Embodiments of an apparatus are disclosed. The apparatus includes a changing mat, a mat-native restraint system, and a pass-through structure. The mat-native restraint system is coupled to the changing mat at a location on the changing mat to receive and secure a user on the changing mat. The pass-through structure is disposed in the changing mat to accommodate pass-through, at the changing mat, of at least a portion of a mat-foreign restraint system to secure the changing mat to a changing surface and to further secure the user on the changing mat.