They’re a common addition to baby registries and many parents use a nursing pillow at some point, but could they be deadly? According to a recent NBC News investigation, over 160 infant deaths have been linked to popular breastfeeding pillows (1).
There are many brands and varieties of nursing pillows, but for the most part, they all have a “U” shaped design that is meant to cradle the baby’s head and body while they’re breast- or bottle-fed by a caregiver. Depending on the brand, some pillows are also marketed as infant supports or loungers.
What the New Study Uncovered
The product’s danger generally occurs when used outside the manufacturer’s guidelines. Parents sometimes use the pillow as a prop for napping or resting, which goes against safe sleep guidelines. Debbie Gerken, a Certified RN in NICU, Certified Pediatric Gentle Sleep Coach, Postpartum Parent Educator, and founder of Sleep Like a Baby Consulting says, “The American Academy of Pediatrics is clear that babies should be placed down alone, on their backs, and in their own sleep space. The National Institute of Health also addresses safe sleep for babies by saying the space should be firm, flat, and level.”
The 160+ deaths are attributed to the pillows in a number of ways; in some cases the child was reclining on the pillow and their neck angle caused a cessation in breathing. In other scenarios the infant’s face pressed up against the pillow and they suffocated. Other deaths were unexplained, but a nursing pillow was found near or in the child’s sleeping space.
Dr. Harvey Karp, pediatrician, author, and child development specialist, says the pillows can cause injury or death because, “If you place the breastfeeding pillow under your baby’s head, their head can tip toward their chin onto their chest, potentially causing something called positional asphyxiation. Since a baby’s neck muscles are often too weak to pull their big heads back up, they can get stuck in this dangerous position, which can obstruct their narrow airway.”
Because of reports of improper use, The Consumer Product Safety Commission (CPSC) released a statement in 2020 warning against potential dangers (2), but held off on tightening product regulations. According to the most recent CPSC operating plan, they are currently working to develop voluntary safety standards for nursing pillows and supports. However, the process is cumbersome and may take years.
In reaction to warnings and negative media, a lobbying group formed to push back against efforts to take the pillows off the market. The Breastfeeding Infant Development Support Alliance (BFIDSA) is primarily funded by manufacturers such as Boppy and Snuggle Me, and claims that removing the product could negatively affect breastfeeding rates.
What Should Parents Do?
The contradicting information has left many parents confused about whether or not to use these products. For parents questioning whether nursing pillows are safe, Gerken reassures parents that they can still be used safely. She says they are safe “when used for [the] intended purpose of supporting a baby during breastfeeding or bottle feeding.” The pillows often assist in obtaining an effective latch, which can bolster breastfeeding success. However, Gerken cautions “Once the feeding is over, the nursing pillow should be put away until the next feeding.”
Macall Gordon, M.A. researcher and certified pediatric sleep coach says, “Any headline with ‘infant deaths’ in the text is going to get a lot of attention. The issue here is that we already know what can be an unsafe place to leave a baby to sleep, especially when unattended. Rather than a blanket recall of a product that’s helpful when used for its intended purpose, we need to invest with public education about safe spaces for newborn sleep.”
Acknowledging that early parenthood is exceptionally challenging, Gordon adds, “We also need more and better support for parents in the newborn period—especially those with very unsettled, colicky babies. A flat, firm surface is usually not something that most newborns take to.”
Gerken agrees that education is key. She urges parents to educate themselves about the intended use of each product. She says “[Parents] should read the labels and the manuals that come with them. They should understand the risks and how to avoid them. Once fully educated on these products, they need to convey their intended use and how to properly use them to ALL caregivers, including daycares, family members, and babysitters.”
Finally, Karp says that the pillows are best used for feeding but there are other uses that may be safe. He says, “If 100 percent supervised by an awake adult, some breastfeeding pillows can be used as a tummy time aid — or as a “helper” when big siblings want to hold their new baby brother or sister while safely seated under a grownup’s watch.”
Until the CPSC releases more concrete safety guidelines, caregivers who use nursing pillows should use them only as directed and never leave an infant near a product unsupervised.
- , Chuck, Elizabeth; Khimm, Suzy; Martin, Kate, “Nursing pillows are associated with more than 160 infant deaths, NBC News investigation finds,” NBC News; https://www.nbcnews.com/news/us-news/nursing-pillow-baby-deaths-breastfeeding-infant-investigation-rcna97725; August 7, 2023.
Gerken, Debbie. Author interview. August 2023.
Karp, Harvey. Author interview. August 2023.
2. CPSC; “CPSC Warns Parents Not to Use Nursing Pillows for Sleep; Agency Is Investigating Infant Deaths that May Be Associated with Pillow-Like Products,” https://www.cpsc.gov/Newsroom/News-Releases/2021/CPSC-Warns-Parents-Not-to-Use-Nursing-Pillows-for-Sleep-Agency-Is-Investigating-Infant-Deaths-that-May-Be-Associated-with-Pillow-Like-Products; October 7, 2020.
Gordon, Macall. Author interview. August 2023.