Thank you for viewing. *Please read the profile before purchasing.* Pigeon Baby Rhythmn Manual Breast Pump Box and instruction manual are included. Six packs of sterilized wet cotton are included. It has only been used a few times, so it's clean. However, it has been stored for a while since I stopped using it, so there may be some aging. It was disinfected with a chlorine-based disinfectant and stored, but I touched it during the photo shoot, so I recommend disinfecting it again before use. Pigeon's dedicated baby bottle and nipple are not included. #Pigeon #BreastPump #Manual #BabyRhythmn #Breastfeeding #SterilizedWetCotton