I got this item because it's easier to have another top layer for my changing table so I don't have to keep changing the nice cover all the time. If your child pees on it it is not waterproof so the wetness very quickly goes to the changing table itself. If you have a pack n play with the changing table feature you need something, in my opinion, as the pnp table is plastic and cold to the touch. I'd say a blanket that's not your favorite would do the same trick as this one slips around anyway.