Understanding hip dysplasia in babies

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Hip dysplasia in babies and children is common, but it can be difficult for parents and caregivers to navigate. Below, find out everything you need to know about hip dysplasia, from what causes it and the signs to look out for to how the condition is treated. 
reviewed by Genevieve Titov, Sleep Angel
5 min read |
16 June, 2022

What is hip dysplasia in babies?  

Developmental Dysplasia of the Hip (DDH), or clicky hips as it’s commonly referred to, is where the head of the femur bone doesn’t sit in the hip socket correctly. The ligaments of the hip joint may also be loose. This can cause the hip to become unstable and will cause problems further down the line if left undiagnosed.   

Usually, only one hip is affected but sometimes both can. DDH can occur at birth or develop in the weeks and months that follow. DDH can vary from mild to severe but usually isn’t painful. However, it can become troublesome later in life if left untreated.  

What can cause hip dysplasia in babies?  

From family history to the sex of your child, discover the most common causes of hip dysplasia below. 

  • DDH is 12 times more common if there is a family history of the condition. 
  • Low amniotic fluid in the womb. 
  • Breech position in the womb. 
  • First or twin pregnancy. 
  • The sex of your child. DDH is four to five times more common in females.   

What are the signs of hip dysplasia in babies and children?  

Doctors and midwives will examine your child’s hips when they are born. Your GP will continue to check your child’s hips at every appointment over the first 12 months.  

If you’re concerned that your child might have hip dysplasia, look out for the below signs.   

Common signs to look out for in babies: 

  • Your baby’s legs are tight when you try to open them to change their nappy. 
  • Your baby has uneven thighs. 
  • One of your baby’s legs appears shorter than the other.   

Common signs to look out for in older children: 

  • Your child took longer than average to learn how to sit up or walk. 
  • Your child limps or leans to one side when walking. 
  • Your child waddles when walking. 
  • There is a popping or clicking sound when the hip joint moves. 
 

    What age does hip dysplasia show?  

    DDH is usually diagnosed shortly after birth, but can also appear later in life. Parents and caregivers should keep an eye out for the common signs and symptoms of DDH. If concerned, please speak to your GP. 

    DDH is usually diagnosed during an ultrasound or x-ray. An ultrasound is recommended for infants aged four months or under while an x-ray is recommended for children aged between four to six months.     

    How common is hip dysplasia in babies?  

    Hip dysplasia is very common in Australia. On average, one in 100 children requires treatment for hip dysplasia in Australia. It is more prevalent in first-borns and females.    

    What is the most common management of a newborn with hip dysplasia?  

    For mild DDH, children often wear a hip brace for 23 hours a day for three months. For more severe DDH, babies might wear braces for six months or more. In more severe DDH, children may need surgery. 

    Treatment for hip dysplasia varies from child to child depending on the severity of the condition.  

    A special brace 

    The Pavlik Harness and Denis Browne Bar are commonly used to treat mild DDH. The braces are designed to hold your child’s hip in the correct position so that the joint can develop properly. A brace is usually worn for a few months until the hip is stable.  

    Closed reduction procedure  

    If a brace doesn’t work, your child may need a closed reduction procedure. This is where the hip join is repaired without surgery. The hip joint is moved into the correct position under anesthetic.  

    Open reduction surgery  

    When a brace and closed hip reduction haven’t worked or your child is diagnosed with DDH after six months, open reduction surgery is the next choice. This is where the hip joint is moved into the correct position by operating on the surrounding ligaments.  

    After surgery, your child will need a hip spica (a cast that covers your child’s body from the knees to the waist). This will need to be worn for several months until recovery.  

    Osteotomy 

    When hip dysplasia is diagnosed later in life, more surgery to the thigh or pelvis may be required to ensure the hip joint stays in place. This is known as osteotomy.   

    How long do babies wear a Pavlik Harness for?  

