Spica Cast Equipment List

Spica Cast Equipment list 

Helpful products and tips for use while wearing a hip spica cast.

While preparing for their child’s treatment many parents ask, “Will we need lots of special equipment?”.  

In most cases, everyday baby items are suitable for use while your child is undergoing treatment, although some may need slight adjustments. There is also some equipment available that is specially designed to accommodate the hip spica cast and bar. 

Steps asked families who have experienced hip surgery and wearing a spica cast, to share the products and adaptations that made day-to-day life easier during treatment. 

Every child’s treatment journey is different, and not all suggestions will be suitable for all children, so we recommend you discuss and share experiences with other families in our Facebook groups. Some products are designed for babies, while others are suitable for older children. We hope this list helps you feel more prepared and supported. 

Please note that some of the products recommended are no longer in production, but we have marked these with an asterisk (*) as families tell us that they have found suitable equipment second hand. 

This is not medical advice, and Steps does not endorse any of these products or the purchase of previously owned equipment. These are suggestions gathered from parents. It is important that individuals ensure the safety and suitability of a product for their child. 

Car Seats and Travel

It is unlikely that your child will fit in their normal car seat, as it has not been designed to be used with children in a hip spica cast. It is recommended that you do not add any parts to adapt your child’s car seat (e.g. cushions), as this could affect their safety in the event of an accident, causing injury to your child, and may invalidate your car insurance. 

If your child weighs over 9kg once in plaster and is under the age of four years, they may be able to use a specially modified car seat. However, this will depend on factors such as the position of your child’s legs in the hip spica and the age of your child. The modified car seat can be used as a standard car seat once the plaster has been removed for children up to 25kg. 

What our families say:

“Axkid Minikid 4 – recommended by lots of parents on Facebook DDH groups. We ended up buying one and it worked perfectly for the first cast, reasonably well for the second cast. Needs to be the one that’s NOT on the isofix. The isofix one has a bar across the seat area.”

“Disabled blue badge – most councils include spica casts as bulky medical equipment. Very quick to get it approved. Are expected to return it when no longer in the cast.”

“Maxi Cosi… have adapted their Opal car seat for children in a hip spica cast.” 

“I was told it was 8 weeks (wait for the Maxi Cosi loan service) however they actually got back in touch after 3 weeks to say one had become available and we managed to get one right in time for her surgery. It is a much better option than buying one” 

“Nuby travel booster seat… was absolutely amazing as it attached to my chairs so she could sit at the table with us still.”

Used by parents:

• Maxi Cosi Opal HD (car seat specifically designed for a child undergoing treatment for hip dysplasia. Maxi Cosi offer a loan service for this car seat. See their website for further details)
• Britax Two Way Elite (Wide seat, adjustable harness which fits over casts, rear-facing car seat, 9 months – 6 years, 9 – 25 kg)
• EZ-ON Harness (Specially designed to allow a child to lie down across the backseat, has been used for older children in spica cast)
• Axkid Minikid 4 (Wide seat)
• Nuby travel booster seat (foldable booster seat that doubles as a portable highchair, 6 months+)

Prams, buggies and wheelchairs:

Depending upon your child’s age and shape of the hip spica, they may fit into their own pram/buggy. It may be possible to adapt your existing pushchair by extending straps and using extra cushions, but always consult the manufacturer for advice before making any changes. Whatever style of pushchair you use, it is essential that your child is always strapped in securely using the harness provided. 

What our families say:

“Ickle Bubba Aries [.] worked well for us in both casts. Small pillow needed to boost the seat slightly, but overall worked well with 5 point harness fitting well over the cast.” 

“Always check if your hospital can provide a suitable wheelchair before hiring or purchasing.”

“Joie Aire Twin Pushchair, ideal for wider casts as there is no divider between the seats.”

