It is hard to see. Usually buttons can interfere with quilting so you just have to know when they are getting close when you are quilting. I think this would be gorgeous if you crosshatched the background. I use to quilt my Sunbonnet Sue after attaching all the decorations. I would do a few tiny stitches as you approach an applique, then just jump over the applique, then a few more tiny lock stitches and continue quilting. Very pretty applique.