Pigeon Breastfeeding Real Nipple SS Size, 4 pieces These are used items, used by a child born at the end of September. We used size S nipples from about a month after birth (used in rotation). After each use, they were sterilized and dried using a "pochi-to" sterilizer. (There may be something like water residue after using the "pochi-to". If you are concerned, I will sterilize them with Milton.) Please understand that these are not new. Please sterilize them again before use. No box. No instruction manual. Please understand that they have been stored at home. Please understand that the nipples will be folded for shipping. The fifth photo shows how they were stored after use. Thank you for looking.