Once your child gets past the initial pain of a broken bone, dealing with the day-to-day maintenance of the cast is the next hurdle. You're no doubt learning that this can be a tricky task to handle as her mobility is limited, it's boring to miss out on playtime and the darn thing sometimes feels hot and itchy. Ugh!
Fortunately, the injury simply needs some quiet time in a cast so it can heal. (Kids rarely need surgery for a broken bone.)[1]
To help you through the cast process, here's more about the different types your child may have to wear, how to prevent the device from getting wet and some smart ways to keep your tot comfortable while she wears it.[2] Hang in there and know this bump in the road is truly temporary.
Types of casts
Depending on the type of injury that caused the broken bone (bike crash, hard fall …), one of the following cast types will immobilize the injury so it can heal properly.[3]
Fiberglass cast
Most casts today are made from fiberglass, which is a moldable plastic. Fiberglass is lightweight and durable, so it can withstand the wear and tear from active kids. Some of these casts are waterproof, and X-rays can better penetrate fiberglass material to show your tot's healing bones.
Plaster cast
Doctors use this type less often, but plaster's moldability can make it more useful for some injuries.[4] Plaster casts usually cost less than fiberglass ones, too.
They're made from a paste of white powder and water that then hardens when it's completely dry. But because of this, wetness and plaster don't mix — so this cast is more difficult to care for.
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How to keep a cast dry
A dry cast is the goal for your little patient since moisture inside it can cause skin irritation, an infection or even tissue scarring. Here are some tips for keeping the cast dry when bathing:
- Check with the doctor. Find out if the cast your child has can get wet in the first place. Some fiberglass casts have waterproof liners that can withstand water in the tub.
- Offer a sponge bath. Tub bathing and showers can prove tricky with a plaster cast or a fiberglass one that's not waterproof. Instead, try a sponge bath with your kid.
- Try plastic. If sponge baths aren't popular, help your child in the shower by covering the cast with a plastic bag that's taped shut. (A bread bag works well.) Check to see if the cast is still dry after washing.
- Pick up a cover. These special plastic sleeves cover the cast and protect the limb during baths and showers. You can find them in some stores and online.
- Skip the pool. It's hard enough to keep a cast dry when bathing, so unfortunately your tot will have to sit out her swim lesson or pool party if the one she has isn't waterproof.
What to do if the cast gets wet
If a plaster cast gets wet, let the doctor know right away as it's important that it's repaired or replaced so it can hold the broken bone in place.
But you can fix small drips or splashes on the cast at home by aiming a hair dryer on the cool setting at the wet spot. You can also try using your vacuum's upholstery attachment to pull air through the cast, helping it dry out.
How to reduce swelling under a cast
If you notice swelling around the injury, here are some ways to ease the pressure and discomfort:
- Elevate the limb. Raising the injured body part above the level of your child's heart can help reduce swelling, especially the first couple of days after the injury. Use a pillow to prop up her arm, or have her lean back on a couch or easy chair to lift up a leg cast.
- Use ice. A cold pack can bring down swelling. Just cover the ice in a thin towel so the cast stays as dry as possible.
- Wiggle it! Reduce swelling by telling your little one to move the fingers or toes around on the affected limb.
How to relieve itchiness under a cast
The need to scratch under the cast can drive your tot crazy! Here's how to get to that itch safely:
- Blow cool air. Grab the hair dryer again, and aim it into the cast on the cool setting.
- Skip lotion and powder. Don't try to sprinkle powder or smear lotion on the itch.
- Don't poke it. Nix sticks, rulers, coat hangers and other sharp objects. Don't push anything between the skin and cast to get at an itch as it could injure or infect the area.
- Avoid tugging. Remind your tot not to pull on the lining or break off pieces of the cast as it can lead to more irritation and itching inside. It may damage the device, too.
- Ask about medication. Antihistamines may ease the itch, but check with the pediatrician first before giving any to your child.
How long will my child need to wear a cast?
The length of time your tot needs to wear her cast depends on the type of injury she has as well as the severity.[5] A bigger break, of course, will take longer to heal.
That said, if the cast is well-cared for, your child will probably end up wearing it for several weeks before it's taken off.
When to call the doctor
If you think something's amiss with the cast, make a call to the doctor. Here's what to watch for:
- Lots of wetness. As mentioned, if the cast gets very wet or cracks, it'll need fixing.
- Increased pain. Tightness in the broken limb, as well as worsening pain, numbness, tingling, excessive swelling or stinging under the cast warrants a call.
- Toe or finger trouble. Seek help if her digits are hard to wiggle, or they're cold or blue.
- Chafing or sores. Redness or irritation around the cast is cause for concern.
- Strong odor or drainage. A bad smell coming from the inside of the cast or drainage that's leaking out could mean an infection is present.
- Fever. Call the doctor about an oral temperature that's higher than 101 degrees Fahrenheit, one that's higher than 100.4 degrees F in the ear or rectum, or more than 99 degrees F in the armpit.
What happens after a cast is removed
Once the cast is finally off, your tot's skin might look flaky and yellowish. The hair on her arm or leg may have grown long and dark, too. That's normal since they've been hidden away under the cast for so long. In a few weeks, their usual appearance will return.
You can soak the affected limb to soften the dead skin, and then pat it dry and use a bit of lotion. Don't scrub the skin, however, as it's likely very sensitive.
Your tot's muscles may also look smaller and will probably feel weak right after the cast comes off. The pediatrician may suggest physical therapy to work on strengthening the area and to improve your tot's range of motion.
Alas, wearing a cast is really no fun for a small child. But know that with careful tending around water, you can keep the cast dry and in good shape while it works to heal the little bone inside.
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