Healthy Hips: What is Hip Dysplasia? - Dr Golly Sleep Program

Healthy Hips: What is Hip Dysplasia?

The hip joint is a ball-and-socket joint that allows an incredible range of movements without much risk of dislocation (unlike the shoulder). 

The socket (pelvic bone, called the acetabulum) is very shallow, not holding the ball tight. 

This is how all babies are born. The socket matures over time and most babies develop a nice, stable hip joint without any intervention being required. 

1 in 6 newborns have some hip instability - incorrect swaddling techniques can increase the risk of Hip Dysplasia. 


What is hip Dysplasia?

Hip dysplasia is a common condition which occurs when the ball and socket of the hip do not fit together in their 'normal' position. When the socket fails to mature properly and remains shallow, this leaves the hip joint vulnerable and predisposes to early-onset arthritis, indeed it's the most common cause of hip arthritis in adults.

Early diagnosis of Hip Dysplasia optimises treatment outcomes


Risk Factors of Hip Dysplacia Include:

  • Female (Hip Dysplasia affects girls more than boys)  
  • First born
  • Family history of hip dysplasia (in first degree relative)
  • Breech lie
  • Neuromuscular or connective tissue disorder associated with DDH
  • Inappropriate swaddling 

Hip Dysplasia isn’t always present at birth hence the name Developmental Dysplasia of the Hip (DDH) 


Signs and symptoms of hip dysplasia:

  • ‘Clunk’ or ‘Click’ when moving hip
  • Uneven thigh creases 
  • Crooked buttock creases
  • Leg(s) difficult to spread apart
  • Weight off to one side when sitting
  • Different leg lengths
  • Avoiding weight bearing
  • Walking on tippy toes on one side• Limping when walking
  • Torticollis , Plagiocephaly and Metatarsus adductus

Every child’s hips need checking at:

  1. Birth
  2. 1-4 Weeks
  3. 6-8 Weeks
  4. 6-9 Months
  5. 12 Months 
  6. Then at the normal health reviews until 3.5 years

Your doctor will examine the hips and determine the need for an ultrasound to measure the degree of hip maturity, then guide you accordingly. 
The best resource for all information regarding Hip Dysplasia is“Healthy Hips Australia”.

Safe Swaddling for Hips:

Swaddling the legs can impede this process and could lead to hip dysplasia and incorrect swaddling techniques can increase the risk of hip dysplasia.

It is important to swaddle the arms but leave the legs to ‘flop open’ and encourage the hip to mature.

See below the Dos and Don'ts when swaddling your baby:

 

Safe Swaddling/Wrapping

Tips to allow for natural hip development during swaddling/wrapping

DOs 

DON’Ts

  • Position your baby with their hips bent and knees apart in a frog position
  • Allow room enough, from the waste down, for free leg movement (a triangle not a sausage shape is a good guide).
  • Swaddle the upper body firmly, but not tightly.
  • Consider swaddling the arms only
  • Follow SIDS guidelines
  • Stop swaddling once your baby is rolling
  • Swaddle legs tightly or straight down/pressed together.  
  • Use sleep sacks and pouches that are snug around the thighs 

Why is this important?

  • Research indicates inappropriate swaddling can increase the risk of developmental dysplasia of the hip (DDH)



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