds.2018-3408
- Colvin JD, et al. Sleep Environment Risks for Younger and Older Infants. Pediatrics. 2014;134(2):e406-e412. DOI: 10.1542/peds.2014-0401
- Health Canada. Cribs, Cradles and Bassinets Regulations (SOR/2016-152). Canada Consumer Product Safety Act