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When Can I Give My Child a Pillow?

You're gazing at your little 5-month-old angel sleeping soundly in her crib. You've gone to great lengths to make her sleeping quarters not only cute, but also safe. You've read and learned the recommendations about safe sleep, but still can't help but wonder if she wouldn't be more comfortable resting her head on a small pillow; after all, she knows how to pick her head up now and has started to roll over. You ask yourself, "What could be the harm?" Unfortunately, allowing babies and toddlers younger than 2 years old to sleep with pillows — or other soft bedding — can have devastating consequences.

Crib Safety

Most new moms-to-be find joy in planning and decorating their baby's nursery. Whether you choose a storybook theme or a simple color scheme, chances are you'll been tempted to fill your babe's crib with a colorful bumper pad, matching little quilt, an infant pillow and even a few soft stuffed animals. While you mean well — and these items are certainly sweet — they all pose a significant suffocation and SIDS (sudden infant death syndrome) hazard to your child. According to Nilima Karamchandani, M.D., medical director of the Neonatal Intensive Care Unit and director of the Infant Apnea Center at West Penn Hospital in Pittsburgh, "In addition to placing your baby on his/her back to sleep, it is very important to create a safe sleep environment. This includes a crib, a mattress and a tightly fitted sheet." There should be absolutely no pillows or soft toys present in the crib that can lead to suffocation or entanglement.

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Age Considerations

Parents may worry that their older babies or toddlers might be uncomfortable sleeping without a pillow – or maybe your toddler has been asking for a pillow because he sees you sleeping with one. According to the American Academy of Pediatrics, the jury is still out as to when it's 100 percent safe to let young tots have pillows, stuffed toys and bumper pads in the crib, but experts do tend to agree that after 12 months of age, the suffocation risk drops considerably. For instance, Dr. Karamchandani, who also is past president of the American Association of SIDS Prevention Physicians and serves as a board member for SIDS of Pennsylvania, says, "Although SIDS occurs in infants less than 12 months of age, and the safe sleep environmental recommendations are for this group, accidental suffocation and strangulation can occur in older infants and toddlers. As long as the child is sleeping in the crib, avoid objects in the crib that can cause suffocation." When your child moves to a bed, typically around 24 months of age, you can give him a small, flat, firm pillow, similar to the ones that are given out on airplanes.

Infant Pillows and Sleep Positioners

The baby product market is flush with products like wedges, infant pillows and sleep positioners that are typically marketed to new moms by pledging to help your baby sleep more soundly, breathe more easily and even prevent acid reflux. Despite these claims, these products are not only unnecessary, but also dangerous, because babies can slide down them and suffocate. "There are many popular wedges, infant pillows and sleep positioners available in the market," Dr. Karamchandani says. "NONE of these should be placed in the crib. Keep all soft objects, toys, loose bedding and padding out of the baby's sleep area. The baby should sleep on the back, not the side or tummy, alone in a crib. There should be no non-essential items in the crib." If you end up receiving one of these items as a gift, return it and replace it with a safe-sleep product, such as a wearable blanket, which replaces loose blankets in the crib and therefore reduces the chance of suffocation. If your baby has a cold or struggles with acid reflux, and propping him up seems to help him breathe, pillows inside the crib should still be avoided; instead, place a pillow UNDER one end of the mattress (between the mattress and box spring) to raise the mattress an inch or so.

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Bed-Sharing Hazards

Weary moms — especially those who are still enduring late-night breastfeeding sessions — are sometimes tempted to let their little ones fall asleep beside them in bed. However, because most adults sleep with pillows, comforters, sheets and other safe-sleeping contraband, bed sharing should be avoided at all costs. "The correct place for a baby to sleep is in the mother's room, but not in her bed," said Dr. Karamchandani. "Room sharing is important, but bed sharing is not allowed. Breast feeding has important health benefits for babies, but when finished, the baby should be returned to the crib. The baby should only be in the bed with mom if she is wide-awake. If mom is tired or sleepy, the baby must be placed in the crib or bassinet." Moms who want to keep their babies close should consider co-sleepers, which are bassinets that attach to a parent's bed. "Co-sleepers are becoming popular and are acceptable, especially for breast-feeding mothers," said Dr. Karamchandani. Until your child is old enough to sleep in his own bed, keep him within arms' length, and avoid letting him sleep with pillows or other soft objects.

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