The idea of small hearts going upward from the girl to the moon came to me immediately. I'd quilt them in the same color as the background so as not to take away from the applique. You may want to add other ideas as mentioned as well.

Jan in VA

Love the quilt - your friend will feel so loved when she's wrapped up in it!

What a wonderful quilt. I think, if it were me, I would eco stitch around all the appliques & then a straight stitch from the left hand bottom corner to each of the stars with either gold or silver thread. Would make it look like all the stars & the little girl would be shooting to the moon. I am sure she will treasure it no matter how you finish it.

Very nice quilt - your friend will really love it! Lots of good suggestions for the quilting. Please let us know what you decide to do.

How about tying the centre making the threads look like stars. It is a beautiful quilt.

I like Jans idea with the hearts, what a great way to finish this quilt

Very nicely done!

How wonderful and personal. Best wishes for her complete recovery. Sounds like she is soldiering on in spite of the obstacles.

I agree, great ideas!!!!

Very cute!!!