New. Clean in microwave with reusable case. Accepted by 95% babies (Based on Market Research 2017, tested with 307 pacifier users). No nipple confusion (Based on Market Research 2017, tested with 307 pacifier users). Recommended by moms. BPA free. Improved NUK Shape. 1. 8% flatter-More room for natural sucking motion. 2. 23% slimmer-Reduces pressure on jaw and teeth. 3. 9% narrower-helps prevent teeth misalignment. Nuk-USA.com. Nuk-Canada.ca. Made in USA.