I received this pillow when my baby was two months old. I think it shaped my baby's head a bit, but her head is by no means perfectly round just because of this pillow. I like that the pillow is relatively heavy and not easy for baby to move (hence not dangerous) - some other pillows are very light and move easily when baby's arms are dangling. Even if the child rises from the pillow, their height does not pose a breathing hazard, even if they sleep on their side with their nose/face pressed against the pillow. I don't like that there isn't a washable cover (none of the pillows I checked have one, which is ridiculous). Unfortunately the spit and drool have accumulated and all I can do is try to clean them up so they end up just being thrown away which is very wasteful. This is one of three pillows I have bought for my child and it is by far the best of the three. Don't rely on this to create a perfectly round head, but it helps, so I would recommend this to parents concerned about flat head syndrome.
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