When can a baby sleep with a pillow or duvet?
Keep pillows and duvets out of a baby’s bed for at least the first 12 months. Use a well-fitted sleep bag or a firmly tucked lightweight blanket instead.
NHS advice is clear: do not use pillows or duvets for a baby under one. They can cover a baby’s face and cause suffocation, and a young baby may be unable to push a duvet away. This applies to naps as well as night-time sleep.
If your baby was born prematurely, follow safer-sleep advice for one year from their due date, rather than their birth date. The Lullaby Trust’s premature-baby guidance explains this longer timescale.
After that point, there is no need to change bedding just because a birthday has passed. You can keep using a sleeping bag that still fits and meets its manufacturer’s size limits.
Why pillows and duvets need to wait
A pillow adds soft material close to the face, where it can block the nose and mouth. A duvet can cover the head and be difficult for a baby to move. Soft, bulky bedding can also trap too much heat and is associated with a higher risk of sudden infant death syndrome (SIDS).
A small pillow or a thin duvet is still a pillow or duvet. Rolling, sitting or having good head control does not bring the under-one limit forward. A baby can sleep on a flat mattress without a pillow under their head.
What to use instead
Start with a firm, flat mattress that fits the cot, with a waterproof cover and a fitted sheet. Keep your baby’s separate sleep space in the same room as you for every sleep for at least six months. If your baby was premature, count those six months from their due date.
NHS safer-sleep guidance describes two bedding options:
- A baby sleeping bag: check the manufacturer’s weight and size limits. It should fit around the neck and shoulders so your baby cannot slip down inside. Use it without a duvet or extra blankets on top.
- Lightweight blankets: place your baby with their feet at the foot of the cot. Tuck the blankets securely under the mattress, no higher than the shoulders, so your baby cannot wriggle down beneath them. Do not fold a blanket over to make it thicker.
If a sleeping bag is too big, use the blanket setup until your baby meets the bag’s fit requirements. The age range on the label is only a starting point; the actual fit matters.
Keep warmth under control
Cold weather is not a reason to add a duvet to a baby’s cot. Aim for a room temperature of 16–20°C, and follow the sleeping bag’s guidance on warmth, or tog, and clothing.
Check your baby’s chest or the back of their neck. If the skin feels hot or sweaty, remove a layer of clothing or bedding. Cool hands and feet are common and do not, on their own, mean a baby needs more covers.
If your baby feels cold while using a sleep bag, adjust clothing or choose an appropriate warmer bag rather than putting blankets over it. The Lullaby Trust’s dressing guidance explains how to check comfort without piling on bedding.
What about after the first birthday?
For a child born at term, 12 months is the earliest point to consider a pillow or duvet, not a deadline to introduce them. Keeping a familiar, suitable sleep bag or lightweight bedding is an option. A pillow and a duvet are separate choices; they do not have to arrive together.
Before changing the setup, check the bedding’s instructions for the intended age, size and sleep space. Keep within any later minimum age stated by the manufacturer. Moving from a cot to a toddler bed does not, by itself, mean your child needs either item.
If a medical or developmental condition affects how your child moves or sleeps, ask their health professional about the setup before adding bedding.
When to ask for individual advice
Your health visitor can help if you are unsure about bedding or sleep-bag fit. If your baby was premature or has an existing sleep or discharge plan, follow the advice from their neonatal or paediatric team and ask them about changes that are unclear.
Do not add a pillow to treat reflux or a flattened head. Babies with reflux should still sleep flat on their backs. If reflux is worrying you, speak to your health visitor or GP. For head-shape concerns, ask a health professional rather than buying a positioning pillow; supervised tummy time while awake is one of the alternatives described in The Lullaby Trust’s bedding advice.
