Spica Cast Advice

What to expect (and how to cope) when your child with
congenital hip dysplasia is placed in a spica cast.

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Proper diapering is critical to your child's (as well as your own) comfort.

As with any cast, the goal is to keep it dry and smelling okay (a wet cotton cast liner will never dry, resulting in skin irritation and stink).  However, this goal is made infinitely more challenging by the fact that the cast surrounds the crotch, which means even a minor error in diapering technique can leave you with a cast that smells like (and contains) urine and feces.  The good news is, with the proper supplies and techniques, you can dramatically lessen, if not eliminate, the odds that your child’s cast gets soiled.

What you need:

The Technique

If you don't like to read, simply watch our instructional video (below).

You are going to use a three layer approach (Poise pad, smaller diaper, then large diaper). The first two layers will continue the pee/poo, and the third layer holds the first two in place. It's a pretty simple process, and is best to do with your child laying flat on their back.

FIRST... tuck the back of the small diaper up under your child's rear end. Don't force it, but do make sure you tuck it into the cast as far as is comforable/possible.

SECOND... tuck one end of the Poise pad up under your child's rear end so it's between your child's skin and the small diaper (the pad should be the first layer of defense).

THIRD... tuck the Poise pad into the front of the cast so that it craddles your child's crotch. It simply needs to go from front to back. Chances are it will be a bit too long which is fine, so long as it's in there.

FOURTH... tuck the rest of the small diaper into the crotch opening of the cast. Make sure you tuck all edges of this diaper into the crotch opening. In order to protect your cast, make sure you select a diaper that is wide enough in the crotch to span the width of the opening.

FINALLY... wrap the extra large diaper on top of the cast. This is simply a safely layer to keep the Poise pad and smaller diaper in place.

Our Instructional Video

The Critical Rule

Change your child's diaper OFTEN! The Poise pads are amazing at trapping moisture. But they have their limits (and they do not absorb poop). The more often you change your child's diaper, the less risk there is of their cast becoming soiled.

Maximum vs Ultimate Pads... why?

Earlier I mentioned getting the Poise maximum absorbency pads for the day time and ultimate absorbency pads for the night time. Here is why...

The 'ultimate' pads are much larger than the 'maximum' pads. Therefore, the larger 'ultimate' pad takes up more space in my 8 month old daughter's crotch (which means there is less space for poop). As a result, when she goes poop, the poop is more likely to project sideways and possibly leak beyond the edges of the small diaper. This would be disasterous (read: soiled cast)!

However, when she wears the smaller 'maximum' pad, he poop tends to stay on the pad and therefore within the small diaper.

Therefore, since she never poops at night, we use the smaller 'maximum' pad during the days and only use the larger 'ultimate' pads at night.

But kids come in different sizes, so you should experiment. And I'd caution you to start with smaller pads first and then increase the size during the day to gauge performance and 'poop displacement' factors.