One thing many parents worry about when their child goes into a spica is how they are going to change a nappy and keep the cast clean and fresh.

Gone (temporarily) are days when you would simply take off one nappy and swiftly replace with another but do not panic.

Like most things DDH once you have the hang of something new, it becomes second nature.

Whilst the toilet area of a spica is small, the need to keep it clean and dry is big as this keeps your child comfortable and the cast dry.

If wee or poo remain in contact with your child’s skin (under a wet or soiled nappy or beneath the edges of the cast), nappy rash and skin irritation can occur which you want to avoid.

The nurses on your ward should give you details about cast care but the steps we used were pretty simple and effective:

• Use disposable nappies rather than natural ones. This is personal preference but these tend to be easier to use with a spica cast and generally soak up more moisture
• We suggest using a smaller size nappy and tuck this inside the cast. Then place a larger one over the cast to secure it
• Tuck the edges of the nappy inside the cast but make sure they aren’t irritating the skin
• A sanitary towel, incontinence pad or cotton wool balls can be placed inside the nappy for extra absorption and to catch any unavoidable accidents
• Frequent, regular checks of the nappy must be made; at least every two hours during the day and ideally every two to three hours during the night
• As well as frequent checks, as soon as you notice a dirty nappy, change it immediately as this will help minimise skin irritation and soiling of the cast
• If your child is ill, has loose bowel motions or if you are having trouble keeping wee from running under the plaster, cotton wadding or sanitary towels can be used to soak liquid up. Just like nappies these need to be replaced as soon as they are wet as they can cause skin irritation and moisture in the cast

Allow the nappy area to be open to air for a few minutes each day. This will decrease the possibility of rashes and skin irritation and even offer your child a little relief and normality

We have a great blog post from a parent that shows this information in photographic steps.