New Safety Guidelines Recommended for Nursing Pillows After Infant Deaths

For many breast-or-chest-feeding parents, nursing pillows are a staple in their arsenal of must-haves for finding comfort during long, sometimes arduous, sessions. Nursing pillows wrap around a parent's torso to provide the height needed to comfortably nurse a baby without extra strain on the neck, arm, or back muscles.

Because many nursing sessions end with the baby fast asleep (and the parent utterly exhausted), these pillows have taken on double duty as a napping spot for babies. But parents should think twice about letting them sleep on these pillows, according to the Consumer Product Safety Commission (CPSC).

CPSC staff is recommending the first federal requirements to make nursing pillows safer and discourage caregivers from setting babies down on the pillows to sleep. This comes after an NBC News investigation found more than 160 babies have died in incidents associated with nursing pillows since 2007.

The CPSC's reports 154 infant deaths associated with nursing pillows between 2010 and 2022. Nearly all of those deaths were babies under the age of 6 months. Sadly the official causes of death were reported as asphyxia, suffocation, overlay, sudden unexpected infant death (SUID), sudden infant death syndrome (SIDS), or a similar cause.

Nursing Pillow Recommendations from the CPSC

In a statement to Parents, the CPSC explained its concerns with nursing pillows, especially when it comes to infant deaths.

“Nearly all of those deaths involved the use of the pillow for sleep. Our goal is to make nursing pillows safer; and preserve their functionality while eliminating a known hazard.  Nursing pillows can be incredibly useful for parents and caregivers to assist in baby feeding.  But the reality is, some nursing pillows are designed not just for nursing, but to allow for infant lounging and sleeping, which we know is unsafe.  Nursing pillows should be designed and used for infant feeding—period.  And babies should only be put to sleep on a firm, flat surface—like a crib or bassinet—without pillows or other products that could suffocate the infant. The priority of CPSC is to address the safety issues of these—and all—products, particularly when they put at risk the most vulnerable among us, our children.”

Given that, the CPSC is requesting the first federal safety requirements for nursing pillows. Among the proposed new rules:

• Require nursing pillows "to be sufficiently firm that the product is unlikely to conform to an infant’s face and occlude its airways."
• Require nursing pillows to have wider openings that fit the adult who is using them rather than the infant. That would reduce the risk of a baby's head becoming stuck in the pillow's opening or be restrictive to the infant's head.
• Requires new labeling to warn parents of the suffocation risks and fall hazards that can be associated with nursing pillows.
• No straps on nursing pillows to secure infants. They say the straps may give parents a false sense that it's safe to leave their babies alone in the products.

The Dangers of Nursing Pillows

Harvey Karp, MD, FAAP, a pediatrician and founder of Happiest Baby explains that when you use a nursing pillow as it’s intended for breastfeeding, not sleep or lounging, and only use it when the nursing parent is awake, nursing pillows can be a safe and helpful tool for breastfeeding.

“The problem is that exhausted parents are using breastfeeding pillows as infant sleep aids, or the parent is accidentally falling asleep while using a nursing pillow. Falling asleep while using a breastfeeding pillow puts your baby at risk of slipping between cushions, rolling to an unsafe position, and falling to the floor,” Karp explains. “Infants who fall asleep on breastfeeding pillows can roll or move into positions that obstruct their breathing. Also, if you place the breastfeeding pillow under your baby’s head, their head can tip toward their chin onto their chest, potentially obstructing their narrow airway.”

As for why there was no prior safety standard for nursing pillows already in place, Shelby Harris, PsyD, a licensed clinical psychologist and director of sleep health at Sleepopolis, says it’s because nursing pillows are a newer product category, and safety standards usually develop as products gain more popularity and risks are recognized.

What Should I Do If I Have a Nursing Pillow?

Dr. Harris says if you’re currently using a nursing pillow, you should follow the manufacturer's guidelines for safe use, supervise your baby closely while using the pillow, and avoid letting babies sleep on it.

“Whether to keep using it depends on personal comfort and preferences, but following safety tips and staying updated on guidelines from the CPSC is key,” she adds. 

Dr. Karp believes every parent must leave the hospital with all the info they need regarding safe sleep. For example, always placing the baby on the back for sleep and making sure sleeping babies are always on a firm mattress in an empty crib or bassinet. He also understands new parents are human and “wonderful, caring parents make mistakes when they’re exhausted and desperate.”

By ensuring breastfeeding pillows are sufficiently firm, cannot conform to an infant’s face and parents are properly educated on using them, Dr. Karp believes that babies can be kept safe.

“If you are using a nursing pillow as a baby lounger or to help your baby sleep, you need to immediately stop. But if you have a nursing pillow and you are using it as recommended—to help support your baby during breastfeeding while you’re awake and alert—it’s okay to keep using it,” adds Dr. Karp.

But, don’t hesitate to rethink your routine if you notice you’re dozing off while using a nursing pillow. Dr. Karp says to consider getting out of bed to nurse or pick a chair that’s not so comfy that you could nod off.  “Avoid sofas because falling asleep there can be even more dangerous than falling asleep in bed with your baby. Drink water or have a snack during middle-of-the-night feeding,” says Karp. “But if you feel you might doze, set an alarm while breastfeeding or have a partner get up with you to make sure you stay awake.”

If the CPSC’s recommendation makes you worried about continuing to use a nursing pillow, there are other options. Dr. Harris suggests regular pillows, cushions, Boppy-style pillows, rolling up blankets, trying different feeding holds, and using furniture like couch armrests, nursing chairs, or baby carriers with care.

“Make sure your baby's comfortable and supported, and always consider safety,” she says. “If in doubt, consult your doctor for personalized advice.”