The Cast {tips on life with a hip spica cast}

About seven weeks ago we were told the news that our daughter would be soon sporting a hip spica cast. Since I was in the hospital with her for a while I began looking around online regarding how to care for the cast and the child in the cast. There are lots of technical & medical information out there, but not a lot of ‘real life’ tips. In comes my blog. Who knew writing a blog would mean numerous readers would email me tips from their experiences! Our transition into life with The Cast was so much smoother because kind moms who had been down this road before offered me help. Thank you.

Since so many of you kindly read this blog (side note…if we meet, please do not be embarrassed to tell me you read my blog..)…anyway, since there are a good number of you visiting here I knew if I wrote a post about hip spica casts that it would probably pop up on search engines for future moms given the news their child would be going home in one. So, I am going to write this to those moms….my very small way of passing on all the great tips I was given. Hopefully it will help another mom who sees some crazy stuff online when doing a hip spica search!

Thank you to those of you that have passed on tips from diaper changing to matted hair repair. THANK YOU!

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Transportation: There are a few options available here. Some children can fit in their car seats – my daughter could not. There are special hip spica car seats available for purchase online. Larger cities often have resources to rent one. Another alternative is a harness that looks like a skydiving vest. Not every hospital has these available. Thankfully we were able to get one from our Children’s Hospital to use for the duration of the cast. In the car she lays on her back in the back seat. One seat belt wraps through the back of her harness. Another seat belt uses an attachment to wrap around the leg with the cast. Her legs are propped up on pillows. Climbing to the back of a mini-van carrying her is a pain, but worth the ability to get out of our house.

This is the day we left the hospital, I was thrilled…she was drugged.
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Hospital Hair: After 18 days in traction on her back her hair had to be cut the day we got home. I used de-tangling spray 3x a day in the hospital. After ripping out knots for that long the ends of her hair were in bad shape. If you have to do traction – do your best to work out tangles a few times a day. You could also use a hat and a silk pillowcase. She didn’t want to use either.
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Sleeping: A bean bag has worked best for her. We play lullabies to help her fall asleep. The first few nights were really rough, but she quickly settled into her new routine. The combination of the cast and the bean bag made her pretty warm….and sweaty. I recommend covering the bean bag with a blanket or sheet that can be washed.
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Diaper Changing: This advice from readers was the most helpful. The hospital told us just to do two diapers….she got urine in her cast within the first hour. This method did not work early on. She was on IV fluid – which created more fluids coming out. This is for a girl – I imagine there are unique challenges with a boy as there are a girl. (Thanks Nancy for the great tips on this!)

What worked the first weeks:

1. Cut a newborn diaper in half, tape the cut ends closed.

2. Line the edges of the diaper between legs with the cut newborn diapers (absorbent side touching skin). Tape to cast.

3. Use Poise pad (yep those are for adults), tuck it up the back & front of the cast. (we started with the regular size, then switched to the long ones)

4. Use your child’s sized diaper – tuck up front & back of the cast.

5. Use a large diaper to wrap around entire cast – keeping poise pad & other diapers in place.

What worked the second week on :

The cast got looser and we did not need the newborn diapers.

1. Use the long Poise pad and tuck up front & back of cast.

2. Use current size diaper to tuck up front & back of cast. Fold the front over the edge of the cast (hold it down with the big outer diaper)

3. Wrap with big diaper

If you change the Poise pad at least every two hours you probably don’t need to change out all the diapers. If you are able to completely line the inside top half of the cast with the diaper this helps a ton. The cast will get urine in it. No matter how hard you try and how OCD you are about keeping it dry….it will happen. Don’t break down and cry over it (like I did). Just prepare yourself. My daughter’s got urine in it from laying on her tummy…then we started wrapping the inside diaper up and over the cast to completely line it.

We didn’t use one, but I’ve heard great things about Cast Coolers.

Poise pad & regular sized diaper….larger diaper would then wrap outside of cast.
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Sitting: Our daughter’s cast had her in a “frog” position. She couldn’t sit in a normal chair because of the angle. An infant seat with the tray removed worked by inclining it a bit. This has been a life saver as she is able to eat and play in this chair.
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My grandpa built her a custom table to fit over her cast since the tray would no longer fit.
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Dirt & Stench: If you have an active child, most likely the cast will get dirty. I tried putting a sock over her foot, but it just made her mad. You can clean the cast with a damp towel, but it didn’t work so good for us. The dirt was not a big deal to me, but the smell of the cast is horrible.

