Wear as a backpack, messenger, or holding the handles. Comes with everything pictured. Messenger strap, stroller straps, and changing pad. No keychain. I used this bag for 2 babies, it holds ALOT of stuff. In very good pre-owned condition. Juice spilled on the inside and got on the changing mat and the bottom of bag. The inside needs a good wipe down and it will be perfect. The mat can get thrown in the wash! I kept forgetting because it's been stored in the back of the bag. Happy to answer questions! Offers accepted.