Patient education: How to care for your child's cast (The Basics)

Why does my child have a cast? — 

The doctor gave your child a cast to treat their broken bone, also called a "fracture." The cast reduces pain and protect their bone as it heals.

Casts are made of hard material that goes over a soft liner and padding. Your child needs to keep the cast on until a doctor removes it.

It's important to take care of the cast so the skin underneath doesn't get hurt or infected.

Can my child get their cast wet? — 

It depends on what the cast is made of. Casts can be made of:

●Plaster – This is a smooth, white material. Plaster casts should never get wet.

●Fiberglass – This material is rougher on the outside. It can come in different colors. Fiberglass is waterproof. Casts made of fiberglass might be able to get wet, if the padding underneath is also waterproof.

The doctor will tell you if your child's cast and padding are waterproof. Otherwise, do not get the cast wet.

If your child needs to keep the cast dry when they bathe, you can:

●Cover it with 2 plastic bags, and secure each bag (separately) to your child's skin with a rubber band or duct tape (figure 1).

●Have your child keep the cast outside the tub or shower when they wash their body.

You can also buy a waterproof cast cover to use for bathing. If your child uses one of these, it's still a good idea for them to keep the cast outside the tub or shower. These covers are not completely waterproof. Your child cannot swim with a waterproof cast cover.

If your child's cast is not waterproof but gets wet, use a hairdryer on the cool setting to dry it. Do not use a warm or hot setting, because they can burn the skin. You can also use a vacuum cleaner that has a hose to help dry the cast. Put the hose next to the cast to suck wet air out of the cast.

How else should my child care for the cast? — 

They should:

●Keep the cast clean, and avoid getting dirt or sand inside it

●Not put anything inside the cast

●Not put powder or lotion on their skin near the cast

●Not pull the lining out from inside the cast

●Cover the cast when they eat, so it doesn't get dirty

If the cast is on your child's leg or foot, do not let them put weight on it, unless the doctor says it is OK. The doctor might give your child crutches or a walker. You might need to use a stroller, wagon, or wheelchair to help a very young child keep weight off the cast.

What if my child has pain under the cast for the first few days? — 

They can:

●Put ice on the cast – Use a cold gel pack, bag of ice, or bag of frozen vegetables every 1 to 2 hours, for 15 minutes each time. Do not put the ice (or other cold objects) directly on their skin.

●Keep the cast raised (for example, on pillows) to help reduce swelling and pain – The cast needs to be raised above the level of their heart. The doctor might have your child use a sling to keep a cast on their arm raised.

●Take pain medicine – The doctor might have prescribed a strong pain medicine. If so, give it your child exactly as directed. You can also give your child over-the-counter pain medicines instead, like acetaminophen (sample brand name: Tylenol) and ibuprofen (sample brand names: Advil, Motrin). Before you do this, ask your child's doctor or nurse how much to give and how often.

What if my child's skin itches under the cast? — 

You can use a hair dryer on the cool setting to blow air inside the cast. Do not let your child put anything in the cast to scratch their skin.

When should I call the doctor? — 

Call your child's doctor right away if:

●Your child has severe pain or pain that is getting worse.

●Your child has sores or cuts on their skin under the cast.

●The cast smells bad, feels too tight, or cracks.

●Your child cannot move their fingers or toes.

●Your child's fingers or toes are blue, gray, or cold.

●The cast gets wet, and it's not supposed to get wet.

●An object gets stuck between the cast and your child's skin.

More on this topic

Patient education: How to care for your cast (The Basics)
Patient education: How to use crutches (The Basics)
Patient education: How to use a walker (The Basics)
Patient education: Fractures in children (The Basics)
Patient education: Sprains (The Basics)

Patient education: Cast and splint care (Beyond the Basics)