DBB questions

[Guest guest]

I just re-read the " Tips & Tricks " thing. Even though it feels like

Ava's been wearing them forever it's only been 8 days, so I figured

I could use the brush-up! Anyway, it leads me to 2 questions...

1) Ava has no problem keeping her heels down & the shoes on. So

sometimes I don't tighten them REALLY hard. Is that okay? I didn't

think it was a problem as long as her heels aren't slipping.

And...

2) This has been discussed in another post, but now I'm really

wondering. Is it supposed to be the width of the shoulders is the

length of the bar as measured from heel to heel? That seems really

strange, because on a 6 " bar, even with one set at 45 degrees,

there's still only about 3 " between the heels. And no baby, no

matter how small has a 3 " shoulder span! (Well, maybe some premies,

but you know what I mean) It also seems like that would be less

comfortable...DH & I were practicing (haha) & our feet set at angles

with our HEELS at shoulder width was very uncomfortable. Feet set at

angles with the CENTER of them at shoulder width was much more

comfortable. Thats how Ava's are set, and she's been quite happy.

And just as a side note, has anyone noticed that nosurgery4clubfoot

has over 600 members, while the regular Club Foot group only has

about 130? (Of which one is me, and I haven't been back since the

day I joined, and then found this group, so it's really like 1

less!!) How about a little teenage-boy-team-spirit? We could pick a

mascot...hmmm, the possibilities. We'll have a chant & everything...

Ponsetti Rules!

We want a cast-er

Not a...uhh...help???

,

[Guest guest]

About the length of the bar...

Here's info from the Ponseti Links site from Hall, an

orthotist at the hospital in Iowa:

d. Width of bar: outside shoulder width equals width between the

center of the heels (after shoes are abducted)

http://pages.ivillage.com/ponseti_links/id9.html

(click on section called " setup of foot abduction brace " )

Here is info from Page 15 of the Global Health booklet:

" The bar should be of sufficient length so that the heels of the

shoes are at shoulder width. A common error is to prescribe too short

a bar, which the child finds uncomfortable [C]. A narrow brace is a

common reason for a lack of compliance. The bar should be bent 5 to

10 degrees with the convexity away from the child, to hold the feet

in dorsiflexion [D]. "

http://www.global-help.org/publications/cf-english.pdf

On that page, you can see the picture (marked " C " ) of a baby with a

bar that is too narrow. It is given as an example of an error. (Note

that some of the pictures are of unusual styles of the bar, but not,

as I recall, the or the kind supplied in Iowa, with the red

two-piece bar. There are pictures of that type at the Ponseti Links

site; just scroll down.)

I'm sure there can be some variation, but the bottom line is that the

heels should be pretty close to shoulder width apart, or the baby

will be uncomfortable (or have other issues). That being said, I'm

sure there are some babies who do fine with it slightly wider or

narrower; but I've always heard that too wide isn't good, and neither

is too narrow. Too narrow " binds " the baby in an uncomfortable way.

Many parents have found that when they test this themselves, if they

stand with toes turned out to 70 degrees, it's more comfortable to

have their heels under their shoulders, rather than only a few inches

apart, especially if you imagine trying to roll around, crawl or pull

to a stand that way. (As they get older, the babies often sleep on

their tummies with their knees tucked up under them.. with their

bottoms tucked in between the heels of the shoes..)

As the children grow, the bar needs to be adjusted wider, (but not

too wide! we did that once..) Sometimes people will all of a sudden,

after months of no problem with the FAB, have a fussy baby, and

discover that is the reason. Once the bar is adjusted, everything

goes back to being fine.

Not sure if this is exactly what you were asking about or not, and is

probably more than you needed, but hope it helps, and continued best

wishes!

and Claire, 4 yrs old