EO Newborn Series - What's all the fuss about hips?
The hip is a “ball and socket” type of joint. At birth, all babies are screened for hip dysplasia, a condition where the ball and socket don’t fit together in the “normal” position. By nature and name, developmental dysplasia of the hip (DDH) means that it can gradually develop and this is why we often continue to assess your baby’s hips in the clinic as they grow. We will be doing specific tests and moving their hips to feel the range of motion and stability of each hip joint. We will take into account risk factors for DDH (these include low amniotic fluid, breech presentation, family history, twin pregnancy and gender), as well as observing the hip.
Sometimes you may notice that your baby has uneven hip creases. There are many benign reasons that a baby may have uneven hip creases, and these can often be a “red herring”, but given that DDH is relatively easy to treat when diagnosed early, and can have complications later on if not picked up, we always err on the side of caution. This might mean that your baby has an ultrasound when they’re quite small, and then x-rays later on if ongoing monitoring is advised.
As a parent you can feel your child’s hips and observe their leg length and creases from the front and back - do they look even? When changing your baby’s nappy or after a bath can be a good time for this.
Hip positioning in daily life plays a big role in the development of the hip joint for a baby. To put it simply, we want to encourage a hip position where the hips are turned out and knees are bent - like a frog.
Some strategies that encourage healthy hip development include:
swaddling - if wrapping your baby, always ensure that their legs are loose and able to move freely.
Keep an eye on head shape and neck preferences - sometimes a baby will have a preference for turning their head in one direction which in turn affects the position of their hips. You can read more about head shapes and preferences here.
If using a baby carrier, look for a wide base that supports the whole thigh and supports legs in the ‘M’ position or “frogleg” position (you don’t want their legs dangling). Likewise, avoid jumpers and walkers with narrow bases where a baby’s legs aren’t touching the ground.
Healthy Hips Australia recommend that parents are familiar with the risk factors and signs of hip dysplasia and to ensure that your child’s hips are checked regularly from birth right through until 3.5 years of age. If you have any concerns about your baby’s hips, please mention it to your osteo, paediatric physio, MCHN or GP.
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