I purchased this four years ago for my first child and used it for about two months. I didn't have the opportunity to use it with my second child, so it has been stored at home for a long time. I believe this item is recommended to be hand-washed, but I think I washed it in the washing machine a few times, so it may have lost its shape. I never used the insert. I used it because I was concerned about the shape of my baby's head after a vacuum delivery, but now people say the shape is beautiful! I am not accepting price negotiations.