Bathtime: Sponge baths. Every day. It gets old. No great tips here.

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Clothes: Dresses a size big work for me. She, on the other hand, has her own ideas of what she wants to wear. She picked out this entire outfit.
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Moving around: My dad built her a custom skateboard. It is skinny on the front and wide on the back. The front wheels are enclosed so she doesn’t roll over her fingers. It is also padded.
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Walking: We were 2 weeks into having the cast before I showed her she could stand next to the table in it. After that all she wants to do is push her stoller (with me close by to catch her when the cast goes one way and she goes another). I think if she was just a bit bigger and stronger she could probably figure out how to walk by herself in it. I have a radiologist friend that said walking like this is great to promote bone growth around the break.

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Bean Bag & Car riding hair: Again with the hair….this is how it looks 90% of the time. I keep detangler, a water bottle & comb in the car now.
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Carrying: Hip spicas are awkward & heavy. Her’s has a bar between her legs that has given me a bruised and calloused hip bone. When I carry her I feel like I am carrying a cast not my daughter. This too shall pass. I miss feeling her legs wrap around me when we run through the yard and spin.
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Adjusted: Eventually she just adjusted into life with The Cast. She still gets mad when I tell her she can’t jump on the trampoline, but she moves on to other things like rolling and wrestling with her big brothers. I’m pretty sure if she could figure out how to jump she would.
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When I was in elementary school I broke my foot (my second time) and had a cast from the knee down. I was at the gym (gymnastics) and my coach stepped in the office. I had be dying to know it if was possible to do a round-off backhandspring in a cast. The moment he stepped out (no other adults in the gym at that time) I knew I had my chance. I went for it. As I landed the backhandspring I heard a CRACK. I cracked the bottom of my cast in two places BUT I ACCOMPLISHED A ROUND-OFF BACKHANDSPRING IN A CAST! I didn’t tell my coach, but had to tell my parents that night. Our doctor lived nearby. My parents made me walk to his house, knock on the door and tell him what I did. That was not fun, but yes I am still proud of my achievement. I am also thankful my daughter doesn’t know how to do flips yet – she’s too much like her mom.
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I think one day she will enjoy looking back at all these pictures of her time in a cast.  She is being such a trooper in this.
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Those of you that have dealt with hip spicas and have additional tips or resources, please leave a comment sharing them.

If you are visiting this post looking for hip spica help…I hope you found some!

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  • Jenny - My 20 month old daughter just broke her femur trying to climb onto a bed. She got stuck, twisted and fell off. She’s been in the spica cast 1 week and it’s getting easier. Thanks for the tips on the 2 diapers. I’m going to try to fill the sink with bubbles this afternoon. All she wants is a bubble bath and her bike! We have 5 more weeks to go.

  • Shannon - Thank you so much for your tips. I’m gonna have to try the bean bag for sleeping, my daughter is so uncomfortable in my bed. And thank you for the link to the cast cooler – mine is on it’s way as of 5 minutes ago. The last 4 days have been a blur, my daugther got her spica cast on Monday due to a broken femur from a 100 lb. TV falling on her thigh. Since she’s 2, and has hair longer than you’d believe, i noticed that putting her hair in pig tails helps the most. It’s out of her face and split down the middle so she can lay easier. I also found that a wagon lined with pillows is the best form of transportation. Also, we bought a little activity tray from walmart that she can lay on her lap (like your wood table) where she can eat and color on. Thanks again for the tips and for the link to the Cast Cooler…only 5 weeks and 2 days to go!

  • Shannon - Also…the Children’s Hospital we went to lined her entire cast in moleskin so it wouldn’t scratch or irritate her skin. She has little strips all around the oustide openings – for her legs, diapering area, and top. they’re replaceable when they get soaked or dirty and it helps with the comfort.

  • Chantel Crispin - What a lovely blog, the photo’s of your daughter are so gorgeous. I have had both my daughters in spica’s for Hip dysplacia and possibly will be having my son go into one. Your tips are great, I don’t think I can even add anything. But if anyone knows an easy way to do the grocery shopping I’m keen to know. My girls could fit in their pushchair, but I couldn’t get many groceries that way.

  • Ellen - I read these posts last spring, thinking how awful this would be. Then my daughter leaped from a table in early November (she seems to be a very similar personality to your daughter… and yes, she jumped on purpose)and we’ve had a hip spica since.