Used by parents:

• Ickle Bubba Aries (Harness fits over the cast) 
• Chunc Spica Cast Wheelchair (A wheelchair specially designed for older children in spica cast. Can be hired direct from Chunc)
• Joie Aire Twin Pushchair (No divider between the seats, birth – approx. 3 years, 0 -15kg)

No longer in production

• Nanu Stroller – Mothercare* (Wide seat, adjustable harness which fits over casts, suitable from birth to a maximum weight of 15kg)
• Mamas and Papas 3 Wheeler Sport* (Wide seat, suitable from birth to 15kg)
• Maclaren Triumph Stroller* (Wide seat with no side barriers, suitable from 3 months up to 15kg)

Seating

Your child may no longer fit in their usual highchair so you may need to find an alternative way of sitting them up whilst eating. A toddler booster chair that straps onto a standard dining chair is often a good option for mealtimes. A ‘hip spica chair’ is useful for eating, reading, craft activities and colouring. Parents may find these second hand on the Steps Facebook page or forum. 

What our families say:

“Smirthwaite Hip Spica Chair can be bought or hired.”

“Tried alternative but same design as Tripp Trapp but didn’t fit our daughter in either of her casts.”

“Used a portable picnic folding highchair for both casts, for all meals at home, attached to dining chair.”

“Doomoo Beanbag used for short periods of time, generally too small for long time sat in it as very reclined for 17/18 month old when she wanted to see what was going on. Fit both cast shapes but only limited usefulness.”  

“Main beanbag used was Dunelm rucomfy kids beanbag snuggle chair. Fit best on second cast but still usable on first cast. Much more upright position for toddlers than Doomoo beanbag. Would recommend.“

“Spica Table (Erica’s Table design) – used so much at home. Flat pack version so can be transported. Lots available by parents of DDH children on the UK Facebook DDH group, usually only have to pay postage for them.”

“Tot Seat can be taken out to restaurants etc – converts most dining chairs into a highchair. Machine-washable and fits into a small travel pouch that can fit into a changing bag.”

“Babymoov Doomoo Beanbag is good for babies and toddlers in a hip spica as there is an adjustable 3-point harness to secure them.”

“Bean bag chairs are suitable for older children in cast and work well with ‘Activity Table’ (see playtime section).”

Used by parents:

• Portable picnic folding chair with crotch strap instead of bar
• A bean bag chair
• Erin’s Chair (Specially designed for children in hip spica casts)
• Smirthwaite Hip Spica Chair (Specially designed for children in hips casts)
• Stokke Tripp Trapp Chair (Wooden highchair with adjustable seat depth and height and foot supports, grows with your child to around the age of seven)
• Tot Seat (Fabric which fits over most standard seats and is secured by looping between the child’s legs, suitable from 8 to 30 months) 
•  Dunelm rucomfy kids beanbag snuggle chair (Supports upright position)
• Babymoov Doomoo Beanbag (Soft bean bag type seat can easily be ‘moulded’ into numerous positions, suitable from birth to 30kg)

No longer in production

• Svan Highchair* (Removeable crotch bar)

Playtime

Babies in plaster casts do well on standard play mats. To offer a change of position, some parents lay their child on their tummy on a bean bag, with a beanbag-bottomed lap-tray in front of them for craft games or jigsaws. 

What our families say:

“Bibado bigs cover full front and sides of the cast to ensure everything stays dry. We also used the bibs for painting and messy play. “

“Large pillows / sofa pillows, used as crash type mats for behind when independently standing and playing. We preferred this as we wanted to let her play but she also had situations where she fell back and could stop her own fall.”

“A suitable highchair can be used for seated play with a tray.”

“Folding bed tray helps while children are doing arts/crafts jig-saws etc whilst sat on beanbag.”

“Padded lap trays are good for mealtimes but also for craft while lying on tummy on a bean bag.”

“Smyths Activity Table seems to fit nicely over the cast of older children for eating and craft activities.”

“A large dog mattress works for older children to lie on their tummy with a bean bag lap tray for craft and homework activities.”

