With the Pavlik Harness, diapers, rather than cloth nappies, are the best idea. The only thing to remember with changing a baby in a harness is not to lift by the legs, but rather under the thighs. The legs of the harness may need protection from mess. A piece of fabric will do. Putting on a fresh diaper is slightly challenging at first with the threading that needs to be done. The nappy must always be under the harness!
Babies in harnesses should not have them removed for bathing. A full size infant bath sponge can be used. Place the sponge next to the kitchen sink and lay baby on top. Fill the sink with water and wash exposed skin with a damp washcloth. Pull baby to the edge of the sponge with your hand cradling his or her head to wash and rinse hair. Never leave baby unattended even for a second.
Note: sometimes doctors do allow the harness off for bathing. If, and only if, the doctor says so, then make sure you are totally clear on how to replace the harness when the bath is over.
Your baby may be in a Hewson Brace for a while. You may be told to not remove it for diaper changing, but many find this completely impossible. It is important to put the diaper on with no creases or folds as the brace will press them into the skin. This brace is very easy to take off and put back on. However, it should not be left off for long periods (unless your doctor says so).
The Hewson brace is generally allowed off for baths, however, check this with your doctor.
Diapering a baby in a spica can be a complicated process! Outlined below is one member's solution.
Supplies used: Pampers Diapers (sizes 1 and 5), Poise adult incontinence pads (Ultra with side shields - important), Cotton roll (type used by hair stylist for perms).
Instructions: Cut the tabs (tape) completely off the back of the size 1 diaper. Insert the Poise pad centered inside the small diaper, press down on adhesive to stay in place. Fold a 12" length of the cotton in half and tuck it around the baby's legs, just inside the edge of the cast. Insert the diaper and pad into the back of the cast by lifting the buttocks. Pull the diaper under the bar in the cast and tuck the into the front of the cast. (NOTE, some people find it easier to flip the child onto the stomach then push the back of the small diaper up into the cast. Since the child is on its stomach there is less pressure and pushing the diaper further up is easier. Turn child over onto the back, and push the front of the small diaper up as far as you can.) Make sure that the Poise pad does not get folded over - it should cradle the diaper area. Use the larger diaper on the outside of the cast to keep everything in place. Change the diaper regularly, every 1-2 hours to prevent any wetness from the diaper from wicking into the cotton batting underneath the cast. Always remove the inner diaper slowly from the front first so that you can prevent stool from touching the cast when the diaper is removed.
Other mothers have found that they get away with just an incontinence pad tucked into the cast, with a large diaper wrapped over it to contain it. Experiment to see which works best for your baby. The picture shows a smaller diaper being tucked between the baby's skin and the spica cast. A larger diaper is hanging down waiting to be wrapped over both the small diaper and the spica cast.
Bathing instructions for the spica would be as for the harness, above. You can also reach under the cast with a damp washcloth, and then a towel.
To protect the edges of the cast from getting soiled: Start with a piece of waterproof tape about 4 inches long and wrap it short side over the edge of the cast. Add another piece remembering to overlap the pieces as you go all around the opening of the cast. At the turns it resembles the petals of a flower;this is why it is called petalling. This will protect the child's skin from the rough edges of the cast and will also add an extra layer of protection in case urine or feces gets through/around the diapers. If the tape does get soiled it can be removed and replaced with clean tape. This is especially important at the diaper cut out area of the cast.
For smell: If the cast gets soiled (and it will, no matter how hard you try!!) and starts to smell you can dab a bit of perfume on the cast itself. This will make it more bearable to be around. Pick a scent that is not overpowering and one you want your baby to smell like. Love's baby soft perfume is particularly nice for a child.