Some say once your baby is out of their cot and into a bed. This is an important statement regarding SIDS safety, but it does not consider what is good for your child’s spine.
My opinion as a chiropractor considering spinal health:
No pillow for toddlers.
Consider their first pillow at an average sized 5 year old depending on their sleeping position - see the checklist at bottom.
Why? Because, their head is still significantly bigger than the width of their shoulders. What I mean is this; an average adult’s shoulder width is equivalent to their width of their head - and so when an adult lays on their side, there’s a big drop in the angle of their neck toward the mattress. Therefore it needs support for the neck to stay aligned with the rest of the spine. In toddlers, the shoulder will sink into their mattress a bit, and their head will hit the pillow keeping their neck inline with their spine.
Another reason why I wouldn’t recommend a pillow for toddlers is that many of them flop around the bed a fair bit and even do some sleeping acrobatics at times! How often do you find your child in a completely different end of the bed than you tucked them in? For this reason, the pillow won’t be used properly anyways.
Exceptions to the rule? Of Course. There’s always exceptions.
Here are two of them:
- Your child is developmentally bigger than most for their age - feel free to use a pillow sooner - just keep in mind the objective of keeping their spine inline with their neck and the checklist below.
- Your child is asking for a pillow because you have one, and won’t sleep without it. In this case, I’d recommend one of the following:
- Make up a thin pillow by folding a small soft towel into a pillow case that won’t measure more than 2.5cm thick.
- Buy this pillow: https://www.naturessway.co.nz/collections/toddler/products/toddler-pillow
Here’s a checklist of when your child may be ready for their first pillow:
- They are out of the cot, and into a bed.
- They stay relatively in one place throughout the night
- For Side Sleepers: their shoulder width has increased such that when they are sleeping on their side it causes their head to drop and their neck is no longer inline with their spine
- Back Sleepers, have a feel under their neck to see if the mattress supports the curve of their neck (specifically: slide your fingertips facing upward under your child’s neck - do you have to push your fingers down into the mattress to get under your child’s neck? If you do, then they are getting enough support from the mattress at this stage. If not, they’re ready for a pillow. (this could be as old as 8years for back sleepers - it depends on the mattress they lay on)
- For Tummy Sleepers, they do not need a pillow no matter their age (even as an adult). (because a pillow will cause the neck to be extended back)
Yours in health,
Dr. Nik Dukovac