You would have been asked to bring your baby in for an ultrasound scan (USS) of their hips within the first 4-6 weeks of their birth. An USS is used to determine the ‘maturity’ of an infant’s hip joints. Hip joints are a ‘ball and socket’ joint. The socket, ideally, is cup-shaped. An immature hip joint will not have a cup-shaped socket; it is more shallow, so the joint is less stable/secure. An immature hip is described as dysplastic and the condition is called Developmental Dysplasia of Hips (DDH).
Your baby has been examined by a paediatric doctor or specialist practitioner and no abnormality was felt and their hips appear stable, although this examination does not detect all levels of immature hips. There are a few other factors which increase your baby’s risk of being born with a degree of DDH. These are:-
· Breech presentation
· Birth weight over 4.5 kg
· Family history of DDH
· Presence of talipes
· Moulded babies
If your baby has any of these risk factors, you will have been told about them and an explanation given.
There are some simple ways of caring for your baby which can help protect their hips from long term immaturity and promote normal development of the ball and socket. Good positioning and time increases the chance that your baby’s hips will mature correctly.
Positioning Do’s and Don’ts
Do –place your baby on their back for sleep. Their legs should naturally bend at the knees and ‘fall’ outwards.
Do – carry your baby so that their legs are apart, again knees bent and outwards.
Do – dress your baby in loose fitting clothes so their legs are freely able to move outwards.
Do – place your baby on their tummy when they are awake.
Do – change your baby’s nappy by raising their bottom by lifting under their lower back.
Do not – swaddle your baby with their legs together.
Do not – position your baby on their side to sleep.
Do not – change your baby’s nappy by lifting them with their foot. This will pull the hip joint on that side into an unfavourable position.
When to seek advice from your Health Visitor or GP
If your baby shows any of these signs, do seek advice:
· restricted movement in 1or both legs when you change their nappy
· 1 leg dragging behind the other when they crawl
· 1 leg appearing longer than the other
· uneven skin folds in the buttocks or thighs
· a limp, walking on toes or developing an abnormal “waddling” walk
· failure to weight-bear when you would normally expect this
Read more about DDH here