The hip is a ball and socket joint. Infant hip dysplasia occurs when the socket part of the joint is too shallow. Therefore the ball part of the joint does not have a secure position to "sit" in the socket.
This hip deformity is not uncommon, and newborns are usually screened for infant hip dysplasia before they leave the hospital.
Infant hip dysplasia can be mild and go away on its own as a baby grows. In other cases, it is more severe and can require a positioning harness or surgery.
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My daughter had infant hip dysplasia when she was born.
For the entire last month of my pregnancy, the providers at my clinic assured me that baby girl was in the perfect position. Then, at my first post-date appointment, the midwife seemed concerned and ordered an ultrasound.
To her very suspicion, baby girl was actually sitting upright in my uterus with her butt wedged down in my pelvis! The providers had confused her head for her butt all along. Whoops!
The next morning I went to the hospital for a version procedure, to try and turn the baby. A version is a very uncomfortable procedure that I will never forget!
The version did not work so we had to move on to a cesarean section. I was sad at first to miss out on the experience of labor, but so happy to see my heathy girl after just minutes of surgery.
"S" was born!
I was in utter bliss those first few days after "S"'s birth. Then her pediatrician diagnosed my daughter with hip dysplasia, and I was suddenly in state of worry, bewilderment and sadness.
"S" had to go through a number of ultrasounds and orthopedic appointments to track the progress of her hip development. With each appointment, her hip socket was developing well, which gave me some reassurance.
After 4 months of doctor's appointments, and hypervigilance on my part, "S" was officially free of hip dysplasia!
Ultimately she had a mild case that resolved on its own without intervention.
I did however learn a lot about infant hip dysplasia during that period of time - through all of those doctor's appointments, on top of what I know as a physical therapist!
INFANT HIP DYSPLAGIA SIGNS AND SYMPTOMS
1. Asymmetrical hip flexibility on one side of the body compared to the other side
2. Clicking and popping when moving the hip
3. Apparent hip dislocation
4. Once leg shorter than the other (indicating hip dislocation)
5. Increased thigh folds on one side (indicating hip dislocation)
6. Visible deformity at the front or back of hip (indicating hip dislocation)
Undetected or untreated hip dysplasia in older children or adults may result in progressive hip pain, a limp and/or osteoarthritis in the affected hip joint. Some young adults, even go on to have hip replacement due to uneven wear and tear on the joint, from having a shallow hip socket long-term.
Infant hip dysplasia is often congenital and the baby has it when she is born. It is more common in breech babies, first borns and girls.
Although you cannot fully prevent hip dysplasia, there are actions you can take to help improve hip dysplasia for healthy hip development.
HOW TO IMPROVE INFANT HIP DYSPLAGIA
1. Do NOT Swaddle Your Baby's Hips
When swaddling your baby, the legs should be unrestrained, so that she can rest in a "frog leg position" or "M position". This position allows for normal hip development and encourages deepening of the hip socket.
Check out this post for the best ways to swaddle your baby and why swaddling is beneficial.
Most carriers will specify if they are designed for hip health. Carriers that are best for babies with hip dysplasia will support your baby's thighs to again allow for that frog leg or M positioning in the carrier.
Check out this post for details on all of my favorite carriers and how to wear them.
This Baby Wrap Carrier was awesome for carrying my newborn ALL THE TIME and I used it for the first 4 or so months. Then switched to this BABYBJORN Carrier until Sofia was about 12 months. Next I used the LiLLEbaby once she was heavier and I needed more back support.
3. Do See a Pediatric Orthopedic Doctor
Early detection and intervention is key for resolving hip dysplasia and healthy hip development.
A pediatric doctor will complete physical exams to assess your baby's hip dysplasia and will conduct ultrasounds to measure the depth of her hip sockets over the first few months of your baby's life. The doctor will be able to give you guidance on what level of intervention may be necessary based on your baby's specific severity of hip dysplasia.
In more mild cases of hip dysplasia, the affected hip(s) achieve normal development over time and no further intervention is needed. For more severe cases, a harness or surgery is required.
4. Use a Proscribed Hip Harness as Necessary
If your baby's hip dysplasia does not improve naturally, she may require a hip harness. The most common type of harness is called a Pavlik harness, which maintains your baby's hips in that desired M position to allow for healthy hip development.
It can be hard to accept that fact that your baby will be in a harness for a number of weeks (this varies based on the severity of hip dysplasia). Keep in mind that it is only temporary and that it will give your child the wonderful gift of healthy hips!
5. Surgery if Needed
In some cases, hip surgery is required to deepen the hip socket for increased hip stability. Surgery is often the next intervention if the hip harness was unsuccessful. Surgery can also be required in older babies and children with hip dysplasia.
Lets talk about double diapering...
Layering 2-3 diapers to keep the legs apart has historically been used as a strategy to improve infant hip dysplagia.
It definitely doesn't hurt to double diaper. Just know that double diapering really isn't enough for moderate to severe cases of infant hip dysplagia.
Hearing that your baby has infant hip dysplasia can be scary and overwhelming. Keep in mind that if hip dysplasia is detected and treated early enough, most babies go on to have normal and healthy hip development.
I hope this post gives you some guidance and peace of mind!