No, foam pillow does not need to be fluffed. Our foam pillow was designed for durable support, so without any fluffing you can be sure that your pillow will support you night after night. There are no industry standards for foam pillow durability, so we created one ourselves modeled after the industry standard for mattress durability. We essentially pounded a 10lbs weight onto the foam pillow for 100K cycles to see if there was any indentation or degradation of the foams. Happy to say, there was none and our foam pillow lasted 100K cycles of a weight repeatedly hitting the same spot over and over again.