Purchased new last September and used approximately 5-6 times for short periods. There are no stains from spit-up, etc., and I believe it's clean, in my opinion. It has been home-cleaned. I will ship it with two pillowcases, the instruction manual, and a dedicated storage bag. The storage bag is new and unused. Please consider the condition based on the photos, as it is a used item. The following is a quote: [Esmeralda] The highest-end baby pillow model [Breathing Donut Pillow Slide Type] OK from newborns | Easy to adjust angle and height | Perfectly round head | Supports all head-turning preferences | Excellent breathability for safety | Resists flattening | Pressure distribution | Washable