Not bad for a changing pad. The nice thing is, even if it's too loose around your neck, you can flip it around where the buttons are on the outside and tighten it. BUT, if like me you want to use him as the girl in the first photo, that just won't work. As soon as you tilt your head, it moves. I bought it for my mother-in-law who sits in a chair a lot and ends up with severe neck pain from her head falling on her left shoulder. Keeping your head up didn't help at all.
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