We can make a cast waterproof by using a special kind of padding. Children can bathe and swim with waterproof casts.
Waterproof casts aren't right for all broken bones. Your child's doctor will let you know if a waterproof cast is possible.
Please note that the Emergency Department (ED) at UPMC Children's Hospital of Pittsburgh does not do waterproof casting.
We only offer waterproof casting in the Orthopaedic Surgery Clinic. Parents will need to buy the special padding themselves (see below for more details about that).
Basic Waterproof Cast Care Tips
Whether your child's cast is waterproof or non-waterproof, some of the same basic tips apply.
These include:
- Weight. Follow what the doctor says about when your child can first put weight on the cast.
- Elevation. For the first 3 days, prop your child's casted limb on a chair or pillow when sitting or lying down. Make sure it's above the level of their heart. This will help decrease swelling.
- Movement. Have your child wiggle their fingers or toes in the waterproof cast once an hour during the day. This improves blood flow to the injured limb. It's normal for the color of fingers or toes to differ slightly from the uninjured site.
- Pain management. You can give acetaminophen (Tylenol) or ibuprofen (Motrin) as needed for pain. Your doctor might prescribe your child a medicine for breakthrough pain. Use this as directed.
Showering and swimming with a waterproof cast
You can submerge a waterproof cast completely in water. This means a child can bathe as normal with a waterproof cast. They can even swim with a waterproof cast.
But there are a few things to keep in mind:
- No natural bodies of water. Avoid swimming in oceans, lakes, rivers, and other natural water bodies. Small pieces of kelp, sand, or dirt can get stuck inside the cast and cause skin problems.
- How and when to dry. Let the waterproof cast dry out completely before getting it wet again. Don't leave it wet at bedtime. Use a blow dryer on cold or very low heat to help dry the cast.
- How often to get wet. We suggest getting the cast completely wet every other day, instead of every day. This lessens the risk of skin problems.
Skin care
Both non-waterproof and waterproof casts can irritate the skin and cause rashes. Waterproof casts can cause more skin irritation if you don't care for them properly.
Make sure to avoid sand, and don't swim in natural bodies of water. The risk of skin irritation is too great.
Make sure your child's waterproof cast is completely dry before they go to bed. Check the skin around the waterproof cast once in the morning and once at night.
Be sure to:
- Look under the edges of the cast.
- Notice if skin is red, irritated, swollen, or broken.
Just as with regular casts, the skin under a waterproof cast can itch. Never put anything down under the waterproof cast to scratch. Instead:
- Fill a container with cold water and submerge the itchy area, then dry the cast as usual.
- Use a hair dryer on a cool, low setting and blow air into the waterproof cast.
- Use your knuckles to knock on the cast around the itchy area.
- Give your child diphenhydramine (Benadryl) for severe itching.
Where Do I Buy the Waterproof Padding?
Keep in mind that insurance doesn't cover waterproof padding. You'll need to pay for it out of pocket.
We suggest buying AquaCast Liner because it seems to cause fewer skin problems. Note: UPMC Children's Hospital has no financial ties with this company.
You can buy waterproof padding :
How much padding you need depends on the type of cast and how big your child is.
The doctor can't put on the waterproof cast if you don't have enough padding. It's a good idea to buy extra and return what you don't use.
Pharmacies (and most online vendors) will have kits and instruct you on how much you need.
When To Call the Doctor
Seek health care right away if your child has:
- Numbness or tingling that doesn't go away with a change of position.
- Severe pain when moving fingers or toes of the casted arm or leg.
- Extreme soreness, redness, or blueness of fingers or toes.
- Coolness of the casted arm or leg that doesn't go away.
- A bad smell or drainage from the cast.
- A decreased ability to move fingers or toes.
- Severe itching that doesn't go away.
- Red, broken, or swollen skin around or under the cast.
- Cracks, splits, or softening of the cast.
- A fever above 101°F (38.5°C) by mouth lasting more than one day that cannot be otherwise explained.
Scheduled Waterproof Cast Care Follow-up
- Follow up in 5 to 7 days at the Orthopaedic Surgery Clinic. Our number is 412-692-5530. Or you can follow up with your child's own orthopaedic doctor.
- Call our clinic on the next business day between 9 a.m. and 5 p.m. to schedule your child's follow-up visit. We don't see people without an appointment.
- After 5 p.m. on weekdays or on weekends and holidays, call 412-692-5325. Ask to speak with the orthopaedic surgery resident on-call for any urgent questions.
