I’m not going to lie to you. Diapering with a spica cast is a massive pain. I can’t use my normal cloth diapers because I need something that keeps moisture out of the cast. I’m bummed about that, but I’m getting over it. I can’t do it all. If I could, I would’ve fixed her blasted hip myself and avoided this cast altogether!!
Everything I read before Sara had her surgery (except from one person) was that full diapering would not be possible. People suggested incontinence pads and smaller diapers than normal. They said to cut the tabs off the diapers and just stuff those little diapers and pads up and in the cast as best I could.
Well, one person said to me in passing that she was able to diaper fully (meaning she got a normal sized diaper up in the cast and fully closed around her baby’s skin) and I hoped I would be so lucky. It seems to me diapering fully will give us the best shot at keeping that monster of a cast dry. It’s on for 12 weeks, after all.
I know I’m lucky as far as Sara’s cast is concerned. I’ve seen pictures of casts that come up almost to the underarms. I don’t think any diaper would be tall enough to fully diaper if she were casted like that. Sara’s cast comes up just over her belly button.
We’re now two weeks into the spica cast, and I think I’ve got a pretty good system down. The first week was really hard because she was swollen from the surgery. I could hardly get a little pad up in the cast the first few days. I thought I was doing a good job diapering until about day 5 when that cast started to smell. We had a blow-out pooh and I pulled poop covered stuffing out the back and front and realized the whole cast was soaked. Not good!!
After that 45 minute diaper change, and with the help of my sister, we devised a new diapering system. So far so good. Cast is dry and Sara seems happy. And best of all, the cast doesn’t stink much worse than it did on day 5. Or, I have just grown immune to it. That’s always possible!
Here’s what works for us. No baby was harmed in the taking of these pictures…
First you need supplies:
- 2 diapers (In the beginning, it was important that the diaper be super thin. Pampers worked best for me. But now, after practice (and probably because I’ve taken out a bit of stuffing), I’m able to get the fatter diapers in there too.
- Flashlight to check out the skin inside the cast . For obvious reasons, you want to be very careful to keep the skin free of sores and rashes. Skin has a really hard time staying dry in that cast if the cast itself is soaked.
- Blow dryer (or cast cooler) to dry out the cast in the case of leaks.
- Back scratcher or other long, thin “poker” to help get the diaper in place
- Good quality wipes. I wanted to use my cloth wipes, but they were too thick and I like that store bought wipes have a little alcohol to wick away extra moisture. Under normal circumstances, I would not like that added alcohol, but they’re good for this application.
Once you’ve got your supplies and your baby cleaned, stick a diaper up the front, pull it out the top, and spread the diaper out, and then pull it back down into place:
Fluff out the bottom – pulling the sides out. You don’t want the sides turned under and stuck up your baby’s rear and potentially leaking:
Stick the sides inside the spica. Again, make sure they they’re out and not tucked under baby’s tooshie:
Then start stuffing the back of the diaper as far up the back of the spica as you can reach. This is the tough part for me. After you get it tucked up as far as you can from the front, flip your baby over and try to get it from the top of the back of the cast. We make the flip part fun. I count to three, rock her hips back and forth, and we laugh as I turn her over on to her belly.
I can never reach the diaper at first, so here’s where the back scratcher comes in very handy. Being VERY CAREFUL (if you’ve got bulky rings you may want to take them off so you don’t scratch your baby), poke the back scratcher up the back of the cast and push the diaper out. Even with the poker I have to stick my hand down quite far in the cast to get the diaper. I take my rings off because otherwise I’ll hurt her. Yes, you can laugh if you want. Or you can cry with me. I vacillate between the two emotions.
After you’ve got the back of the diaper up to the top and have spread it out, flip your baby over, find the tabs, and connect the diaper! Now, you can put a second diaper on the outside of the cast. I’m not exactly sure why it’s necessary if you’re able to diaper fully. If you can’t diaper fully, that second diaper is there to catch any leaks. But it does soften the cast a little and makes holding her a little more comfortable so I sometimes have the second diaper on there. I reuse it if it’s clean (which it normally is).
Then, hope to high heaven that your baby doesn’t start grunting the second you get the diaper fastened because you’ll need to rest for a few minutes before wanting to tackle that again!
When changing the diaper, you’ll want to make sure you close the tabs again after you unfasten the diaper. Otherwise, they may get stuck on your baby’s skin and hurt when you pull that diaper out. Trust me, babies don’t like that! Also, if the diaper is poopy, you want to try to get as much poop covered with a wipe as possible. You don’t want to smear the poop inside the back of the cast where you can’t get it. Changing a poop covered diaper in a spica cast is not for the faint of heart. I’m glad I used cloth diapers before, not sure why, but maybe they helped a little with the ick factor? I’m just glad she doesn’t poop as much as she pees.
And that’s it. Have you diapered a baby in a spica cast? What are your secrets??
To read the rest of our hip dysplasia journey, click here.