We had a reader make a suggestion on how they kept their baby dry in a spica cast. We wanted to pass it along to others who might be preparing or trying different methods. I personally have not tried these, but it does make logical sense. According to Garren (our reader), she said that instead of using feminine pads to keep a child in a spica cast dry, she used TENA male guards. I had never personally heard of these but I did a quick search and found that they are available at lots of stores, including Wal-Mart.
Since spica casts are not pre-made, each one is unique. According to the reader these male guards are wider and a little bit shorter than a feminine pad. However, according to Wal-Mart there are different sizes, I suppose it may just take some experimenting to find out which ones will work for your childs cast.
Again, I just want to make the comment that I can not really vouch for these as we never tried them. However, you may find that for your baby’s cast that they are easier to use. The process is done the same when it comes to tucking them into the cast in a way that is safely done, but will hopefully protect your child from a skin rash and the cast from smelling bad.
Here is a list of helpful tips to keep everyone happy
1. Keep the cast dry - If the cast becomes wet, I suggest you use a blow dryer on cool so that you do not burn their tender skin. I did this often those first two weeks, but she was so sick that you just couldn’t keep it dry. So I came up with a different solution. Remember that your child’s cast can become wet from excessive sweat so dress them lightly even during the winter months. It is best to carry around a blanket then for them to be dressed in layers. Natalie developed her sores because of her Halloween costume. It was made of a thick material that made her sweat while indoors. It was perfect for outside unfortunately we were indoors most of the evening.
2. StayFree Feminine Pads - I placed stayfree ultra thin feminine pads on the inside of the cast. The pads would get wet or soiled instead of the cast. You can remove the pads, and the child stays dry and happy. Natalie developed sores before we could figure out the solution with pads. She now has scars on the outside of her hip from where she had either soiled the cast or it did not dry from the excessive sweat that her Halloween costume caused. They are in a place that while in the cast it was impossible to reach. I know this because I tried every possible way to get every inch of her cast dry and clean. Sometimes it is just not possible. Placing the pads on the inside of the cast may be slightly difficult for parents with larger hands. Detailed directions for this are at the end.
3. Baking Soda - You will want to keep some baking soda around for the smell if you cannot get the cast completely clean. This will help a whole lot with the smell. ONLY place the baking soda on the outside of the cast because their skin can be easily irritated.
4. Support Blankets - we did this because there are commonly weak spots in the cast that can cause breaks. If the cast breaks, a new will be needed to replace the broken one. This means more anesthesia for your child and the possibility of the hip coming out of place. This is unnecessary if you take the extra precautions.
5. Cast and Food - Do not allow food to fall inside the cast while your child is eating. A large t-shirt or a one piece outfit is the best solution for this particular problem. If food or small toys fall inside the cast, you child’s skin can become irritated or could possibly cause an infection.
Taking care of child in a spica cast can be difficult. I found that the one thing that kept everyone happy was to keep the cast as dry as possible. If the cast becomes wet or soiled it will become very uncomfortable for your child. Natalie’s cast was wet off and on because of a stomach virus in the first two weeks. I found once she was dry, she was a lot happier and everyday life became a whole lot easier. She was more willing to play by herself for about 30 to 45 minutes at a time before she became bored.
Directions for placing the pads on the inside of the cast are a little complicated to explain so I will try my best. You will need a total of three pads to fully protect your child’s skin.
1. Take a pad and cut in half. Take half of that pad and place on the inside of the leg so that half is inside the cast and half is on the outside of the cast. You will want it to be long ways. Then use white medical tape to tape it into place. The sticky part of the pad will only help a little bit that is why you will want more tape. Repeat this step for the other leg.
2. Now take the two remaining pads and slide them through the back side of the cast. The soft cotton side should be to their skin. You should have enough left over so that you can tape the pads into place on the outside of the cast. That means you will want them to be taller than they are longer. If that explains it, like I said it is somewhat difficult to explain. You will want to tape the pad into place so that they do not slip around and irritate your child. This may not be very pretty, but your child will be a lot happier if they are dry.
When Natalie had her surgery we did not really go anywhere for about 10 days. She really did not feel up to going any where. It can be difficult for them to get comfortable while in the cast. You also have to reposition them every two hours. This is recommended so that they do not get sores on the pressure points caused by the cast. This can make it hard to travel for long periods of time. I would not recommend going more than thirty minutes to one hour from home because the ride can be tough on the child. The special car seats that are designed for the spica casts try to make them the most comfortable, but too much bumping around can still make them very unhappy. This was sometimes the case for Natalie.
It can be difficult to travel with a child in a cast especially if you plan on staying for a short trip at a family member’s home, church, or a hotel. This is because you pretty much have to bring your entire home with you. That is what it seemed like to me any ways. You have to pack plenty of diapers because you have to change them so often. I always brought a bean bag for Natalie to sit in so that she did not have to be held most of the time. We also brought extra pillows that I made for her. She had three pillows that we took every where. You never know when might need to give her more support. The bean bag would fit around her to support her cast so that she could sit up almost on her own and play. The bean bag worked well at my parent’s house and at church. I know it sounds like a lot to bring for one place, but she liked to be able to sit up with out being held all the time.
