PREVENTING BLISTERS:
Unfortunately, B&B can cause some terrible blisters to babies’ sensitive feet. You can take proactive steps to try to avoid this. Here are the steps we took (at the advice of other clubfoot parents):
WEARING B&B:
B&B ROUTINE:
You’ll come up with your own routine to make 23-hour wear work. We were very strict and never took the bar off for car rides or anything else. Remember that the boots don't do any good without the bar. Generally, we split our free time into 30 minutes in the morning and 30 minutes in the evening. On nights that she took a bath, we changed that to 20 minutes in the morning and 40 minutes in the evening. We preferred this instead of a solid hour of free time, because it gave us a chance to make sure she didn’t have any blisters forming. Here was our morning routine, for you to view as a sample:
STRETCHES:
This video reinforced the stretching techniques our doctor recommended.
FIRST BATH:
Many parents are excited to finally give their baby a real bath again, after weeks of sponge baths during casting. Some babies do great with their first bath and have no problems. For others, however, the feet and legs are very sensitive, and giving a bath right away is too much. This was the case with us. We were thrilled for our baby to finally get a nice bath, but she shrieked the minute her legs touched the water. We thought the water must be too warm, so we adjusted the temperature and tried again – with the same result. The next day, research on the Facebook forum told me that many babies have the same reaction, due to skin sensitivity. We continued sponge baths for another week, and just dripped little bits of water on her legs until her skin seemed less sensitive. When we gave her another bath about a week later, she loved it.
BAR WIDTH:
As your child grows, the width of the bar will need to be periodically adjusted. Follow the instructions that came with your bar, but the typical rule of thumb is that the bar should be shoulder-width on your child.
DEGREES:
For typical cases of clubfoot, B&B are generally set to 60-70 degrees. If your baby has unilateral clubfoot (just one foot), then the non-clubfoot is usually set to 30-40 degrees. If you notice that your B&B are set for anything different, and your baby does not have complex clubfoot, consult your doctor.
Unfortunately, B&B can cause some terrible blisters to babies’ sensitive feet. You can take proactive steps to try to avoid this. Here are the steps we took (at the advice of other clubfoot parents):
- Had the B&B sent to us prior to the day our baby’s final casts were removed.
- Put the Mitchell boots (not the bar!) in a pillowcase and washed them in warm water (without soap) on gentle cycle, with some towels for protection. This helped loosen up the leather.
- Put moleskin in the heel of the boot (in between the two holes) & over the sharp tab in the back of the boot.
- Put sheepskin on the tongue of the boot to distribute the pressure more evenly. This was a lifesaver for us, thanks to a suggestion by another clubfoot mom. We purchased sheepskin & leather glue at a leather repair shop. Other parents bring their boots to a shoe repair shop (or their orthoist) and have sheepskin sewn into the boot. Many people use pressure saddles, which can be purchased from MD Orthopaedics.
WEARING B&B:
- The Mitchell boots have holes in the back, so you can make sure your baby’s heel is visible. This is important to prevent blisters and keep the foot in place.
- Note that it can take a few weeks for your baby’s heel to drop all the way, so it might not sit perfectly in the boot at first. Get the heel back as far as possible.
- If your child’s foot ever slips out of the boot, don’t panic – but know that you probably need to get the middle strap tighter. Parents often find that it is a challenge to get it tight enough. It often needs to be tighter than you think to keep that little foot in place.
- The middle strap is the most critical to preventing the foot from moving. It helped me to fasten the strap loosely, and then adjust the tongue and pull it tighter -- one or two holes at a time. Make sure the tongue doesn’t bunch up as you tighten. Since leather stretches and your baby’s foot will grow, you’ll have to periodically adjust the tightness.
- Know that the first few weeks are the most difficult. It does get easier! You can do it! Keep up the hard work – it will pay off!
B&B ROUTINE:
You’ll come up with your own routine to make 23-hour wear work. We were very strict and never took the bar off for car rides or anything else. Remember that the boots don't do any good without the bar. Generally, we split our free time into 30 minutes in the morning and 30 minutes in the evening. On nights that she took a bath, we changed that to 20 minutes in the morning and 40 minutes in the evening. We preferred this instead of a solid hour of free time, because it gave us a chance to make sure she didn’t have any blisters forming. Here was our morning routine, for you to view as a sample:
- Remove boots & socks when baby is happy (so they don’t learn that crying leads to boot removal)
- Set the stopwatch on your phone
- Inspect each foot for red spots
- Wipe the feet down with Baby Wipes
- After five minutes, do stretches (see below)
- Allow baby to kick and play; touch their feet. Enjoy free time!
- Get a clean pair of socks & put three shakes of baby powder in each sock
- After 25 minutes of free time, apply blister prevention stick to heel, top of foot, and any other part of the foot that is red or has appeared red in the past
- Put the clean, powdered socks on baby’s feet and put B&B back on
STRETCHES:
This video reinforced the stretching techniques our doctor recommended.
FIRST BATH:
Many parents are excited to finally give their baby a real bath again, after weeks of sponge baths during casting. Some babies do great with their first bath and have no problems. For others, however, the feet and legs are very sensitive, and giving a bath right away is too much. This was the case with us. We were thrilled for our baby to finally get a nice bath, but she shrieked the minute her legs touched the water. We thought the water must be too warm, so we adjusted the temperature and tried again – with the same result. The next day, research on the Facebook forum told me that many babies have the same reaction, due to skin sensitivity. We continued sponge baths for another week, and just dripped little bits of water on her legs until her skin seemed less sensitive. When we gave her another bath about a week later, she loved it.
BAR WIDTH:
As your child grows, the width of the bar will need to be periodically adjusted. Follow the instructions that came with your bar, but the typical rule of thumb is that the bar should be shoulder-width on your child.
DEGREES:
For typical cases of clubfoot, B&B are generally set to 60-70 degrees. If your baby has unilateral clubfoot (just one foot), then the non-clubfoot is usually set to 30-40 degrees. If you notice that your B&B are set for anything different, and your baby does not have complex clubfoot, consult your doctor.