Hip Dysplasia – what to know

Developmental dysplasia of the hip (DDH) is a problem with how a baby’s hip (or both hips) is developing. Your maternal and child health nurse or pediatrician will check your baby’s hips at each appointment, but to help you further, we’ve compiled a list of what you need to know about hip dysplasia.

What is hip dysplasia?

It is when the ball at the top of the thigh bone is not stable within the cup-shaped socket of the hip.

What causes hip dysplasia?

When you are pregnant, you release hormones that help the ligaments in your body to relax, which assists with the delivery of your baby. Some of these hormones can enter your baby’s blood, making your baby’s ligaments relax as well.

Hip dysplasia is more common in babies who were born in the breech position (bottom first), girls, firstborn babies, or those with a family history of dislocated hip joints (according to the Royal Children’s Hospital).

How about swaddles and baby carriers?

Hip dysplasia can also be caused by wrapping or swaddling your baby too tightly. Remember that babies should be able to move their legs and bend their knees when they’re swaddled. We recommend a hip healthy swaddle like this one, and you can check out our basic guide to swaddling.

When using baby carriers, the International Hip Dysplasia institute recommends that your baby’s knees should be above his bottom, with their legs spread in a squat position. Here’s our guide to choosing the right baby carrier.

What are the signs and symptoms of hip dysplasia?

Sometimes hip dysplasia isn’t obvious, even to doctors, so the signs to look for in your baby are:

• Uneven creases on your baby’s thighs or groin
• Legs that are different lengths
• A stiff or ‘clicky’ hip joint
• Legs that don’t move normally

When should I see a doctor if I suspect hip dysplasia?

It’s important to see your doctor as soon as possible. If hip dysplasia is left untreated, your baby may develop a painful limp, a ‘waddle’, or toe walking. In time, they may ultimately require a hip replacement.

Your doctor may refer your baby for an ultrasound or x-ray to diagnose hip dysplasia.

What is the treatment for hip dysplasia?

If hip dysplasia is picked up, treatment varies depending on the child and the severity.

Your baby may need to wear a soft brace (a Pavlik harness) until the hip is stable, which could be several months.

If the brace doesn’t work, your baby may require a closed reduction procedure, which means the hip is repaired while your child is under anaesthetic.

If those treatments are unsuccessful, your child may require open reduction surgery (which is done through a small cut in the body to operate on the surrounding ligaments). After surgery, your baby will need a plaster cast (called a hip spica) from the knees to their waist, which they’ll wear for several months.

Read more about hip dysplasia on the International Hip Dysplasia Institute website, or more about the Pavlik Harness on the The Royal Children’s Hospital Melbourne’s website.