Not always the case.
I gave one to DS when he was just over 10 months, he sleeps in our bed a fair bit but goes in to his cot first up. When he's in bed with us he likes to sleep up on the pillow and be close to me and it got to the stage he wouldn't go in his cot at all without a pillow.
He has a very thin junior pillow and sleeps much better with it.
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