Purchased officially from Rakuten in March 2025 and used less than 10 times. A towel was always placed on the head area. No spit-up, urine, or feces leaks. Washed at home several times. I think it's clean with no stains or marks, but please understand that this is a used item. The bamboo cover is soft to the touch. Inner head cushion is not included. - Yunisleep Pillow - Bamboo Cover - Dedicated storage bag - Instruction manual Will ship without compression, but will be shipped in a large bag because I don't have a cardboard box.