This pillow does what I expect. It keeps my back warm when I recline on it, and keeps my head above water when I use it flat on my back. It is just the right size to be comfortable under the neck with no straining.I will say that it is just a tad narrow. It definitely does not span from shoulder to shoulder. So to protect your back from a freezing cold tub back, you will need to position it very strategically.Overall, though, this was a good purchase.Update 1+ years later:The pillow has developed a few drawbacks over time.First, it started leaking, which means it constantly fizzles and sputters air out when you're leaning on it. This can range from insignificant annoyance to major detractor from how relaxing your bath is.Second, the pillow's exterior is very susceptible to growing bath mold. If you let this get bad, you will not want to use it in your bath again. I literally have had pieces of mold flaking off and floating in the tub with me while using this pillow. I've tried soaking it in a vinegar solution, and I've tried spraying it with anti mildew spray and scrubbing it with a plastic bristle brush. Nothing seems to keep it clean anymore.I didn't buy this pillow intending it to have a useful life of only about a year. But that's about what I got. After that, you'd better have been cleaning it routinely, because otherwise, it gets *funky*. Your mileage may vary.