Question 1

How can I make casting easier on my baby?

cancss · Accepted Answer

Most children are not bothered by casting or are easily distracted. Some doctors recommend breastfeeding or bottle feeding your baby during casting, you can also try a sound machine or a toy that they are interested in playing with.

Question 2

What do you do if the cast gets soiled during diaper changes?

cancss · Accepted Answer

Try to dry the cast the best you can and contact your doctor. If the soiling is minimal, try to clean it with a wipe and dry with a towel. If the cast is very wet it will need to be removed to prevent skin break down. Wearing leg warmers over the cast or adding Coban to the top of the cast can be a protective layer to help prevent any soiling or wetness.

Question 3

How do I bath my baby when they are in casts?

cancss · Accepted Answer

It is best to give your baby a bed bath by cleaning your baby with a wet cloth on the change table or other surface.. Do not submerge the baby in water to prevent the cast from getting wet. Some parents will buy cleansing wipes to clean the baby’s body from the waist up, and then wash the baby's hair over a sink with a small squirt bottle and some mild shampoo. You can cover your baby’s casts with a towel to prevent any misplaced water from landing on the casts.

Question 4

How do I make my baby comfortable?

cancss · Accepted Answer

Comfort your child the same way you would previously, with lots of cuddles, rocking, bouncing, singing, and nursing. Many parents feel scared that they will not be able to hold their baby in the same way they did prior to casts, but rest assured that there will still be plenty of ability to snuggle and cuddle in the same way. Your baby is likely more upset with the casts than in pain. If your child is inconsolable your child may not be properly casted and you should contact your healthcare provider.

Question 5

Can I use a carrier?

cancss · Accepted Answer

Yes, you can use a carrier. You want to make sure that it has a wide seat base to support the legs and casts. Carriers are recommended to be designed in M sitting.

Question 6

I am pretty sure my baby’s cast has slipped, should I remove it?

cancss · Accepted Answer

If your baby’s cast slips it can be really hard to determine exactly what to do. You should contact your doctor immediately, but sometimes they are not immediately available and you need to make a decision about whether to remove the cast or not. If you think the cast has slipped, you should remove the cast to prevent damage to the foot. It is important to remember that another cast can always be placed, and if you baby loses a bit of correction, that can be achieved with the placement of another cast. If the slipped cast is left on, it can cause damage that is very difficult to correct. If you are unable to get direct guidance from your doctor, trust your instincts, and if you think the cast has slipped, remove it.

Question 7

Is it okay for my baby to do tummy time while in casts?

cancss · Accepted Answer

Yes, your baby’s casts should not impact their ability to do tummy time. Many children do not enjoy tummy time. Consider laying your baby on your chest, so he can see your face, start on an incline and overtime lie closer to flat on your back. Remember to help your baby by propping him up on his arms or even putting a rolled up towel under his chest to help elevate his upper body. Remember that babies who cannot roll over by themselves should not be left unattended on their stomachs.

Question 8

Do I need a special carseat?

cancss · Accepted Answer

A regular car seat will work. You may want to look for one with a longer buckle, as it will be easier to do up. It’s not recommended to leave the boots and bar done up while in the car seat.

Question 9

How do I keep their feet warm?

cancss · Accepted Answer

If you are outside you can keep their feet warm by placing large socks over the casts and there are some places that sell boot covers. You can also use leg warmers and pull them down further over the toes, or place a blanket over the toes when the baby is in the carseat.

Question 10

What kind of clothes are best?

cancss · Accepted Answer

In warm weather environments, simple onesies with crotch snaps work well as the casts do not need to be covered. In cooler environments, pants with full leg snaps work well or stretchy pants that are removed easily. Footed sleepers can be used when in casts, but you may need to go one size up.

Question 11

Will my baby get too hot?

cancss · Accepted Answer

No, it is unlikely that your child will be too hot in their casts alone. Dress your child following regular recommendations for weather and nighttime wear.

Question 12

How do I keep them cool?

cancss · Accepted Answer

It is unlikely the casts will cause your child to experience difficulties with temperatures if dressed appropriately on top. You can simply wear a onesie and the casts in warmer weather.