Used by parents: 

• A folding bed tray (Allows space for legs underneath, can be placed over your child) 
• A padded lap tray (Easy to place on top of legs)
• Steps Hip Spica Chair (Specially designed for use with hip spica cast, with tray to allow play)
• A large pillow/sofa pillows
• A bean bag or dog mattress (allows lying on the stomach comfortably for play)

No longer in production

• Smyths Activity Table* (Allows space for legs underneath)

Sleeping

Children in casts may not need any special sleeping equipment or beds. They may only sleep for short periods and often become restless and distressed. Disturbed nights can also result from cramp, itching and the inability to turn over. 

What our families say:

“Low toddler bed – switched from cot as she was too heavy to lift into. Low to ground toddler beds are much easier to get even younger children out of. We found having a couple of towels under the sheet at her head end of the bed graduating it to make a very small slope made her more comfortable with lying on her back and without it having her head lower than her back.” 

“If, for practical reasons, you have been told your child needs a downstairs bed, this (single Millie bed with trundle) wide single with pull out ‘sleepover’ bed is ideal for staying close for comfort and toileting.”

“If you want a piece of furniture that can be used once your child has returned to their own bedroom, the Ikea range of day beds with built-in guest beds are an option.”

Used by parents:

• Baby or toddler specific, lightweight sleeping bags (Allow room for cast) 
• Low toddler bed (Low to ground, accessible)
• Single Millie Bed in white with Trundle Extra Sleepover Bed 2 in 1 (Wheels allow bed to be moved easily)
• Ikea Day Bed/ Guest Bed (Often wide-based, close to ground)
• The Hip Pose sleeping bag (designed specifically to accommodate boots and bar, now sold as DDH Sleeping Bag/Hip Harness Sleeping Bag/Hip Dysplasia Sleeping Bag with wider space at the bottom of the bag, 6-12 months)

Clothing

If the spica cast is patterned or coloured, the cast itself can act like a pair of trousers, using a pair of shorts or vest with poppers to cover the nappy area. Baby leg warmers are also useful in colder weather. If the cast comes down to the ankles, remember your child’s feet can get cold even in warm weather, so they may be more comfortable wearing thick socks or leather-soled ‘moccasin’ style slippers.  

What our families say:

“Next are the only highstreet retailer we could find still selling Hip Spica Clothes. Next hip spica vests true to actual age size in spica cast, no need to size up. “

“Some smaller online shops available with hip spica clothes. Generally, more success though finding items on Vinted and Facebook groups for second hand options and new unused hip spica clothes.”

“We first tried a poncho tucked in around legs but that didn’t work well. But what did work well – Adults waterproof, with each wrist tied on itself, one leg of spica cast into each arm, body of waterproof around the waist, hood tucked under nappy area. Much less likely to be pulled off and you can ensure full spica cast covered, no toes peeking out.”

“Adult fluffy socks fit well over the cast.”

“General advice 1-2 sizes up. Aim for loose clothing, in layers so that it’s easy to add or remove as they get hot. Some coats with zips hard to close around a cast, and definitely needed in the wet – go 2 sizes up or a flared out design. Bodysuit vests 2 sizes up also might work on some cast types (we had some ‘normal’ vests that fitted fine), some vest extenders also add the extra length needed.”

“Elasticated waist skirts are ideal especially if they are flared skirts as they fit over the cast, shorter ones are better once they start crawling in the cast as the skirts just hinder them. Also recommended are jersey dresses as they are stretchy enough to cover the cast.”

“Jogger pants in a bigger size are ideal for pulling up over the cast but depending on the bar on the cast may have to be cut up short or have poppers sewn into the inner leg.”

“Slipper socks are great especially in winter as they stretch over the cast and stay on longer.”

“Long sleeved popper vests are ideal whilst in cast (sizes bigger than normal).”

“Underwear – for older children who are already toilet trained and object to going back into nappies, boxer shorts in a bigger size seem to be the most popular. Boys boxer shorts in stretchy material are ideal. Some parents cut up the sides of girls’ knickers and sew on Velcro or ribbons to tie at the sides.”

