Caring for your Baby /Toddler in a Hip Spica Plaster Cast

Information for parents and carers

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Caring for your Baby /Toddler in a Hip Spica Plaster Cast – PIAG 93 (277kB)

Introduction

Your child is going home in a Hip Spica plaster cast. This factsheet aims to help you prepare to care for your child whist they are in plaster. The plaster cast is holding your child’s legs in the correct position to allow for healing following surgery/injury. The plaster cast is a medical device which must be looked after correctly so that it does not cause any harm.

In-Patient Stay

While your child is in hospital you will be shown how to care for your child in the plaster cast. 

Your child will only be discharged when you can carry out all the care on your own.  We appreciate it may be difficult for you to stay in the hospital, however you need to spend as much time as possible on the ward learning how to care for your child in the plaster cast.

Pain

It is recommended that you give your child the medication as prescribed regularly on discharge. Once at home reduce pain relief gradually as advised by the medical/Nursing staff

Skin Care

The key to preventing skin problems is ensuring that the skin is kept clean and dry at all times.  When changing the nappy, wash and dry the skin at the back as well as the front of the nursing area.  Remember to ensure that the plastic covering around the edge of the plaster is kept dry.  It should be dried using a towel.  You will be shown how to change the plastic covering but only do it when absolutely necessary.

Observe the skin around the edge of the plaster cast regularly. Please change your child’s position regularly throughout the day as shown to you by the nursing staff. If you see red areas under the plaster cast, contact the Nurse Specialist or District Nurse visiting your child.

Clothing

For baby girls, dresses are the ideal.  Dresses can be used for nightwear as Babygrows will not fit over the cast. For baby boys, clothing that have fastenings along the crotch seam may be used without alterations.  Alternatively, clothing can be adapted by either undoing the trouser side seam or crotch seam and the sewing on bias tape fastenings or Velcro.  

A bar may be put onto the plaster cast between the knees (known as a broomstick) to make the plaster cast stronger if it becomes weak during treatment. If you have bought clothing that is unworn and is now unsuitable, take them back to the shop and ask for an exchange.

Nappies

While in the hip Spica plaster cast your baby will need to wear two nappies.  One nappy should be  a size smaller than currently in use and the second nappy two sizes larger.  While you are in hospital you will be shown how to change the nappies.

Equipment

• Car Seat

As parents, it is your responsibility to ensure that you are able to transfer your child securely in the car.  You will need a suitable car seat to take your child home. The car seat used must be one recommended by the manufacturer for your child’s age/ weight. There is not a car seat on the market made especially for children in plaster casts.  Your baby will not fit into a car seat with high sides.  The best type of car seat for babies is one with low sides.  You may find that the crotch strap is not long enough, but you may be able to obtain a longer crotch strap from the manufacturers. 

For toddlers, the best type of car seat is the booster type car seat with a removable back and low sides.  Booster type car seats must be suitable for the age of your child as per the manufacturer’s recommendations.

Remember:  If you alter a car seat in anyway it will no longer be covered by the manufacturer’s safety guarantee.  Your child’s safety is the first priority, so we strongly advise that you get advice from In-car Safety Centre   Tel: 01908 220909 or visit their website:   www.incarsafetycentre.co.uk

• Pram

Bring your child’s own pram into the hospital with you so that it can be assessed for suitability. We strongly advise that we look closely at your own pram first before considering purchasing a new pram. The Stroller type pram is the most likely to be suitable, we advise that you do not buy a new pram until your baby/ toddler has had the plaster cast applied.

• Highchair

Your child will not fit into a standard highchair in the plaster cast. There are specialist highchairs available that are suitable for infants in plaster casts and we will provide the information on request.   N.B. infants who have surgery over 18months of age should not be put in a highchair.

Other Equipment

If you have a bean bag you may find this useful to position your child on in the plaster cast but remember your child must be supervised at all times.

Pillows are also useful to help position your child for feeding. At night-time, your baby will be most comfortable in the cot, free of pillows with just a rolled-up towel or baby blanket positioned under the legs to keep your child’s feet off the base of the cot.

Will my child be admitted to hospital when the cast is removed?

Generally, children under the age of four years will have their cast removed in clinic or as a day case, then be allowed home. Older children may be kept in hospital for rehabilitation. This is because they are generally more co-operative with the exercise programme due to their level of understanding.

Handling your child

For the first few days after the cast is removed, it is important to move and handle your child as though they still have the cast on. When lifting, support the lower parts of the legs, being careful not to let the legs drop down from the knees. For the first month we advise against using tights or other tight-fitting clothing.

Exercises

You should encourage your child to move their lower limbs; bath time is a good way to begin this. Encourage gentle leg movements such as bending and straightening the knees and gently bringing the legs apart and together. It is important not to force the legs together.

Mobility

It is important not to stand or walk your child too early. Children will tend to pull themselves up when they are ready. You may find your child will crawl or shuffle on their bottoms first and gradually use the furniture to pull up and walk. It is not advised to put your child in a baby walker.

General Do’s and Don’ts once the cast has been removed

• Do encourage gentle movements
• Do support the lower legs if lifting and moving
• Do not force your child to stand or walk
• Do not force your child’s legs together
• Do not use a baby walker.

STEPS

STEPS is a support group for parents of children with lower limb abnormalities. It is a national charity that can give you support. STEPS helpline: 01925-750271 [email protected]

Please Do Not

• Allow the plaster to get wet
• Use a hairdryer on the plaster cast
• Remove any parts of the plaster cast
• Push anything down the plaster cast
• Let your child play with sand or small toys that may fall down the cast
• Allow your child to stand in the plaster cast
• Allow them to go in a baby walker/bouncer.

Please contact the hospital by telephone if:

• Your child’s feet become white or blue
• Your child becomes distressed without any obvious reason
• The plaster cast appears tight and/or it is digging into the skin
• The plaster cast becomes damaged or broken.

Contact Numbers

Ward 4A 0151 228 4811 Ext 3109 / 2578

Plaster Room 0151 228 4811 Ext 2754

Outpatients Clinic 0151 252 5350

Physiotherapy Dept. 0151 228 4811 Ext 2236

Orthopaedic Nurse Specialist 0151 252 5619 / 0151 252 5282

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.

PIAG: 093