Finding out your baby may have Hip Dysplasia can be a stressful time for parents. The thought of putting your baby in a harness can be very upsetting. Please share your experiences past or present and help support others going through this tough time.
Developmental Hip Dysplasia affects approximately 1 in 600 girls and 1 in 3000 boys in Australia. It is a condition where the hip joint is dislocated or prone to dislocation, due to either the socket being too shallow or the ligaments being too slack allowing the ball of the joint to fall out of place. The left hip is 3 times more likely to be affected than the right, and bilateral hip dysplasia is not uncommon. There are a number of known causes of hip dysplasia including family history (1/3 of cases have a family history), congenital disorders (eg spina bifida or cerebral palsy), breech delivery or a multiple birth.
Signs that a baby may have Hip Dysplasia can be reduced joint mobility, a low clunking sound when the leg is rotated or an unusually large perineum. If only one hip is affected, some other signs can be that the skin creases of the buttocks don't match or one knee may look higher than the other. Sometimes diagnosis doesn't come until later (about 2 or 3 years old), and this is indicated by an unusual waddling gait, a limp, uneven hips or walking on tiptoes.
Approximately 95% of babies born with hip dysplasia can be successfully treated. Treatment for a newborn involves a Pavlik harness which holds the joint in place while the baby's skeleton grows and matures. Subsequent x-rays will track the hip joint's progress. The Pavlik harness is effective in over 85 per cent of cases. Most babies will require the harness for between six and 12 weeks and do not appear to be distressed by its use. Babies diagnosed over 6 months old may require a general anaesthetic to manipulate the hip back into position, and an operation may be required.
Most babies with successfully treated hip dysplasia have no further hip problems later in life, although they may be susceptible to arthritis.
Sourced from The Victorian Government Better Health Channel Website
Thanks everyone for your support - Well today has been our first day in the dennis brown bar. Bailey has handled it pretty well, but had a few cry's as has this new frustrated/sad cry which is a little heartbreaking but from what I've read in a few days he'll be back to normal. This afternoon he was giving us this look, we are pretty sure it was a "what have you done to me" glare - very sad, my DH was very upset by it and cried, but it will get easier.
He did a massive poo on the way home from the fitting and even managed to get it on his new brace, I think it was his way of telling us that it was sh*t - hahahaha. I am getting used to nappy changes (although turning him over mid poo change to clean the other side is a bit difficult, especially when its a massive one!!)
The annoying thing is that hardly any of his pants will go over the brace - the waistbands just aren't stretchy enough, so we will have to buy some bigger sizes. Never mind!
The surgeon gave us a bit of a reprieve and we can take it off for 30 mins a day for baths once he is used to it (I think he felt sorry for me, I was practically begging). We go back to the orthotist to check the fit etc in 2 weeks and then every 2-4 weeks, and we see the surgeon again in January. I am hoping that at some point the 23.5 hours will be reduced, we are very lucky to get the bath time, it will make the world of difference.
Bridee - I am wondering if the positioning of the brace is right, it seems to ride up a little and rest against his back, it is cushioned by the nappy but depending on whether Bailey is sitting or laying, sometimes it sits above the cushioned part of the nappy and I am worried it would be uncomfortable for him, sometimes he has let out a little cry - eg when I have put him in the pram or highchair, but not sure if thats why or its just him getting used to it. When the fitting was done this morning it was positioned more behind his bum, does it move around a bit as the babies change position?
Jesska - hope your visit with the Dr went well this arvo and Lahni is out of the harness soon
first of all i went into the peds appointment expecting bad news!
he sat me down and said i am happy with the way the ultrasound went! huh?? wat?? was my reply as the u/s ppl thought her hips weren't the best.
anyways he said her right hip (the one that was the concern at the start) is great!! its a normal hip now...
its the left one now that they are concentrating on.
He explained everything to me and put my mind to ease.
