Life With Clubfoot.

Some of the Little Every Day Things
You'll Need to Learn

    One thing you'll probably end up surprised about
    is how quickly that first year of life with clubfoot
    will pass.







    At first you might feel so deep in to this thing that you fear
    there will never be any way out, then one day you'll wake
    up and realize it's practically over with - or so far away
    and so normal to you that you hardly notice anymore.  Any
    why not?  After all, this is your new normal.

    But until you get there, you probably have a few basic
    questions about a things regarding that first year or so of
    living with your child's clubfoot correction process.   On
    this page,  we will talk about the topics in the following list,
    along with a few other things on this page.  Click on a link
    below to quickly head to that topic.
























Diapering:
If you are a die-hard cloth diaper person, you can still use the cloth
while your baby wears casts.  With that said - I would
recommend
against cloth diapers
during the serial-casting phase, because it's
important to keep the top of the cast at the groin clean and dry which
may prove more difficult in a cloth diaper.  The casts your baby will
wear will go all the way up the thighs, making the tops an easy target
for diaper leaks.  
Read more about Baby Diapers here....

Dirty Casts:

Face it - your baby will probably get his or her casts dirty at least
once - and probably the very first day!   If the cast is soiled by ...
baby
poop
...  clean off what you can  using a disposable wipey or a damp
wash cloth, perhaps with a little bit of soap to scrub.  The stain will
remain there, sorry to say.  Just be very careful you don't soak the
cast with lots of water in your attempts to clean it.

The casts also become dirty just from your hands and daily wear,
turning the bright white of the plaster to a dull gray.   Again, you can
freshen them up with a damp wash cloth but do not saturate the cast
with water.

Using the
Ponseti Method, the cast will be changed every five to
seven days so don't fret a little stain here and there.  It won't be there
for long.

Bathing Your Baby:
Bathing your baby with clubfoot isn't as bad as it might sound, but
here are a few tips for you should the project worry you!  
Read more
about bathing your baby and making home made diapy-wipeys
here.

Clothing The Clubfooted Newborn:
When it comes to life with clubfoot, parents often stress over the
clothing their child will wear.   There are two schools of thought on
this.  

One side says there are a lot of issues with finding clothing that will
work over the casts and brace.  The other school, which I subscribe
to after having raised three kids with clubfoot is that
there are very
few complications or considerations to be given towards
clothing.

If you are using the Ponseti Method, your baby will not be in casts for
all that long - an average of five weeks.   Babies grow very fast at this
new born age and will quickly outgrow everything anyway, so don't
drop a lot of money on cloths here, clubfooted or not.  
Read More
About Baby Cloths Here....


Baby Wearing:
Yes, it is still possible to use a sling, Maya Wrap and other baby-
carriers with your clubfoot baby,
 Click here to read more about
using a sling, and to view photos.


A Note on Sleeping / Pajamas:
While we talk about the clothing, let me make a small note here that
swaddling a new baby in casts is often the most comforting
thing you can do for him or her.
 A tight swaddle prevents the
child from moving his or her legs - and thus, removes much of their
frustration that comes from the weight of the cast(s).

Clothing the Clubfooted Baby After Casts:
Once the casting phase is over, your life with clubfoot moves in to the
FAB phase (foot abduction brace).   The same two schools of
thought regarding clothing apply here:  You can make it as
complicated or as simple as you like.  I prefer simple.

For babies this age - say 2 to 6 months old - I still recommend one
piece loose fitting outfits simply for baby's comfort.   In warm climates,
the "Onsie" is a good choice.  As a mother though, I understand
there are times when you will want your baby to be dressed sharp!  
You can do that too!

A baby in a FAB can wear anything a baby who doesn't use a
FAB can wear.  
Seriously.  I have never not bought an outfit I
wanted due to the brace wear factor.

If you are using the Markell brace, it's difficult to change the child's
pants because you have to totally remove the brace with all those
long shoe strings, but seriously how dirty does a baby really get?   A
bib and/or a towel laid over their lap can keep the pants clean while
they eat solids.  

Using the
Mitchell FAB, life with clubfoot is a lot easier because the
shoe  unsnaps from the bar, leaving the shoes on the baby's feet,
and in most cases, the shoe will fit through a pant-leg with out coming
off the baby's foot.   This makes changing pants a lot easier.

Pants that snap up the inseam will make diaper changing easier, but
most pants can also just slip down the baby's legs past the knee to
change the diaper that way while he has on his brace.   Myself, I hate
navigating all those tiny snaps on a wiggly baby and opted for non-
snap pants as much as possible, but either are good, and both will
work.

