Hip Dysplasia In Infants and Children | Pediatrics East
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Hip Dysplasia In Infants and Children

June is Hip Dysplasia MonthDr. Lum and her daughter.

As parents, myself included, we all like to think that our children are truly special in some way. Little did I know how true this would feel until I discovered my daughter was one of the 1 out of every 1,000 babies born with developmental dysplasia of the hip that required treatment. As a pediatrician, healthy hips are always something that we check for on our well-visit exams, but as a parent, there are things that we can do at home to help those hips stay as healthy as possible while our babies grow.

What is developmental dysplasia of the hip?

I know that the term “Developmental Dysplasia of the Hip” is quite a mouthful but let’s examine what that means.

Hip dysplasia is a broad term for an infant hip joint that doesn’t fit together quite right. That is, the hip socket (called the acetabulum) doesn’t fully cover the top part of the thigh bone (the femoral head). If the joint becomes loose it can cause the femoral head to slip in and out of the hip socket, or in some cases, to become completely dislocated.

What causes hip dysplasia in children?

The cause of hip dysplasia is not fully known. The condition typically develops around the time of birth and can progress as the baby grows. Hip dysplasia can describe a spectrum of issues and is not always present at birth. It is something that can develop over time, thus the “developmental” part of the name.

Are some babies more at risk than others?

Yes. Though hip dysplasia can affect every baby, there are some that are more at risk for developing it than others. These babies include:

  • Girls
  • Babies born in the breech position
  • Babies born into families with a history of developmental dysplasia of the hip

What are some signs to look for during a physical exam?

As I mentioned earlier, examining a baby’s hips is one of the routine things that your pediatrician will do at each well-visit. You may notice them gently flex and move your baby’s hip joints to make sure that they are in the proper position. There are few things that you as a parent may also notice at home that could indicate hip dysplasia. If you notice any of the following, be sure to bring it up with your pediatrician to check out:

  • Asymmetry — You may notice that when your baby is laying on their tummy that one buttock crease is lower than the other. Asymmetrical buttock creases can suggest hip dysplasia in some cases, but can also be a normal finding.
  • Hip click — When changing your baby’s diaper or moving their legs, you may feel a click in their hip. Like asymmetry, this can also be a normal finding, but can also be an indicator of hip dysplasia.
  • Limited Range of Motion — As babies with hip dysplasia get older, if left undetected, the affected hip will not be able to move out as far, so you may notice decreased movement on that side when trying to diaper the baby. Or if the child is older, their walking or gait may seem odd.
  • Different Leg Lengths — You may notice that one leg seems longer than the other. This can be an indication of hip dysplasia.

flexing baby's legs

How is hip dysplasia treated?

Luckily, the treatment for hip dysplasia when diagnosed early is non-invasive. In most cases, babies can be treated with a harness that keeps their hips in the proper position to develop normally. In some cases though, like with my daughter, this doesn’t always work and those babies may need further help with corrective surgery.

What can I do to help keep my baby’s hips healthy?

Hip dysplasia is not 100% preventable—as my daughter’s orthopedic surgeon told me, it just comes down to anatomy and there is nothing that you can do to control that. However, there are some things that parents can do to help keep those hips in a healthy position as they grow and develop.

Hip-Healthy Swaddling

If your baby is anything like my daughter, swaddling was a pretty big part of her early days. When you make those little baby burritos though, it is important to remember to leave space for their hips to bend up and out. This position allows for the natural development of the hip joints.

If swaddling with a blanket, I recommend checking out the link below from the International Hip Dysplasia Institute to see a video on how to properly do so. If you are anything like me as a parent, and your baby is a Houdini like mine was then a swaddle sleep sack may be a better option. There are a number of them that are deemed “hip-healthy” and allow for space to let those hips move. For those interested, the International Hip Dysplasia Institute also provides this list:

swaddled baby

Babywearing

Babywearing is a great way for a baby to stay close to parents and allow parents some freedom to attempt to get some things done. Like swaddling, proper hip positioning when babywearing is important to help promote healthy hips. When doing so, you want to be sure your baby’s hips are in an M-position—with the thighs flexed, supported, and spread apart. In babies under six months, having the baby facing inward toward mom or dad is recommended rather than outward. For more information on hip-healthy babywearing see the link below.

Dr. Lum’s Expert Advice

With all of the recommendations above, the biggest take-home point I tell my families to focus on is to allow those hips to be able to move. When you position them, think of their legs being able to come up like little frog legs. You never want to have your baby’s legs forced in a straight position since this doesn’t promote good hip joint development.

Pediatrics East Is Here To Help

The good news about hip dysplasia is that it is very treatable. Since it is a process that can develop over time, making sure your baby’s hips have the chance to grow in the healthiest way possible is something that I would like all of my parents to be aware of. Hopefully, the above tips prove useful for you. For any questions or other concerns please don’t hesitate to call your pediatrician to discuss further. Or, if your child has been diagnosed with hip dysplasia and you would like another parent to talk to about it, I’m more than happy to offer support for you! To learn more, make an appointment.

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