Here is an informational list that will help with hip Spica cast care of a toddler. Our son suffered from a spiral femur fracture. Included are multiple photos of my son in a hip Spica cast and links to products we used.
1. Sleeping in a Spica Cast
The first thing we had to figure out upon coming home from the hospital, was how to make our sons bed (crib) suitable for sleeping. Since his cast had a curve at the waste, he could not lay in bed with the mattress flat. We had to put a mattress wedge under the mattress to incline it. We then put a pillow and folded up blanket under the fitted sheet. This way, the bed inclined to the angle of his cast, and the pillow and blanket contoured to his body. We readjusted the pillow and blanket until he looked as “comfortable” as possible. His first night at home was rough and he woke up a lot, but after that first night, we had very few sleepless nights.
2. Diaper Changing Station
So, changing the diaper of a toddler in a hip Spica cast is a task. We couldn’t change the little guy’s diaper on the changing table, so we used the end of the chaise as the diaper changing station. We laid down a beach towel and had the box of supplies handy. We just used a large, empty diaper box. You will want everything that you may possibly need within reach. We used two sizes of diapers, our son was in a size 4, so we used size 3 and size 5. Here was our diaper station checklist:
- diapers, size 3, 12 hour
- diapers, size 5, 12 hour
- wipes (lots and lots of wipes!!!)
- diaper cream
- mole skin
- triple thick antibacterial washcloths for personal cleansing
- masking tape
- bags for dirty diapers (or a diaper genie)
3. Diapering a toddler in a Spica Cast
Okay, so here it is. The dreaded diaper change of a toddler in a hip Spica cast. Hope for solid poop!!! We did have a few blow-outs and it’s bound to happen to you, too! It’s just a matter of time, so be ready for it! Have your diaper changing box ready to go. Here is the process we used. First, we prepped the cast surrounding the opening. We bought a lot of moleskin and taped it on the outside of the Spica cast surrounding the diaper area, then folded it down under the cast. This way, if there is a blowout, you remove the moleskin without getting much poop under the cast. Then, wipe under the cast with antibacterial wipes and replace the moleskin. Next, take the smaller size diaper and cut the velcro tabs off. Tuck the diaper in as far as you can all the way around the opening. Since this diaper is tucked in, I felt that it would be a little more comfortable with the velcro cut off. Next, take the larger size diaper and tuck it in around the diaper area. pull the tabs around to the front and velcro in place. If your child won’t be wearing clothes that can cover the velcro, secure it with the masking tape. So, the small diaper is tucked in all the way around the opening, and the larger one is just tucked in as much as possible, while leaving the tabs out to velcro in place.
When the fall happened and our son ended up with a spiral femur fracture , our twins were only taking a pacifier at nap. Well, this all changed. Our son pretty much got the paci whenever he wanted it. He did have a broken leg! If something as simple as a paci would comfort him, we gave it to him! And, since brother got the paci, of course, twin sister had to have hers, as well!! We are now about a month out of the cast and they are both back to just taking the paci at nap.
5. Bathing in a Spica Cast
As with diapering, we set up a bathing station in the bathroom. We placed a padded play mat down first, then put our yoga mats on top of that. This gave a semi water-resistant surface. For the actual sponge bath, we filled a water bottle up with water and mixed a small amount of his regular soap in with it. We would also have a bowl of clear, warm water nearby (out of reach of him!). We placed a folded up towel under his head to soak up the water after washing his hair. Commence to sponge him down. We just used a washcloth and the diluted soap all over exposed skin and his head. Then, we used the clear water on the washcloth to rinse the soap off. Since the soap was diluted, it was very easy to rinse off his body. We did bath time at the same time as his previous schedule. Since he and sister always got their bath together, we decided that placing his sponge bath station in the same bathroom that sister was in helped. They could still have bath at the same time, just in different ways! One parent would bathe sister in the tub and one would bathe brother on the floor.
6. Spica Cast Clothes
We found the BEST thing for our little guy to while in a Spica cast was snap up rompers. We found them at Carter’s. They would snap around the bar of the cast and cover his diaper. We bought five and rotated through them, washing them constantly.
7. Sitting and Positioning in a Spica Cast
We found quite a few ways for our son to sit upright and play and eat in his Spica cast.
The best innovation of all was the patio chair turned Spica cast seat!!! We took a plastic patio chair and cut out the front of the armrests. Next, we measured where his leg would reach and cut out a hole in the seat of the chair. His leg was able to fit right in the hole! We strapped a belt around his waist (just in case!) and pushed him up to his craft table. He was able to play with toys, eat, paint, color. You name it! It was a lifesaver!! We also put a bean bag behind his chair, just in case he decided to push himself backwards. We didn’t need a head injury on top of everything else!!
He also fit quite nicely in his strollers. They were not special Spica cast strollers, but they worked well.. We took a LOT of walks!
He fit perfectly in a highchair that we borrowed from Gramma. As with the stroller, it was not a special Spica cast highchair, but it did work. The stroller needs to accommodate the width of the cast and the bar that runs between the legs. Underneath the high chair also made a good little hideout for twin sister!
We had previously received Pottery Barn Anywhere Chairs, secondhand, from my sister-in-law. It was great! He could push right up under the coffee table and play with his toys. We moved that chair all over the house and even outside! Whatever room we went in, it went with us. It got to the point where his sister would drag BOTH chairs around the house (and outside) to make sure they had somewhere to sit!
We also bought a hammock Hanging Rope Swing from Amazon. He loved to sit in it and spin in circles.
He also fit in his cozy coupe car. And twin sister loved to push him around! It was actually better if she pushed him backwards. That way, if his body were to scoot down in the car, his cast leg would not hit the ground!
I think a bean bag chair would have worked better if we had a larger one that we could get him more upright in, but it did work.