Hotel pillow fill varies, with some using real feathers and/or down and others using polyester or microfiber down alternative. Any type of high-quality material can make a pillow feel luxurious and supportive.
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Hotels with the best pillows typically use a blend of luxury down and feather and they do so for good reason. Firstly, it's a combination that feels extremely comfortable, yet also supportive - already ticking two big boxes when it comes to getting the perfect night's sleep.
Most hotels do not change pillows regularly… Of course, the pillows will often be clean if they have been washed properly, but that isn't always the case in hotels. They are changed out maybe 5–6 times per year.
They are always washed between guests. Blankets are generally washed between guests. Pillows may never be washed. They are usually in some kind of waterproof pillow protector case and that would be changed and washed frequently.