This is a new set of ameda collection system, the pack has never been opened, along with two extra bottles and lids, duckbills, bag adapters, shield inserts, and a cooler bag that also have never been used. The machine itself has been used, but since it is a closed system, is perfectly hygienic. I am very careful about these things, as the breast milk subject is pretty touchy. The pump itself has good suction, and gets milk out efficiently, and I would call it gentle on your nipples. I would recommend lubrication for ease, though none is included with this set. Any questions for more info is welcome!! The reason I’m not asking a ton for it is I got it through insurance, though I did pay for the extra hygeniKit set.