The first cast she was in was really too big for her to fit any where. We had to bring her stroller for her to sit in at restaurants because she no longer fit in the high chairs. She did not fit in any high chair or any normal sized chair for that matter. We carried her stroller with some special pillows that I made to support her and the cast every where that we went. The pillows that I made fit under her legs and behind her back to give her some extra support when she wanted to sit up.
We read some suggestions of using rolled up blankets, but they always came unrolled during the move. I ended up placing rubber bands around the ends to keep them from unrolling. The rubber bands helped save a lot of time.
It was only a 24 hours after Natalie received her spica cast that she would endure more difficult moments. The following day we found out that she had a stomach virus. This was a huge problem. She was making a mess of her cast. I had cleaned and cleaned and it was still gross. I did not know what to do because there is no information on what to do if your baby develops a stomach virus while in the cast. The poor baby was stuck in a cast that was full of you know what. That is when I cried for the first time. I was alone with a baby in full body cast who could not even sit up alone and she was stuck with no where to go. My husband had gone back to work, my mother was gone, my sister worked, every one worked. I felt terrible like I had let her down because I could not stop it or make it better for her. I used the blow dryer on cool air for hours to dry her out. That did not work at all and nothing else seemed to work.
I was so tired already and this was just the first week. I thought how in the world am I going to make it for 11 more weeks. I thought to myself she is already covered in poop, the cast stinks, and I can not make the diapers work. I was about to lose my mind until I remembered that the pamphlets suggest that you use a feminine pad inside the diaper for extra absorption. I thought this is what I forgot to do and this will make it all better. Well I was so wrong that I was out of my mind. This not only made her even madder because it was so uncomfortable, and it did not work good at all. I thought what in the world am I going to do to survive 11 more weeks of this. So I decided I was going to try to use the pads in a different way. I noticed that any extra moisture was going up her back and down her legs. I placed the pads in these areas. This was the best thing that I could have done for her and myself. The cast was no longer getting wet or soiled from extra moisture that the diaper did not catch. The second diaper is supposed to catch the extra moisture but guess what, it doesn’t. The only thing the second diaper does is hide the first diaper. I placed the pads with the cotton side to the skin and used medical tape to hold them in place. It was soft like wearing pants to her. This completely changed the whole experience for me.
It took three pads for one diapering session. Every morning I would change out the pads, but if they needed through out the day they were replaced as needed. I only changed the ones that were wet not all of them. I would cut one in half and place them on the inside of the legs. I would place them so that half was taped inside the cast and the other half was taped to the outside the cast. The other two where placed on the inside of the back of the cast. I would feed them through from the top and out the bottom. I would then tape them in place on the outside of the cast. This keeps them in place so that they do not fall off or rub her back causing an irritation. You can also spread butt paste to the ones on the back to keep her skin from getting irritated from sweating. The morning diaper change will take about ten minutes if not more to complete, but it is well worth the time.
I figured this method out about the time that the stomach virus was over. The stomach virus lasted like two whole weeks. I think some of it was linked to the anesthesia. I wished there had been this information available to me because it would have saved so much heartache. Natalie would not have suffered so much discomfort as well. By the third week she had figured out how to crawl, roll over on her own, and she was completely dry by this time. She still had to stay in the stinky cast for another three weeks, but we could survive the smell that slowly faded over time. A little baking soda on the outside of the cast helped a lot.
I hope that writing out our families experience will help you through the times that are about to come. There are going to be trying time, but just remember that you can and will survive if you remember to keep the baby dry. If the baby is dry everyone will most likely be happy.
This stomach virus was our first trouble or obstacle to tackle. It is recommended that you change your child’s diaper every time they are wet. That means about every hour when they are this age, but with a stomach virus it could be every fifteen minutes. I know that sounds crazy, but I have been there. The hardest part was keeping the cast dry. A stomach virus makes that completely impossible with out the proper precautions. I am going to tell you what no one told me to do and it was what saved me and Natalie a lot of pain.
The most important thing for your child is stay dry while in the cast. If the cast becomes wet, it can cause it to break or a rash can develop. Breaking the cast means it will need to be replaced and the risk of the hip coming out of place. Moisture in the cast will also cause the skin to become irritated. This can lead to a severe rash which we unfortunately found out. Dressing your child too warm will cause them to sweat making the skin wet and more likely to break out. Natalie had a severe rash due to her Halloween costume that caused her to sweat too much. She had small little blisters from the cast on her back. This could have been prevented if I had better information on how to keep her dry.
I used Stayfree Ultra Thin feminine pads to soak up any extra moisture inside the cast. I lined the insides of the legs and the back side of the cast with these pads. I cut one pad in half to fit on the inside of the legs where you change their diaper. I placed two whole pads on the inside of the back so that the soft side was against her skin. I used medical tape to keep it in place. I also placed butt paste on the pads if I thought that any of her skin was irritated. I changed them once a day in the morning or before bed if needed. I used this method to prevent any leaking from the diaper to stay on her skin. Most of the pamphlets recommend that you use a pad on the inside of the diapers, but this was uncomfortable and really did not work as well. It took a while to figure out the best placement, but Natalie’s second cast was completely clean when they removed it. The first cast was not clean at all. It smelled very badly because I did not have good information. I hope that this will help any one else who is about to take the journey with a child in a Spica Cast.