I don't use the waterproof side of my mattress because I think it would get too hot. I used to just have a waterproof mattress protector, but it wasn't plastic. It was sort of like polar fleece, so I just used that.

I don't use a top sheet. I have only used them to wrap dd when she got too big for other wraps. She has always been wrapped or in sleeping bags.

I also used to put something under her head, but I just used a face washer. That saved lots of changes as most leaks were milk dribbles.