    The first thing I thought when they told me about the cast was, “I saw this on Ashley’s blog!” Funny how these things come back to you.

    We have learned a lot of these same methods. Trial and error! She STINKS right now. Hopefully it will come in just over a week, in time for Christmas! I’m counting my blessings… there was no traction and no bar. The thing I can’t believe is just how very tired I am from hauling around this heap of fiberglass! My daughter is 24 months and has figured out how to stand on her own and cruise along furniture, etc. It’s been helpful as she’s learned all that, but she’s getting very frustrated.

    Good luck to all who have this challenge!

  • Life Is Precious - [...] daughter was in one last summer for a really long time and she was kind enough to share some tips HERE. Thank you Ashley! Our family was blessed yesterday with the continued life of our son Conrad. I [...]

  • Barbara - We just started down the long journey of a full hip spica cast with our 10 month old daughter. Reading websites like yours has helped. Our daughter has more limitations since her cast goes all the way up to her armpits and covers both feet. She’s terribly heavy in it (I was not prepared for the weight of the cast) and although I love your modified skateboard to help her get around, I’m not sure that would be feasible for our little one. One helpful hint for diapering….. tearing off the tabs prior to inserting the diapers in the cast ensures a better fit and no worries about skin scratching. Also, my daughter loves that part of her bedtime routine is about 10-15 minutes of a hairdryer on cool/low warm to air her out and dry any perspiration.

  • Natalia - Hello! We are T-minus 13 days to hip surgery for my daughter and my friend has offered to make the “skateboard” for us. Do you have any tips/plans/suggestions for building the one you used? I like the way the wheels are covered.

    Thanks!

  • cintia - Hi Barbara,
    We also have a 10month old baby girl in a spica cast =(
    how is your daughter doing? did she need surgery? how long did the surgeon give her to be out of the cast?

  • jenny corban - This is soo wonderful! I am an orthopaedic nurse from New Zealand and my main job is applying plasters and so do many hip spicas. I am thrilled to have found this and would like to print it in colour to use as a resource for all my mums.I also plan to give your web adress for reference! I hope this is ok with you. You are helping many people with this post and will continue to for as long as it remains online.
    Thanks so much on behalf of all my future mums and hip spica babies!!
    Jenny

  • Linda Ellis - My granddaughter, Olivia, is having a spica cast fitted at the end of April when she will be six months old. We are hungry for information and tips and your blog is superb. Many, many thanks.

  • Kim - Ah how I love this post. My 5 year old daughter was diagnosed with DDH last week and we’re scheduled for surgery in July. I’m just now starting to navigate the waters of what to expect, etc. I’ll be digging in to your blog big time! Thank you so much for this post!

  • Holly - My little girl is 3 months old, and will be going in a spica cast. The information you have provided will help me greatly! Thanks!

  • Cindy - Hi. Thank-you for the info regarding the spica cast. Do you also have pictures of what the skateboard looks like to build? Any help would be appreciated.

  • Marcie - My daugter has already been in a spica cast for 3 months from 6-9 months. I have recently found out she will have to be placed in one again the end of june. She will be 20 months old. Now that she is walking i wanted to have some way for her to get around the house. do you have any directions as to how to build the scateboard you used for your daughter? You did a great job with your little sweetie. your pictures are beautiful!!!

  • samantha - Wow! Watching your daughter in her cast is heart warming. My daughter just had a hip spica cast put on and I am so terrified of moving her and rolling her… gives me hope that eventually we will be mobile and comofortable.

  • Fabiana - Thank you so much for this info! My son just got has cast this past Saturday and I was feeling completely lost! Thank you, Thank you, Thank you!

  • Pandora - Wow…I hope your daughter gets well soon!

  • Diana - Thank you for posting this. I didn’t look through all the comments closely, so I may have missed this, but can you describe how the wheels of the skateboard were covered?

  • AshleyAnn - Diana – My dad built it kind of like a wood box…with a bottom and four sides. Then turn the ‘box’ upside down so the child lays on the ‘bottom’ of the ‘box’ and the wheels are inside the box, covered by the sides…I hope that makes sense!

  • Diana - AshleyAnn – thank you. Got it.

  • Misty - Thank you so much for this article. As I sit here in years because my baby will be place in one on Tuesday, this post calms my fears a bit. I’m an RN so it’s not like I don’t know what to do, but it’s just not the same when it’s your own kiddo.

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