Brand new in box. Box has slight rip as shown in last picture. Use cold or hot. Comes with machine washable soft covers Cold Therapy - Use as an ice pack to help relieve engorgement, plugged ducts, and mastitis Hot Therapy - Use as a heating pad to encourage milk let-down during pumping Breast Pump Aid - Use hot to encourage milk let-down and reduce time spent pumping Soft and flexible, so they conform to your breast for comfortable, 360° relief