Diapering with a Spica Cast


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Diapering with a spica cast no fun. In fact, it’s pretty horrible. Here’s what I learned about diapering with a spica cast when my toddler was treated for hip dysplasia.

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!!

Diapering with a Spica Cast

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! ๐Ÿ˜‰

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. ๐Ÿ™‚ 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! ๐Ÿ™‚

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. ๐Ÿ˜‰

And that’s it. Have you diapered a baby in a spica cast? What are your secrets??


About Michelle Marine

Michelle Marine is the author of How to Raise Chickens for Meat, a long-time green-living enthusiast, and rural Iowa mom of four. She empowers families to grow and eat seasonal, local foods; to reduce their ecological footprint; and to come together through impactful travel.

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  1. I have no doubt that this post will help LOTS of parents facing spica diapering!!! As always, I love your straightforward and total honesty. And yes, I am laughing at you. I mean with you. ๐Ÿ™‚

  2. Oh, my word! Here’s hoping you have no tummy bugs running through your house while she’s in that cast! They certainly don’t leave you much room to work with.

    1. My daughter is 10 yrs old and she is going to have surgery next week 8/13/2019. How do you use the cloth diaper how stay inside Iโ€™m worried about she pee a lot and wet the cast also she need enemas for constipation Thank you

  3. Oh my! I will NEVER complain about diapering the boys again! I’ve got it easy compaired to you.
    But oh my gosh, the back scratcher? Cracking up!! Very resourceful.

  4. You rock Michelle! Wish someone would’ve even told me that was an option w/ Rowan. We did the small diaper, Poise pad thing and it worked but I’m guessing we would’ve spent a lot less time blow drying his back and the back of the cast if someone had told me that this was even a remote possibility ๐Ÿ™‚ Keep up the good work Momma!

  5. oh wow! i found your blog from the hipbaby yahoo group.

    my goodness that hole is TINY! i will never complain about kate’s hole ever again. it’s much bigger than that. not that we can fully diaper though. we use newborn or small diapers during the day and a large one on the outside to hold it in place as i do take the tabs off and stuff it up.
    at night i manage to stuff a diaper in her regular size up the hole, but it’s not easy – so i use do that at night when it’s going to be on longer. so far (8 weeks) we haven’t had a leak yet. she also does do reasonably solid poop so that helps for sure!

    1. oh i also have to say – i use cloth too and i HATE having to use disposables. i have 4 sizes sitting in a row in her room as she’s on her 2nd cast and the hole is a different size and shape, plus her legs are splayed different and need a bigger diaper to fit around.
      not much fun, but fingers crossed, 2 weeks to go!

    2. I know! I had them make it a teeny bit bigger at her 6 week follow up appointment, but they didn’t want to change it much because they said it would decrease stability to the hips.

  6. Thank you for this information. My 6 week old was diagnosied with hip dysplasia at birth and I am a cloth diapering mamma! He will be having surgery in about a month and will be in a spica cast for 6 weeks. I want to use cloth sooo bad but am learning that will probably not be possible. It is a bit of a mystery as there is not alot of great, recent information on hip dyspasia and spica care for an infant. I must say I am a bit nervous about diapering a newborn in a spica as they pee so often! I’ll be changing diapers non-stop! Praying that I can take the 6 weeks off of work to deal with this…haha! Thanks again!

    1. Good luck, Sarah. I actually have been in contact with one cloth diapering mamma who used g diapers with her daughter in spica! I can’t figure out how, but she made it work…Her blog is linked on my HD information page (her name is also Sarah)- the BC, Canada mom. We had pretty good luck with the disposable diapers. The good thing about them is they are so absorbent that you don’t have to stress about changing them all the time.

  7. Thank you soo much for this post. My son is two years old and has a spica cast. It has been really hard and they have to re cast him because the cast is full with urine. And he sores on his leg. I feel bad because I have done everything I can. But now that I have read this and they do his cast right this time time. I will know what steps to take Thank you

    1. I’m so sorry to hear about your son. I hope you are able to work it out!! Good luck to you! Please let me know how it goes.

  8. Thank you so much for this post! My daughter will be due to go in a spica in the coming weeks and I’ve seen lots of info on all the layering seemingly required. After finding HipStix plus a helpful video on how to make them I thought to myself surely someone has actually managed to fasten up a nappy/diaper inside a cast if they can slide them inside that far! This confirms it. Just hoping we manage it with my daughter!