Car Seats:
Car seats are a must, obviously.  Some will work better than others.  
While wearing casts, life with clubfoot in a car seat is fairly simple -
but there are instances where a child wearing his or her FAB will
quickly outgrow the car seat due to the width of the feet while in the
brace.

I highly recommend you shop at a store that will allow you to
take the seat down off the shelf where you can buckle your
baby in to it, testing for fit and comfort.  
 It's rather common for
one leg to be propped up to a small degree on the side of the seat,
especially while you are in the rear-facing-mode of transportation.   
This is OK as long as it's not drastic or obviously uncomfortable to
the baby.

While in a rear-facing seat and approaching that first birthday, it will
become a little harder for baby to fit comfortably, and their knees
may end up bent a little as they sit in the seat.   Depending on the
size of your baby and how much longer he or she has to wait until
they can face forward, you may need to purchase a larger seat to
accommodate him.

Once your baby is big enough to face forward in the car seat, life with
clubfoot becomes a lot easier to navigate.  Almost all forward-facing
car seats will accommodate a child in a FAB quite easily.   
Read
more about car seats for infants and toddlers here.


Holding, Co-Sleeping and Nursing Your Baby:
Indeed!  How do you hold a baby who is wearing casts or a FAB?

Again - it doesn't have to be complicated.   How would you hold any
new infant?   With casts on, it is really no different to hold, cuddle,
carry or breast feed your infant.

When you begin the use of the FAB however, it may see a little
cumbersome at first.  Don't give up!   You'll find your groove if you
just relax and do it.    I found it
easiest to nurse my babies holding
them to me on their side with my arm slipped through the "V" shape
created between their legs by the brace.

Co-Sleeping may or may not be for you, but it was (is) for me and a
lot of other parents out there.   
Sleeping with a child in a FAB can be
uncomfortable, just know that up front.  As they get older and more
active you can expect to get hit in the ribs (groin, belly, face) during
the night with that hard cold bar!  I often sleep on my side with the
bar wedged between my knees to both avoid the kicks and keep the
baby from falling off the bed.

Everett did not like co-sleeping in his FAB.  He couldn't get
comfortable and quickly took to his crib - which we learned quickly
had to be traded for a play pen (look under the bedding topic).

This may strike you as an odd topic, but sadly,
a lot of clubfooted
babies have ended up with seriously flat heads due to lack of
holding.
 Some parents find themselves fearing how to hold the
baby,
that they might hurt the child's legs; others may find it hard to
bond with a child born with a birth defect or with the child who is
wearing casts or braces.   This is very sad, very, very sad.  Babies
need held, no matter what, and a clubfooted child can be held and
breast fed as readily as any non-inflicted child can be.

While I won't debate diapers, I am going to go on a soap box here
regarding car seat baby carriers.  
Car seats are for safe
transportation in a moving vehicle.
 They are NOT a substitute
for a parent's loving arms.  
 Leave that car seat in the car and
CARRY your child, or wear him/her in a sling.  Hold your baby, and
do so often.    

Keeping a baby caged and strapped down in a car seat while you go
to visit or shop or eat dinner in a restaurant is inhumane.    Infants
need human interaction, they need cuddled and held close to their
mother and father's bodies - not stuck away in a plastic thing
strapped down with no human touch.  This lack of holding with an
increased amount of time in a car seat baby carrier is leading to
babies getting flat heads.  

    Your clubfooted baby has enough on his plate with
    out dealing with correcting a flat head caused by
    what amounts to parental neglect.

A baby born with an illness or a birth defect needs the human touch
more than anything.  Your baby is going through a treatment
process, and while the Ponseti Method is very non-invasive and
hardly painful - it is stressful.  There is nothing natural about having
one or both of your legs bound in hard casts, nor having to wear a
brace on both feet.   
The baby knows it isn't natural and will
really need extra security to feel secure.   

Leave the car seat strapped in the car where it was made to sit, and
carry your baby in your arms where HE or SHE was meant to sit, the
way God and Nature intended.    As a result your child will be
smarter, more alert, more secure, more confident, will cry less, sleep
better and be happier.

I loved to use my
sling while the boys were little.   An infant in casts
can still fit comfy in to a sling, and
slings are really, really great
for the young emotional health of your newborn baby
by
promoting bonding and a strong sense of security being cuddled up
next to your body.  

In a sling, the infant takes on the natural fetal position that is so
pleasing to them for snuggle and sleep; awake, the infant is with in
inches of your face where her immature vision can focus on your
face and recognize you easily.    While you are at home, your hands
are free to wash your dishes, fold your laundry, play with older
children, and everything else while baby rides along participating or
sleeping to the natural sway of your body she spent nine months
growing in and enjoying.

