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Hip dysplasia: what is it, how does it affect people and how to prevent it in your baby

A baby lies on a bed
Hip problems aren't just for older people - hip dysplasia is a condition that can begin during infancy and requires treatment.

When you think about hip problems, you probably think about older people rather than newborn babies. But hip dysplasia is a common musculoskeletal condition that is diagnosed in eight Australian babies every day.

Read on to find out what hip dysplasia means, the signs of hip dysplasia, how it is diagnosed and treated, and what you can do to lower your baby’s risk of hip dysplasia.

What is hip dysplasia?

Hip dysplasia happens when a hip joint doesn’t develop properly. The hip joint has two parts: the end of the thigh bone (femoral head) and the hollow socket (acetabulum) in the pelvis. In babies with hip dysplasia, the socket is too shallow, which means the hip can become unstable or dislocate (come out of the joint). Usually, hip dysplasia only affects one hip, most often the left one, but it can affect both hips at once.

If not treated, hip dysplasia can damage the hip joint. Over time, the hip can become painful and arthritis can develop. In fact, it’s the one leading cause of early-onset hip arthritis in Australia.

Hip dysplasia is usually diagnosed in young babies, but can be diagnosed in older children and adults.

Who is at risk of hip dysplasia?

Anyone can develop hip dysplasia, but some people have a higher risk of the condition than others.

Hip dysplasia is more common in:

  • a twin pregnancy
  • a woman’s firstborn child.
  • babies born breech (feet first instead of head first)
  • a person with a family history of hip conditions
  • girls – girls are four times more likely than boys to have hip dysplasia.

Hip dysplasia can also be caused or made worse in babies by wrapping, swaddling or carrying techniques that pull the legs down or leave the legs hanging, causing strain on the hip joint.

How can I prevent hip dysplasia in my child?

Not all cases of hip dysplasia are preventable, but there are things you can do to lower the risk, particularly when it comes to how you wrap, swaddle, sleep and carry your baby.

When wrapping or swaddling your baby, it’s important that the legs aren’t pulled straight down. Instead, they should be able to splay outwards in the ‘M’ or ‘frog leg’ position. Keep their legs loose so your baby can move them upwards and out to the side.

Some babies really like turning their head to one side when sleeping. Always having their head turned one way can change how their hips are positioned. Try turning your baby’s head to the other side regularly. This will also prevent the skull from becoming flattened in one area.

A diagram demonstrating how to swaddle a baby by keeping their legs loose.

You should follow the safe sleeping guidelines from Red Nose every time and everywhere your baby sleeps.

When carrying or wearing your baby in a sling, wrap or carrier, the legs should always be sitting out to the side in the ‘M’ or ‘frog leg’ position, with support under their buttocks and legs to the knee. The legs should not point straight downwards or lie together across your body.

Follow the T.I.C.K.S system to keep your baby comfortable and safe when being carried

  • Tight – the baby should be secure in the carrier
  • In view – you should always be able to see your baby’s face
  • Close – the head should be close enough for you to kiss
  • Keep the chin up – your baby’s chin should be up off their chest
  • Supported – your baby’s back should be supported

A diagram demonstrating how to carry a baby following the T.I.C.K.S system

You can use Raising Children’s guide to finding a baby carrier or sling that is safe for you and your baby.

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

Your doctor or child nurse should check your baby regularly for hip dysplasia as they grow. There are also signs and symptoms you can look out for, including:

  • their hip joint ‘clicks’ when it’s rotated
  • uneven creases under the buttocks
  • a crooked crease between the cheeks of the buttocks
  • one leg looks shorter than the other – you might see this when your baby is lying down or with the legs pulled up to their chest
  • uneven walking, limping or swaying side-to-side when your baby learns to walk
  • late development to sit up or walk.

Hip dysplasia doesn’t cause pain for babies and toddlers. In older children and adults, hip dysplasia might cause sharp pain in the groin area.

How is hip dysplasia treated?

The sooner a baby or child gets diagnosed with hip dysplasia, the easier treatment will be. If you think your child is showing signs of hip dysplasia, it’s important to show your doctor so the doctor can examine your child, investigate and refer to an orthopaedic specialist.

In babies, braces that hold the legs outwards are commonly used to treat the hip dysplasia. These are made of soft material and might need to be worn for weeks or months. Some babies might require a brace made from a plaster cast, but this is much less common than a material brace. Rarely, surgery is required to treat babies with hip dysplasia.

In older children and adults, several treatments might be required to help keep the hip functioning for as long as possible. These can include anti-inflammatory or steroid medications, injections or physiotherapy. Surgery is sometimes required to treat older children and adults. Some adults with hip dysplasia will require hip replacement surgery.

More information

You can find more information about hip dysplasia at the links below.

Healthy Hips Australia

Health Direct

Pregnancy, Birth & Baby

Raising Children

Healthy Hips Australia DDH Support Group Queensland

Video: How to swaddle your baby

Video: How to carry your baby

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Last updated: 16 April 2020