He then took Lahni over to his table, undressed her n took the bottom bit of the harness of n looked at her hips.
showed me that they are coming along great!!
then took the top part of the harness of (i thought he was goin to put her in another pavlik)
then he handed her to me n said heres ur floppy baby!!!
i was like.... ohhh is she out of it now!!! and he said she sure is, she now needs to wear the harness you have at home!
she'll be in it for 6 weeks, then we'll have another ultrasound. depending on how that looks she may need to be in it for another 6 weeks.
and she may need to be put in the pavlik harness again but for now, we can bath her as much as we like yay!
im so glad we have the best doctor ever!!!! on cloud 9 right now
oh and last night she had her first bath in 7.5 weeks and she LOVED it... was so relaxed looked like she was going to fall asleep
Naomi - i hope your first night went ok and that Bailey is getting used to the DB Bar. I think it took both Lahni and I only a day to get used to the pavlik... i think it was more me than her though because i was trying to understand the whole situation. and i pretty much looked at the harness being a pain in the butt other than something that would help her in the long run. thats fantastic news that he is allowd to have a bath. How long did the doctor say he'll need to be in the DB bar for??
Jesska - I have facebook, look me up (Naomi Graetz). The Dr says that he will be in the brace for 6-7 months, so unfortunately will spend his first xmas and birthday in it
The first night went really well, I think Bailey was absolutely buggered from the big day yesterday, he slept from 630pm until 230pm, woke for a feed and then back to sleep until 6am, he stirred a little this morning, but once I popped the dummy back in he was fine. He normally only naps for 45 minutes during the day, but yesterday had a 2.5 hour sleep and has currently been asleep for his morning nap since 8am (its almost 10am here!). I think all the effort he is putting in to try to move about it just taking it out of him.
Naomi - pleased to hear Bailey had an ok first night. The positioning of the bar does move, however, I never had it move up it was always moving down. Our orthotist said it was a problem because the hips are still in the right position it is just a comfort thing. I was told just to move it back to the correct position (when they are lying down they should be lying on the bar instead of the bum).
With nappy changes our orthotist told us to roll over DD to feed the nappy through and clean but I actually found it easier not to do that, to clean I would just roll DD over a little to each side and then lift her bum up to put nappy down and then thread the nappy through. I was always changing DD nappy mid feed and laying her on her stomach mid feed only encouraged her to bring up some milk.
Jesska - WAY TO GO LAHNI . As you said you are over the moon right now. Congratulations on such good progress.
Naomi - Glad to hear that Bailey's first day with the brace has been OK. I'm not sure about positioning as we've only used the pavlik harness. If you have any doubts at all call up whoever looks after positioning the brace (in our case it is the physio) and ask. Everything might be fine, but for your own peace of mind it is worth it. I've done that and the physio was fine with that.
We are two weeks out from our next ultrasound. I'm hoping for good news but we'll see how we go.
Well i finally had my ultrasound today and my DD has been disagnosed with moderate dysplaysia in both hips. My DH is quite shocked but I think that I instinctivly knew a couple of weeks ago when the whole journey began. Am disapointed that it is moderate though and not just mild and I am also a little concerned as she is almost 7 months now and i don't know how long this whole referring roundabout is going to take before some treatment can be started.
Just wondering if anyone has been through the royal childrens in melbourne as a public patient and if so how long did you have to wait for an appointment. We don't have any private insurance, but are not willing to wait too long for treatment as we obviously want to avoid surgery if possible.
Any melbournians out there with info about referrals, waiting times and good orthapeadic surgeons. Not sure if you are allowed to write DR names on this but please PM me if that is not apporopriate.
Obviously we just want to get our precious bubba treated as soon as possible with the best possible care.
Also anyone diagnosed with moderate at the 6 month mark and how long did your treatment last?
