Hip Dysplasia In Babies

What Is Hip Dysplasia

Hip Dysplasia is the term used to describe the condition whereby the bones of the hip joint are not aligned correctly. It affects thousands of children and adults each year and is known by many different names:

  • Developmental Dysplasia of the Hip (DDH)
  • Hip Dislocation
  • Congenital Dislocation of the Hip (CDH)
  • Loose Hips

Hip Dysplasia In Babies

In babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. This means the ball is loose in the socket and may be easy to dislocate. While DDH is most often present at birth, it may also develop during a child’s first year of life.

According to the International Hip Dysplasia Institute (IHDI):

Approximately 1 out of every 20 full-term babies has some hip instability and 2-3 out of every 1,000 infants will require treatment. In spite of the frequency of DDH in babies and the potential for life-long disability caused by DDH, the awareness of this condition is poor outside of the medical profession.

Early diagnosis, prevention, and simple treatment is the best solution

Currently, it is believed that babies are prone to Hip Dysplasia for the following reasons:

  • Family History – Hip dysplasia is approximately 12 times more likely when there is a family history. (IHDI)
  •  A baby’s position in the womb can increase pressure on the hips
  • An infants hip socket is mostly soft, pliable, cartilage
  • A baby’s positioning during their first year – according to the IHDI:

Cultures that keep infants’ hips extended on a cradleboard or papoose board have high rates of hip dysplasia in their children. Cultures that hold infants with the hips apart have very low rates of hip dysplasia. For this reason, swaddling with the hips extended during the first few months after birth should be avoided, and a hip-safe method should be used.

The Royal Children’s Hospital Melbourne states that:

Pregnant women secrete hormones in their bloodstream which allows their ligaments to relax. These hormones help the delivery of the baby through the mother’s pelvis. Some of these hormones enter the baby’s blood and can make the baby’s ligaments relaxed as well. This can make the hip joint loose in the socket. The way the baby lies in the uterus can also cause the hip joint to become loose or dislocate.

DDH is more common in girls, firstborn children, babies born in the breech position (i.e. bottom first) and in families where a parent has had a dislocated hip joint. DDH can be in one or both hip joints.

Prevention of Hip Dysplasia

The most common advice provided to aid in the prevention of Hip Dysplasia is for parents and caregivers to remain mindful of healthy hip positions.

The healthiest position for the hips is for the hips to fall or spread (naturally) apart to the side, with the thighs supported and the hips and knees bent.

This is sometimes called the jockey position,the frog position, the straddle position, the spread-squat position or human position. Ensuring that the hips are free to move without forcing them together promotes natural hip development.

Hip Dysplasia and Car Seats

  • Tight car seats prevent legs from spreading apart.
  • Wider car seats provide room for legs to be apart, putting the hips in a better position.
Hip Dysplasia and Car Seats
Source: International Hip Dysplasia Institute

Hip Dysplasia and Swaddling

Improper swaddling as it may lead to hip dysplasia. When in the womb the baby’s legs are in a fetal position with the legs bent up and across each other. Straightening of the legs to a standing position when swaddling can loosen the joints and damage the soft cartilage of the socket.

The an animation on the IHDI site illustrates what can happen to the bones and ligaments when a babies legs are straightened and swaddled.

Hip Dysplasia and Baby Wearing

Harness Style

  • If the thighs are NOT supported to the knee joint, the resulting forces on the hip joint may contribute to hip dysplasia.
  • When the thighs are supported to the knee joint, the forces on the hip joint are minimal because the legs are spread, supported, and the hip is in a more stable position.

Baby Slings

  • Baby Sling carriers that force the baby’s legs to stay together may contribute to hip dysplasia.
  • Baby Slings should support the thigh and allow the legs to spread to keep the hip in a stable position.
Hip Dysplacia - Baby Carrier Positioning - Not Recommended
Source: International Hip Dysplasia Institute
Hip Dysplacia - Baby Carriers - Correct Method
Source: International Hip Dysplasia Institute

Key Points to Remember

  1. In babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. This means the ball is loose in the socket and may be easy to dislocate.
  2. Early diagnosis, prevention, and simple treatment is the best solution.
  3. Remain mindful of healthy hip positions.
  4. Straightening of the legs to a standing position when swaddling can loosen the joints and damage the soft cartilage of the socket.
  5. The healthiest position for the hips is for the hips to fall or spread (naturally) apart to the side, with the thighs supported and the hips and knees bent.