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Q: Is the opening big enough to slide over a cast or splint or do you have to stretch it

It needs to be somewhat stretched to go over the cast so you can get a good seal.

Q: Would this work for my 15 month old? She has a cast on her lower leg. Her leg circumference is 8.5" and the length of her cast is only 7".

If the circumference is 8.5 you would need an XSmall full leg. It would be long on her but the circumference would fit (pull it up so extra length is distributed up and down the leg and not flapping around at the end of the foot).

Q: Any recommendations for size on a 6 month old with a full leg cast, im thinking an xs but still not sure?

My daughter was 2 when she fractured her foot and the XS was tight around her thigh but worked to keep her whole leg perfectly dry.

Q: Will the xsmall size fit a 4 year old?

You want to make sure that the circumference measurements fit. Dry Pro Waterproof Cast Cover Sizes Arm/Leg Circumference LengthX-Small Full Arm 6 - 6.75 " 16 "Small Full Arm 6.75 " - 8.75 " 23 "Medium Full Arm 8.75 " - 10 " 28 "Large Full Arm 10 " & up 31.5 "Small Half Arm 7.75 " - 10 " 17.5 "Large Half Arm 10 " & up 20 "X-Small Full Leg 7.5 " - 11 " 19 "Small Full Leg 14 " - 16.5 " 29 "Medium Full Leg 16.5 " - 21 " 33 "Large Full Leg 21 " & up 37 "Small Half Leg 10 " - 13 " 21 "Large Half Leg 13 " & up 23.5 "