You know, I wondered about that too, because they specifically ask for lots of quilting so that the quilt can withstand many washings. Also, they specifically do not allow tied quilts because they can be a choking hazard. Still, there are some testimonials that indicate that at least some of the kids have taken them home. Could be that they are washed by the hospital before they are put into use. It would seem mean to me to give a kid a quilt and then take it away from them when they leave.