Used by parents:

• Special Pavlik harness and hip spica clothes
  • Moonu baby (Facebook store selling Pavlik harness and hip spica clothes)
  • Hiphappyclothes (Etsy store selling Pavlik harness and hip spica clothes)
• Wheelchair blankets/lap aprons/lap wraps (Waterproof blankets that can be placed over your child’s legs)
• Baby Sleeping Bags/Gro-bags (Bought in a bigger size allow room for the cast))
• Baby leg warmers (Stretchy, can fit over a casts and bar)
• Adult waterproof hiking trousers (are excellent for protecting casts if you are out and about. Cut off at appropriate length and get poppers sewn into the inner leg)
• Bibado bibs (Cover full front and sides including cast)
• Plastic Pelican Bib (Cover full front and sides including cast)

Skincare/washing

It is not possible to bathe your child whilst they are in a hip spica, so they will need a thorough wash (top and tail) with a damp cloth at least once a day to keep them feeling fresh. You are advised not to use skin lotion or powder under the edges of the hip spica as this may cause skin irritation and/or be an inhalation risk. Whilst cleaning the skin daily, it is a good idea to check all the plaster edges carefully for any signs of chafing; these are most likely around the spine and ankles. 

What our families say:

“Child’s Farm Leave-in conditioner is an absolute essential for in-between hair washes as it’s a lot of effort to do a hair wash of a toddler when in a cast, and this fills in the gaps in between.”

“Washing hair can be one of the most difficult problems, especially in a younger child who cannot support him or herself. Depending on the length of your child’s hair, you may use a wet cloth for hair washing.” 

Used by parents:

• A baby changing mat with towel (Are wipe clean and with towel ensure that water on body does not reach the cast)
• A hair washing jug (Allows control of hair washing)
• An inflatable hair washing tray (Can be used with older children over the back of a chair or in lying)  
• Child’s Farm leave-in conditioner (Does not need washing out)
• Baby shampoo shields (Protect your child’s eyes when washing hair)
• Sleek Tape (Leukoplast Sleek Strapping 2.5cm, for protecting rough cast edges)

Other items and general advice from parents

What our families say:

“As difficult as it is, try to stay calm and relaxed. Remember that it is your child being treated, not you, save your anxiousness for private. Ask questions.”

“Parent information and guides from Steps when we first found out in pregnancy. Join Facebook support groups.”

“Deuter Kid Comfort Active backpack carrier. Clips for allow […] room to hold child in place in comfortable way. Lots of second hand ones online.” 

“Luggage straps used to allow child at nursery/out and about to use the children’s high chairs without worry of them falling off. “

Used by parents:

• Hippychick Child Hip Seat (For carrying a baby/young toddler on your hip. Suitable from 6 months)
• Sheepskin fleece (These are great for lining the children’s beds/buggies etc – great at keeping them warm or cool, depending on the weather)
• Deuter Kid Comfort Active backpack carrier (Able to fit toddler in spica cast) in this backpack carrier. Clips for the seat allow it to be passed between nappy area and the broom to hold child in place in comfortable way. Lots of second-hand ones online
• Toddler training potty (Can be sat on while in the cast without falling off)
• Low sided bedpan (For the older child in cast when it’s difficult to get to the toilet Available from most mobility shops, but some hospitals do supply them)
• Whiz Freedom (A female urinal device to assist toileting. Always consult with your medical team if you intend your child to stand while using this device)
• Plastic bike capes or large cagoules (Excellent for covering buggies completely ensuring that the cast does not get wet in the rain – sometimes parents find that the rain cover that comes with the buggy will not stretch over the child while in cast)

Prescription items:

Listed below are items which you may find useful that are available free on prescription

• Gamgee (Gauze and Cotton Tissue BP 500g)
• Cellona (Lohmann & Rauscher Cellona Adhesive Cast Edge Padding)
• Movicol/ Lactulose (Constipation treatment generally over 2’s but doctors will give to late diagnosis over 19mths)
• DiproBase cream emollient (Moisturising cream excellent for post spica dry skin)
• Dermol 500 (Lotion for post cast skin – is antimicrobial, moisturising, and reduces itching)

Contact Steps Charity via email info@steps-charity.org.uk (or to leave a voicemail call 01925 750271) with any questions you have.