It isn't natural for an infant to be left alone and being left alone in a
car seat, even if that seat is stuffed in your grocery cart or sitting in a
chair next to you at the table.  Babies need touch.

Shopping:
That said - use a sling to carry your baby while you shop.  Another
non-car-seat  alternative is to lay a plush blanket in the bottom of the
cart and let baby lay there squeezing the grapes and crinkling the
cookie wrappers.  This is stimulating and educational, letting the child
see things and feel things.

Carry your baby in your arms and pull your buggy instead of pushing
it.

Once baby can sit up, he can easily sit in the seat portion of the
shopping cart if he is wearing the Mitchell style of FAB that unsnaps.  
Unsnap the bar, put the baby in the seat, resnap the bar.

With out the Mitchell FAB, your baby can sit in the basket area, or
still be worn in a sling easily with the brace on.

Of course you could always plan to make your shopping trips during
the couple hours your child can come out of the brace.  
Be creative, but please
leave that car seat in the car.



High Chairs:
A lot of modern high chairs have leg holes built in of solid plastic.  A
baby who wears casts or a FAB is going to have a lot of difficulty in a
chair like that.

High chairs are handy little things.  My boys often sit (or sat) in theirs
watching me wash dishes or cook dinner or other things when they
wanted to be up close to the action.  If getting your baby in and out of
the high chair is a major chore, get a different high chair that doesn't
prohibit the casts or FAB from easy entering or exiting.  
Learn more
about high chairs here...

Cribs and Bedding:
Life with a new baby means a lot of missed sleep.  The only place in
the world where babies sleep through the night is in fairy tales and
bogus stories in New Mother magazines that make us all feel
inadequate because
our baby doesn't sleep all night!

Life with clubfoot is no different, and could prove to be worse.   Here
are
some tried and true suggestions for helping your little
clubfooted baby sleep.

The slats on your crib should be very close together so the baby
doesn't get his casted or braced foot stuck between them.

Some babies easily wake themselves up when their cast or brace hits
the side of the crib making a "Thunk" noise.   

In both of these cases, feet getting stuck or just too much noise -
consider trading in that crib for a Play Pen that has netted siding.

Everett took great issue with a crib but slept happily and soundly in a
play pen.  We cut a thick piece of memory foam to lay in the bottom
for his comfort.   He slept in the play pen until he moved in to a
regular twin size bed.

OK, who am I kidding... while all three of my boys had cribs, they
seldom used them and opted to sleep with me instead!  
Read More
About Sleeping and Clubfoot Babies Here....

Blankets - No Blankets!
While wearing casts, your newborn will be comforted by a tight
swaddle of blankets binding his legs tight together and preventing
much movement at all from his body.   This is how he lived inside you
- wadded up tight.   Swaddle a casted baby to help him feel secure
and sleep better, but once you move in to wearing the brace, you
may discover
blankets become the enemy.

Blankets over the FAB tangle up, bind up and in general irritate a
child half crazy.  

Instead,
invest in sleep sacks.  A sleep sack will keep the baby
warm at night but not tangle up around the bar waking the child who
is either cold from losing the blanket, or mad that it's stuck on them.

Older Children and Sleeping in the FAB:
As the child grows and gets independent, sleep sacks are still a great
option but can become hot in warm weather.   My boys like to have
one small blanket.   Sleeping under covers with a FAB on is difficult -
the child can't turn over or move with the weight of the blankets on
him.   You should probably skip buying  that cute little blanket and
comforter set for now and opt for one special "blankie" that the child
can pull on  or push off as needed.

Sleep Sacks are easily made from patterns available in most major
sewing supply stores, or purchased on line ready made.   I like the
kind with sleeves, I use them for pajamas with nothing underneath
but the diaper.

The Big Kid Bed:

When it comes time for a big kid bed - it is probably best to put the
mattress flat on the floor so the child can crawl in and out of bed
wearing his FAB with out needing your assistance.  Life with clubfoot
is hard enough having your feet "tied together" - but children this age
thrive on gaining their independence and this is one area where you
can give it to them freely.  Forget the fashion statement of a fancy
bed, there will be time for that later, for now, let the child have their
own bed they can easily get in and out of with out waiting for your
help.

The Potty:
Life with clubfoot includes potty training.  Potty train your clubfooted
child like you would minus the clubfoot.   If Everett needs to potty in
the night, he crawls in to our room to ask for help.  At our old house
he could walk himself to the toilet, but in our new house the tile floor
is too slick and he falls (wearing his FAB) trying to walk to the toilet.  
Read More About It Here....