    A Pavlik Harness is worn for as long as the doctor recommends, which is usually around six to 12 weeks. The harness will hold your child’s legs in a frog-like position which enables the pelvic sockets to deepen around the thigh bone and allows the hip joint to stabilise.    

    How do babies sleep with hip dysplasia?  

    Babies should always be put to sleep on their backs from birth. Children with hip dysplasia should not be put to sleep with their legs or hips held straight in extension. 

    The best sleep position for children with hip dysplasia is where the knees naturally fall apart with the thighs supported and hips and knees bent. This is called the M-position, straddle position, or jockey position. It is a position designed to promote natural hip development.      

    What is the best sleeping position for hip dysplasia?  

    Babies should always be put to sleep on their backs to reduce the risk of SIDS (sudden infant death syndrome). The best sleep position for children with hip dysplasia is where their knees naturally fall apart with the thighs supported and hips and knees bent. This is called the M-position, straddle position, or jockey position. This position is designed to promote natural hip development.     
     

    What positions should be avoided with hip dysplasia?  

    Children with hip dysplasia should avoid sleeping with their legs held straight in extension with the knees and hips stretched out. Free movement of the hips will promote natural hip development.    

    Should you swaddle a baby with hip dysplasia?  

    Babies with hip dysplasia can be swaddled. Designed to help children with DDH, our Swaddle Up Hip Harness Original can be worn over a Pavlik Harness, Denis Browne Bar (DBB), and a Rhino Race.  

    When your child shows signs of rolling over or pulling up onto their hands, you must stop swaddling. Our Swaddle Up Transition Bag Hip Harness Original™ will provide your child with support on the journey towards more independent sleep. 

    How do you hold a baby with hip dysplasia?  

    Holding a baby with hip dysplasia can be difficult and it will take time to find a position that’s comfortable for both of you. If breastfeeding, there are several positions you can try: the seated straddle position, the football position, the modified cradle position, or simply laying down. Find what works for you and your child.  

    You can still hold and breastfeed a child with hip dysplasia, even if they’re wearing a harness or brace.  

    Can babies with hip dysplasia do tummy time?  

    Yes. Supervised tummy time is important for babies with hip dysplasia as it will promote stability, balance, coordination, and head control. It will also decrease the risk of your child developing a flat spot. You can still do tummy time with a harness or brace on.      

    Do babies with hip dysplasia crawl?  

    Yes. Some babies with hip dysplasia can crawl and walk. Some children are diagnosed with hip dysplasia a couple of years after birth. Common signs of DDH include dragging one leg behind the other when crawling or a limp when walking.    

    How should I dress my baby with hip dysplasia?  

    Children with DDH can wear normal clothes. However, there are a few things to consider. Always ensure their bottoms have plenty of room in the groin and hip area, especially if they’re wearing a Pavlik Harness. Sleepsuits with a side fastening will also make changing your child easier.   

    Can babies with hip dysplasia wear normal clothes?  

    Yes, babies with hip dysplasia can wear normal clothes. At Love To Dream™, we understand the importance of creating sleep garments and swaddles for children with hip dysplasia. The Love To Dream Swaddle Up™ is proudly hip-healthy with plenty of room for your child’s hips and legs to move and grow.         

    Designed to help children with DDH, our Swaddle Up Hip Harness Original™ can be worn over a Pavlik Harness, Denis Browne Bar (DBB), and a Rhino Race. 

    Love To Dream is recognised as hip-healthy   

    At Love To Dream™, we understand the importance of creating sleep garments for children with hip dysplasia. The Love To Dream Swaddle Up™ is proudly hip-healthy with plenty of room for your child’s hips and legs to move and grow.   

    When your child starts to show signs of rolling over or pulling up onto their hands, you must stop swaddling. Our Transition Suits and Bags™ will enable you to remove the wings one by one for a smoother journey towards more independent sleep.

    At Love To Dream™, we know that every child is different, and we’re committed to helping you to find the right solution for your family. With you at every step, Love To Dream™ believes today’s little dreamers are the shapers of tomorrow. For further advice from our experts, visit our blog.

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