Question 13

What if the casts get wet?

cancss · Accepted Answer

If the casts get wet inside, they will need to be removed as it can lead to skin irritations. Please contact your healthcare provider for recommendations on what to do in this situation.

Question 14

My doctor wants me to remove the casts before our appointment. Should I?

cancss · Accepted Answer

It is best practice to remove the casts at the time of the appointment.

Question 15

What type of cast is better, plaster or soft fibreglass?

cancss · Accepted Answer

Both types of casts are effective at treating clubfeet when properly applied. Plaster may have better results in complex cases. Fibreglass has good success and is easier to apply and remove. Every surgeon will have a preferred material with which they work.

Question 16

Should I put cream on the legs before casting?

cancss · Accepted Answer

Unless directed by the doctor, do not apply anything to the skin prior to casting. This may cause irritation or effect how well the cast sets, leading to slippage.

Question 17

How do I tell if the cast has slipped?

cancss · Accepted Answer

After casts are applied it is a good idea to mark on the toes where the casts end and/or take pictures from the top of the foot so you have a comparison, as a good reference point to look back at if you think the cast may have slipped. If the toes slip into the cast beyond your mark, the cast may be slipping. Remove the cast and contact your healthcare provider.

Question 18

My baby's toes look purple. What should I do?

cancss · Accepted Answer

Lay the baby down or hold him in a lying position so that his legs are higher than his body. This helps drain the blood from his legs and reduce swelling. Try not to have your baby with legs hanging down for long periods of time. If the color does not improve, contact your doctor for further direction.

Question 19

How often should I check my baby's cast placement?

cancss · Accepted Answer

Try to get into the habit of checking your baby’s cast placement multiple times a day. Create a routine that is easy to follow. For example, check the placement every time you do a diaper change.

Question 20

Is it okay if the casts are below the knee?

cancss · Accepted Answer

No, the cast should be above the knee to hold proper placement.

Question 21

In bilateral clubfoot, is it normal for casts to look different from one another?

cancss · Accepted Answer

Yes, this is normal. Feet can correct at different speeds as they can be different in severity.

Question 22

How do you get the casts off before your appointment?

cancss · Accepted Answer

Best practice is to remove casts at the appointment to recast shortly after. Casts should only be removed at home in case of emergency or slippage. Fiberglass casts are unrolled while plaster casts are soaked or cut off.

Question 23

The cast is rubbing on my baby’s skin at the top or toes. What can I do?

cancss · Accepted Answer

If you have access to "Coban" from the pharmacy, you can wrap it to provide extra padding by tucking it over the edge. Other materials like cotton can be wrapped and tucked over the edge to provide padding. Do not push padding into the cast. If the cast seems excessively loose contact your doctor as you may need it realigned.

Question 24

Will my child get better with casting?

cancss · Accepted Answer

The Ponseti Method is a proven technique to correct clubfoot with serial casting and possible tenotomy. After the correction casting phase, the maintenance phase is the most important task in order to maintain correction.

Question 25

Why does my baby cry so much with casts on?

cancss · Accepted Answer

Check to see that your child’s feet have good circulation. You can do this by squeezing a toe slightly until it turns white and then count the seconds for it to return to normal colour. It should be less than three seconds. Make sure the casts have not slipped and are still in the correct position. Some infants become uncomfortable because they can not pass gas as easily, due to the inability to kick legs. You can move the baby’s legs for them to assist and practice regular knee to chest movements.

Question 26

Is the casting painful?

cancss · Accepted Answer

Casting should never be painful. Some children experience mild discomfort because of the stretching, or annoyance or frustration from not being able to move their legs.

Question 27

Should I cover the cast or leave it uncovered?

cancss · Accepted Answer

You may cover with loose fitting clothing but be careful to not tug or pull the casts which may cause slipping. It is not necessary to cover the cast.

Question 28

Do diapers need to be worn 24/7?

cancss · Accepted Answer

Diapers, cloth or disposable, should be used while in casts as much as possible to avoid getting body fluids on the casts. The casts cannot be washed or get wet.

