Spica Cast Recommendations

Background: At our daughter Lovett’s six month well baby visit, her pediatrician noticed that her left hip felt loose in the socket during her physical examination. She referred us for an x-ray and to an orthopedic surgeon, and Lovett was diagnosed with developmental hip dysplasia. Lovett had a closed hip reduction in June 2021, which means they were able to go into the operating room and physically maneuver her leg to get the ball of her hip back in its socket (versus an open hip reduction, which requires an incision). After the procedure, Lovett was put in a Spica cast to immobilize her lower body and ensure her hip had time to grow and develop in the correct position.

Lovett was in her cast about 12-weeks total and at the halfway point, she went back into the operating room for a cast change (flirty exposed right calf for the second half!).

I am not a medical expert, but I am an empathetic mom eager to make it a teenie bit easier for any family dealing with this condition and treatment plan. Keep reading for tactical tips and tricks on getting through it.

Practical Tips & Product Recommendations

🚙 – Travel/Transportation:

Car Seat – There are special car seats for kids in a Spica cast and the hospital sent us home with a loaner Hippo car seat (behemoth blue car seat). The thing I didn’t realize before Lovett was actually in her cast is the exact position and angles of the Spica cast are different for every patient and dependent upon how exactly the hips need to be positioned and immobilized. The Hippo car seat was not a good solution for us – its installation didn’t feel stable in our car and it required mountains of hospital blankets propped up behind her for her to even fit in it. We searched high and low for a car seat without sides and found the best option was the Diono Radian 3RXT (discontinued, but they now make the slightly upgraded Radian 3RXT SafePlus Max). It still required some towel bolsters and we did secure her with a travel neck pillow, but it felt way safer and more secure than the Hippo and had the width clearance needed to tolerate the with of her cast.

Stroller – We have the Uppababy Vista and thankfully, the rumble seat still worked with Lovett’s cast. We found propping this little cushie pillow behind her to be helpful and fill the gap between the back of the stroller and the angle of her cast.

Carrier – We have the Colugo baby carrier and it was a great transportation solution while Lovett was in her cast.

😴 – Sleeping:

Sleepsack – This Clickyhips sleep sack was the best sleepsack I found with a wide enough bottom to cover her cast.
Wedge – I don’t know if this was necessary or not, but Lovett slept with a crib wedge in her crib while she was in her Spica cast, which we did to ensure overnight diaper waste flowed downward.
Sleep Training – This is just a plug to share that we started sleep training the week Lovett went into her cast. When it rains, it pours, and we decided there was no time like the present to do it. For us, it was like three nights with up to 15 minutes of crying at a time, which was tough to listen to, but soooooo worth it.

🍽 – Eating:

Breastfeeding – I was nervous before Lovett was actually in her cast that we might not be able to continue breastfeeding while she was in it. It definitely took some getting used to, but we continued breastfeeding the whole time she was in her cast and just made it work!
Booster Seat – This OXO booster seat was the perfect solution for us! We strapped it into a dining chair and Lovett ate at the big kids table. It worked well since the sides were open and the legs of her cast could dangle over.

👗 – Dressing:

Her wardrobe was exclusively dresses + enormous onesies (size 12-18 months that fit over her cast!)

🧖‍♀️ – Lounging:

Bean Bag – We got this Big Joe bean bag and it was a beloved member of the family while Lovett was in her cast. It was the perfect spot to plop her to lounge and play!

🛁 Bathing:

Obviously a big, big bummer that you can’t take a real bath in the cast. We’d give her occasional (weekly, max) sponge baths to kind of wash her hair, but we really relied on wipe downs.
Honest Cleanse Wipes – Under normal circumstances, we’re a water wipes family, but these were super helpful for wipe downs while she was in her cast! Felt like she was maybe getting a little actual cleaning with these.
Micellar Water – We also tried some micellar water wipe downs!

💩 – Diapering: This is definitely the hardest part, but honestly – just like anything – you get used to it! I promise. It’s not actually that bad once you get the hang of it. We used a triple diaper system.

Poise Pad – We started with a women’s Poise pad pantyliner (4 drop absorbancy, no wings!) and tucked that into the opening of her cast.
Newborn Diaper – Then, we tucked a newborn diaper (with the sticky tabs ripped off) into the opening on top of the poise pad.
Giant Diaper – Then, we used a giant diaper (size 4 or bigger) on the exterior of the cast to keep it all contained. These thankfully don’t usually get too soiled, so we didn’t change these every diaper.
Hairdryer – The most important thing is keeping everything dry, so we spent a lot of time blowing cold air on her private parts and down the back of the cast to keep everything as dry as possible.
Gauze/Moleskine – In the later weeks of each cast, we would also wrap the exterior of the opening with gauze and moleskine to keep everything dry + create something that we could easily remove and replace once the padding on the cast itself started getting gross.
Patience – We did our absolute best, but it’s just kind of gross and disgusting and time consuming. In our experience, the timing of Lovett’s cast also coincided when she was eating more and more solids (and the digestive ramifications of new foods). It’s a journey, but you can do it!!

Other Random Thoughts:

Heat was the hardest part – Lovett was in her cast June through September in Washington, DC and the hardest part was really keeping her cool. It’s hard to keep babies cool under normal conditions, but adding all that extra cast made it super tough to be outside and keep her cool.
Activities – I read lots of other blogs on the internet with recommendations for a Spica table. We didn’t get one of those for Lovett, but I don’t think we were missing it. She could do table top activities in her booster seat and was happy playing and lounging on Big Joe or on her back. Pre-cast, we did have a “no toys with noise” family policy, but we got her some instruments that were hits to play with while she was in her cast (Munchkin Mozart cube, magic touch wooden drums, piano).
Babies really are resilient and adaptable – When Lovett first got her diagnosis and we were sharing with friends people would say, “babies are so resilient” and it made me want to lose my mind. I was grieving the normal summer I had anticipated going swimming and pushing her in swings at the park, and I did not want to hear that at the time. Grouch aside, it’s totally true. Babies are really adaptable and resilient and within 24 hours of being in her cast Lovett was just like…okay, this is my life now. Her parents had a harder time adjusting (and that’s fine!), but babies really are amazing!
The anticipation was worse than the actual treatment – The three-ish weeks between when Lovett was diagnosed and her actual procedure were way worse for me than the actual procedure and treatment. While we were waiting for her procedure I felt sad and angry and nervous and scared because there was nothing for me to do but dwell in those emotions in anticipation, but once she actually had her hip reduction and we were just living with our baby in her cast it was easy to be in go-with-the-flow mode and start learning our new habits and routines.
There are good parts – The best part is far and away that Lovett’s team of medical providers caught this condition early and we were able to intervene quickly for hopefully long-term healthy, happy hips forever more. That said, making lemonade out of lemons, there were also some nice parts of Lovett being in her cast. Being in her cast, she stayed a cuddle bug baby longer than she would have otherwise, which was very sweet. I also think while she couldn’t work on gross motor skills, she compensated by really honing her fine motor skills. I know every situation is different, but I think if you look through rose colored glasses, you’ll find some positives from the experience.