|What to Expect?
|1. What is the shape of the cast?
||Her legs are bent slightly at the knees and apart.
The cast goes up under both arms and around her chest.
If she is lying on her back her legs are off the ground
by several inches.
|The whole around the diaper area is about the size of your
|We found that if we used a mini pad as a liner (Kotex Ultra
Thins without wings), and either a newborn diaper or a size
one over top of the pad we had very few leaks. We trimmed
the tabs from each diaper both back and front, and tore just
a small amount of the paper backing off of the top and bottom
of the pad leaving the sticky part covered.
|These pieces removed would either poke the child or make
the diaper harder to fit and slide. Place the child on her
tummy over a pillow or bolster, lay the pad in and tuck edges
in front and back of the cast then put the diaper over the
pad and push it up inside the back (about ¾’s
of the diaper will go up the back side and tuck the remaining
part of the diaper in the front of the cast. (Insert picture
mollycast4a & mollycast4b) Make sure that the entire
underside of the diaper is against the skin and not touching
the cast. It will wick up and wet the cast.
|Overtop the cast we put a large size Pull Up with easy
open sides on just incase of leaks and it helps hold the
diaper in place like underwear. You can reuse the outside
Pull Up’s several times if it doesn’t get wet.
|Note: we precut the diapers and opened the pad
liners. We kept a “Boppy” Pillow in
our mini van for diaper changes on the go!
||Hint: If diapering a girl the urine will run to the
back so send more of the diaper to the back. If diapering
a boy send more of the diaper to the front. If the cast
gets wet use a cool hair dryer to dry. A warm dryer will
really heat up the cast. Be diligent about changes, at
least every 2 hours, and before sleeping. We even modified
our feeding to give her last bottle of the day earlier
than usually and feed her cereal for last meal so we
could change the last wet diaper before bed. Otherwise,
plan on getting up at least one time during the night.
If the diaper does leak in the cast the urine can burn
the child’s skin.
|The cast is formed with the child’s legs are bent
at the knees and out to the sides, therefore a traditional
car seat might not fit, and will probably not fit. We have
a 18 pd daughter and we purchased a very large Evenflow brand
child seat and padded it with a blanket and it fits very
snugly. I think that if she was any larger we would have
had to purchase a special car seat specifically for children
(see below). Keep in mind that if your child is rear facing
and is close to the 20lb. weight to be front facing take
into consideration the weight of the cast which is a few
pounds and they might need to be forward facing. Also the
leg position might not allow rear facing any longer.
|Below is a list of resources for the EZ-On Modified Vest
for Patients in Spica Casts:
|Contact: Jill Bello in New York (914) 907-5580, Rental
Price $10.00/week for vest.
Some insurances are accepted DME code: E1399 Purchase
|HC Armstrong in Pennsylvania 1-866-396-6776. $130.00 plus
|EZ Way in Ohio 1-800-543-0575, $140.00 plus shipping
|Children 18-25 inch waist order model #M203
Children up to 32-inch waist order model #101M2
|Insurances are not accepted with HC Armstrong or EZ way,
but you can check with your healthcare or car insurance to
|Note: you will need to have this transportation in place
to transport your child home. The delivery of these seats
could take 1- 2 days and your medical insurance will not
cover the extra time at the hospital if you are waiting for
the car seat.
|Since most of the body is covered by cast you only need
to worry about covering the upper torso and feet. If it is
summer time a t-shirt with snaps at the crotch will work
just fine. I suggest the snaps because the shirt will tend
to ride up, and even if it is warm the underside of the arm
will chafe after rubbing against the top of the cast. If
is cold out then use a long sleeve shirt that snaps with
or without and undershirt, or a sweat shirt, nightgowns,
or any type of shirt that doesn’t have snaps or buttons
in the back.
|The t-shirts and shirts will need to be 1 or 2 sizes larger
than what they usually wear or use clothing from an older
sibling. For her feet we used ladies colorful knee socks
of ladies footies with cute decorations. They looked like
tights over the cast. Regular socks, tube socks, or Soccer
type will fit well also for boys. We found that even soft
sided shoes bunch up at the heal.
|Keep in mind when heating your house in the winter that
the child in the cast is warmer than everyone else so be
aware of the temperature in the house not being too warm.
|The child’s feet will be a few inches off the ground
so position a pillow under the feet. Also place a few toys
well in reach. Our child woke up several times in the middle
of the night in the beginning so be prepared for that. Our
child also figured out how to wiggle up to the top of the
crib and pull herself by the crib rails, so check often to
make sure they are not smashed up against the railing. If
your side drops down on the side of the crib you could keep
it in the lower position for easy reaching and taking out.
The child can not get out of the bed from that position.
We found that one of the reasons our child was waking was
due to gas. Being so immobile didn’t allow for her
to burp or dispel it so make sure they are well burped and
danced around before bed to help out. We also use Mylicon
drops to aid in gas reduction.
|5. Daily Seating:
||We purchased a bean bag with structure made for Video
Game playing (found at Target).. It is very light weight
and has a handle. It can even travel with you.
||The child can also be propped up on the sofa. We put
a bunch of her toys in a wide, low basket and propped
it up on a pillow beside her for hours of enjoyment.
If you put a pillow in front of the between the legs
that can also stabilize a favorite toy. She also enjoyed
being on her back on the ground to wiggle around a bit.
|We used the video chair at the table for snacks
or to self feed. Or I sit on the floor to feed her, or drag
the chair into the kitchen for meals at the table. If they
are at an age where they like to hold their own sippy cup
or bottle watch for when they are finished so they don’t
drop the bottle or cup because it might leak on the cast.
We found our daughter shaking the bottle of milk out on her
cast because she was bored. If they are self feeding check
around the neck to make sure no food goes down inside the
cast. We also bought a small snack tray with legs, it fits
in front of her so she can snack and eat. Our favorite item
is a small cup with handles and a lid with slits in it it’s
called a “Snack Trap” www.snacktrap.com it holds
crackers, cheerios ect… and it’s great for all
kids to reduce spills.
|Use a wash cloth and a bowl of water daily to clean
all exposed skin. We washed hair once a week on the kitchen
counter top with the baby on a soft pad. We used the
sink sprayer with the child’s head hanging over
the sink. After her bath her favorite thing was to play
with a few small toys in the big bowl of bath water.
We would wrap her cast in a towel and sit and hold the
bowl for safety sake for about fifteen minutes. I think
she likes it so much because she sensed that water is
forbidden right now.
| Our child fit easily into our Century stroller.
This is a larger stroller heavy duty that was a few years
old. She will not fit in any of our double strollers or umbrella
strollers, or smaller compact strollers.
| Their legs are shaped
perfectly in the cast to fit around your hips just like if
casted. They are just a few pounds heavier.
|We are currently half way through our experience and I
have to say that the unknown prior to having the cast on
was worse than that actuality of it. If you are prepared
things should go smoothly and your routine will take over.
Our daughter seems quite happy and doesn’t seem to
mind the cast. After you figure out your own logistics it
might be not as bad as you picture it. We hope that our web
site was informative and helpful to you if you are in our
situation, and the best of luck to your family !