SOCKS:
Ah, the great debate that surrounds socks!   I see no reason to buy
any special or expensive sock but many mothers of clubfooted
children disagree with me so let me say a few words about No-Skid-
Socks - the kind with those gooey patterns on the bottom.

You may actually discover you like no-skid socks.   I have heard a lot
of reports that these help keep a child's foot firmly in their FAB
shoes.  If you think you need them, then by all means use them.

My thoughts on no-skid socks is #1, I've never needed them to keep
my children's feet in their Mitchell FABs.  #2, they can be pricey, adn
#3, the sticky stuff seems awfully uncomfortable to me pressing
through the sock an in to the bottom of the foot.

The only thing I believe you need to know about choosing socks is
that there are no seams that will press in to the foot when the FAB is
being worn.  If the toe has a seam, pull it out so it's not stuck between
the shoe and the skin of the foot because that can be uncomfortable
at best, or lead to a pressure sore at worst.   
Learn more about
shoes and socks here....

Shoes - the Regular Kind!
Alas the day will come when you take your baby to buy that first pair
of real shoes!  Oh the joy!  

Since your baby is wearing his FAB via the Ponseti Method Protocol
anywhere from 22 to 12 hours a day depending on what phase of
correction he is in - think twice about the shoes.

Dr. Ponseti recommends babies go barefoot quite a bit while they are
not in their brace.  This allows normal growth and function of the foot
muscles to take place.

Sometimes shoes are needed though, so what kind do you buy for a
clubfooted baby?  The same kind you buy for any baby:  Shoes that
fit well and fit comfortable.  My boys have all grown up in the basic
white leather baby boots that cost about $10.00 at Wal-Mart or K-
Mart.  These are the regular high top baby boots of yester-year but I
find them extremely durable, washable, comfortable....everything a
baby needs when shoes are necessary.

Some parents fret over buying strictly from Stride Rite or other
specialty stores catering to baby shoes.  You can, if you want.  I
never did.   
I opt to follow Dr. Ponseti's suggestion:  My
children only wear shoes if they are going to be walking
where injury might occur - sticks, rocks, broken glass out in
the woods for example, or, where law requires shoes for
entrance in to a public building.
  My 15 month old baby currently
breaks that law most of the time and will until he's probably a couple
years old.  We just really aren't in to shoes.  

Everett has to wear shoes 12 hours a night; Garrison has to wear
them 16 hours a night - why confine them to hot miserable shoes any
more than I have to?  I hate shoes, can you tell? ha.

Just one more thing about shoes, particularly for girls but boys too:  
Don't send your child out for the day in a new pair.

More than one momma has been guilty of buying that cute new pair
to take on vacation to Disney World where the child walks all day
long having the flesh ripped off in blisters.   The child cannot wear his
FAB that night if his feet are covered in sores rubbed on by those
new shoes.

Break new shoes in a little at a time and guard closely against
blisters.   
Read More About Baby Shoes and Socks Here...

Child Care:
If returning to work is in your plans, finding suitable child care is of
course a top priority.  There is really no reason your child cannot
stay in day-care during the casting or the brace-wearing phase
provided you are comfortable with the person you hire to give the
care.   

At first, your care-giver only needs to know the basic details of how to
identify the possibility of swollen toes in the cast as that is a sign of
trouble that needs immediate attention.  Later, your baby will be in
his or her foot abduction brace (FAB) for 23 hours a day, so the care
giver will not have to be trusted to put the shoes on correctly.  Later
when the hours are reduced, it may become necessary to train your
care giver to put the shoes on properly.   
This should not be a
quick lesson - take your time when there are  not
distractions.
 If the shoes are not put on properly there are going to
be some grave consequences including but not limited to pain for the
baby, blisters on the feet, pressure sores and eventual relapse of the
condition.  

If your child will be going in to day-care, I would recommend the use
of the Mitchell shoe over the Markell because it has three simple
buckles instead of being tightened with shoe strings.   A parent can
mark the proper hole on the straps with an ink pen, so the care-giver
can get the shoe put on and buckled to the necessary (and correct)
tightness required with out any guess work.

I do not mean to insult the Markell style of shoe, but these do require
a lot more time and experience to apply correctly.


SUNBURN:   Sunscreen bare feet thoroughly!   A sunburned foot
cannot wear a FAB!

Other Stuff:
If I've missed anything here and you have a question, you are
welcome to
email me!
When your child
decides to say "No!" to
wearing the foot
abduction brace...

...and other parental
non-compliance issues
that lead to relapse.
FAB:

Abbreviation for "Foot
Abduction Brace" as used in
the Ponseti Method of
clubfoot treatment.

Also known as:
DBB, or Dennis Brown bar.

Learn more about clubfoot
braces here.