Wednesday, February 25, 2009

Mastering Diaper Changes

There are several different methods to diapering that people swear by but everyone will agree that diapering is one of the trickiest and most frustrating aspects of the spica cast adventure. After several failures (that I explain in other posts) I've settled into an approach that has worked for Kennedy and I for the past ten weeks. One of the most important steps is to reinforce the tape petaling around the cast opening to help prevent tears in the gortex lining and leaks into the cast material. The best way to do this is to petal the opening w/ duct tape (you can find colored tape at craft shops if you prefer), approximately 2" strips, starting with the inside of the cast and wrapping around the edge to the outside of the cast. This way, as you wipe the interior of the cast during diaper changes, you don't need to worry about the integrity of the lining. Otherwise, tears can occur in the lining and the original tape can come undone, leading to leakage into the lining and a smelly cast (see in "diapering problems" post).

Diapering should consist of a smaller diaper lined with a pad (either for female uses or inconstinence) that is tucked into the cast along with a larger diaper over the cast to hold it all in place. Personally, I prefer using Stayfree sanitary pads because they don't have wings to mess with and you can buy them in regular for daytime use and heavy for nighttime use. In my experience the inside diaper will be a size or two smaller than your normal diaper and the outside diaper will be a size larger. For example, Kennedy is now 1 year old, about 17 lbs and regularly uses a size 3 Pampers diaper. With her I use the size 1 Pampers Swaddlers diaper (extra soft against her skin) for the inside diaper and the size 4 for the outside diaper. Tucking in the inside diaper can be tricky and frustrating but it will get easier and everyone develops their own technique. An important tip is to try and smooth out the back of the diaper between your child's skin and the cast since this section is especially tight and bumps and wrinkles can be uncomfortable and lead to welts (that's why I use the softer Pampers Swaddlers). I've always used my fingers for this task but many people use the wide end of a skinny spatula if it is especially difficult. Typically, the outside diaper doesn't get much use and I usually only change it in the morning.

The best way to keep your child's spica cast clean and smell-free is to change the inside diaper frequently, ideally every 2-3 hours. This will help prevent the diapers and pad from getting overloaded and moisture from wicking up inside the cast. Another way to keep your cast clean and smell-free is with diligent cleanings at each diaper change. While changing diapers I go through a lot of wipes. To keep the cast as clean as possible I run a wipe the length of my finger all along the inside of the cast, as far as I can reach. This helps ensure that nothing has wicked up or crept up inside the cast. To clean out the back of the diaper opening I lay Kaylee face down over my leg (with a toy in front of her so she can play) while I run a wipe along the inside. This way I can fit my fingers inside and reach as far in as possible. Additionally, I then blot the inside with paper towel to keep the area dry and, again, to prevent moisture from wicking up inside.

I know there are a lot of other methods out there but this is what has worked with me. I welcome you to take from my methods what you will and adapt it to accomodate your own situations. If you have any questions or problems that arise I encourage you to post on the Hip Baby message board as there are many parents with spica experience willing to help!

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