Question 29

How do I take care of my baby after casting?

cancss · Accepted Answer

Your baby will need the same love and care they received before. They can continue to participate in many regular routines, with the exception of baths which will need to be done using a washcloth. Play with, cuddle and soothe them as you normally would. You will also want to check the cast position (slipped casts) and ensure that the casts stay dry between appointments.

Question 30

Generally, how much casting is needed?

cancss · Accepted Answer

The number of casts depends on the severity of the feet and how well your child is responding to treatment. A typical case of clubfoot usually requires five to seven casts, if more than seven are required, consider a second opinion.

Question 31

How many days are there between each cast?

cancss · Accepted Answer

Each cast is typically changed every 7 days. There are doctors who do accelerating casting which have shorter time frames between each cast. Your doctor will let you know how long between each cast.

Question 32

Is it better to remove the cast at home or hospital?

cancss · Accepted Answer

It is best to remove the casts at the hospital prior to the next casting. This decreases the chance of any delay between casts.

Question 33

How do I respond to criticisms/judgement about having a baby in casts?

cancss · Accepted Answer

Educating family and friends about clubfeet is the best way to reduce stigma. Be confident it was not caused by any error on your part as parents, and that your baby is happy and healthy otherwise. Most people assume there is an injury when they see casts. It is up to you to explain that there is a birth deformity being corrected with the casts.

Question 34

What do I do if my baby develops a rash when in casts?

cancss · Accepted Answer

It is important to figure out what is causing the rash. The most likely cause would be rubbing or friction on the thighs or groin. Consider applying a barrier to help prevent the rubbing such as a bandaid or sock over the area. inform your doctor of any rashes as the cast may need to be applied differently.

If a rash occurs in other areas seek medical advice.

Question 35

What do I do if my baby falls when it is in casts?

cancss · Accepted Answer

A child falling is always a danger. Casts do not pose any greater risk to the child.

Question 36

How to napkin/diaper change a baby in casts?

cancss · Accepted Answer

When changing, be careful when lifting your baby’s legs. Pulling on the legs/casts may cause slipping. Consider lifting from underneath their back/buttocks or roll them onto their side slightly, rather than pulling up from their feet.

Question 37

What position should a baby sleep while in casts?

cancss · Accepted Answer

It is recommended that all babies sleep on their back until they can roll over by themselves. You can provide extra support by placing a rolled up towel under their legs to provide support under their knees.

Question 38

Is it okay for a baby to be lifting its legs while in casts?

cancss · Accepted Answer

It is ok if the baby lifts its legs while in casts. Movement should be encouraged as it helps the baby feel more comfortable and can relieve gas.

Question 39

I was bathing my baby and I accidentally got water in the cast. What should I do?

cancss · Accepted Answer

If water enters the casts, they must be removed. It is best not to bathe the baby in water but rather wash the baby with a wet cloth, by giving a bed bath.

Question 40

My baby has just been casted for the first time and won’t stop crying. What should I do?

cancss · Accepted Answer

Comfort your baby as they are now adjusting to the decreased mobility from the casts. Many babies will need extra holding and nursing to feel comforted. Some babies may be extra gassy at night so practice moving their legs throughout the day to prevent gas build up at night. Try providing support under their legs when sleeping by rolling up a small towel and placing it under their knees.

Question 41

Is there a quick reference list of red flags I should watch for during casting?

cancss · Accepted Answer

There are several red flags that parents can look during casting including:

Slipped casts
Skin Issues
Blanching of the toes
Suggested break between casts
Foul smelling odour coming from cast
Temperature of 101.3 or above
A suggested break between final cast removal and beginning BNB

Question 42

When will my baby start casting?

cancss · Accepted Answer

Babies usually begin treatment shortly after birth. Some doctors prefer the baby be a certain weight before casting begins. You can determine the exact timing if you have a consultation with your doctor before your child is born.

Question 43

Any specific items I should bring to casting appointments?

cancss · Accepted Answer

Here are some recommended items that you can bring:

A bottle of formula or breast milk
Bathing items (if your baby can bath between casts)
Permanent marker- to mark the toes after cast is applied
Leg warmers
Receiving blankets or muslin
Noise blocking headphones- for the cast removal if the sound upsets your child
A list of any questions you may have for the doctor
Extra clothing to change your child into if plaster gets on it

Döküm SSS

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