Wiggs - We went through the Royal Childrens Hospital Melbourne as a public and found it great. At six weeks we had the ultrasound on the Wed, results back to GP on the Thurs, on the Fri morning she faxed through referral to RCH, Friday afternoon got a phone call - could we go in first thing Monday morning, we had an ultrasound again they like to do their own for a baseline and Denis Brown brace was fitted after that session. I don't think it was an orthapedic surgeon we saw letter just says Dr/Clinician but she is great. Not sure if that was all so quick because she was young and the dysplasia was severe so they got us in quick (now at almost six months we are brace free) but I think they have clinics specifically for babies. I have been so impressed by the RCH and has cost us nothing (apart from the parking at the hospital) - way it seems to work is they book you in for an ultrasound or xray (depending on babies age) and then in to see the Dr/Clinician to review the us/xray and then you go to Orthotics department where they fit the brace etc.
Everyone else
Have been meaning to post but lost the new thread - CJ is now out of the brace fulltime, the ultrasound after six weeks of wearing only at night showed no improvement from the previous one but they were happy with coverage was just the angle they wanted to sharpen up a bit, but as the brace didn't seem to be correcting that and they think is just an immaturity thing said we could stop wearing it altogether as issue is now only very mild. We have to have an x-ray just before christmas and there is the chance could have to go back in brace but fingers crossed.
Naomi- we only had issue with bar going down but we had no harness as you know and also CJ less mobile, did they mention about sleeping with a pillow under Bailey's legs - with CJ the harness sort of held her legs in the air so they said put a pillow under them to make more comfortable and to keep the brace in a better position.
Wiggs - Bailey started his treatment (denis brown abduction brace 23.5 hours per day) the day he turned 7 months (which was monday this week) and his issue is with the acetabular angle of the hips, rather than the coverage which is 'good'. Our Ortho surgeon said that when bracing babies after 6 months they tend to be treated as per their age - so a 6 month baby will wear a brace for 6 months, an 8 month baby for 8 months and so on, not sure if this is relevent to your DD situation though as I am unsure what they consider to be mild, moderate or severe.
Vic - The Orthotist told us to put a rolled up nappy or towel so Bailey is rolled slightly to the side while sleeping, rather than laying flat on his back, just for comfort so have been doing that. I might actually put a rolled up nappy under his legs as well though as now that I think about it his legs are a bit 'dangly'. He has been sleeping really well this week, I think trying to move around in the brace is tiring him out, he is absolutely buggered when he goes to bed. I'll have everything crossed for you that CJs next appt goes well and she gets the all clear
Thanks girls for all the congratulations regarding Lahni coming out of the pavlik harness.
She is so happy now, that she is only in the brace that she is in. ( even though she was happy while in the Pavlov) it actually took her 2 days to adjust to not having the harness on.. it took her a day to adjust to the harness when it first went on lol.
She is loving her baths, and the freedom of moving her legs a bit more!! you can see the joy in her eyes.
crosswig - goodluck for the ultrasound in 2 weeks time, will be thinking of you and your Little one.
wiggs - Sorry to hear that your DD has moderate hip dysplaysia, but at least its been picked up now, she'll thank you when she is older.Sorry i have no info about the hospital in Melb. Im going through a privet peds.. he is fantastic and i highly recommend him, and he gets babies in quick smart with hip problems.. but i guess sale is a bit far for you guys to travel? When the health nurse thought Lahni had HD she was 1 week and 4 days old, he got us in when she was 2 weeks... best doctor ever, he's name is Dr. Peter Goss.
I hope your dd gets in quick wherever you decide to go, and her treatment is quick.
wysiwyg - congrats on CJ getting out of the brace full time!! i bet she is lovin it!!
Wiggs - we went through the RCH privately. The orth surgeon we used was Michael Johnson PM if you want his contact details. We found him to be vewry good, we used him with DD1, with DD2 we used our paed because it wasn't very severe but if DD2 wasn't responding quickly to treatment we would have gone back to Michael. My understanding is he actually does work in the public clinic as well. In terms of costs going privately you pay for the brace Pavlik was about $150, DB bar was $250 and that includes all app with Othotics then you pay for each visit to specialist (all specialists charge differently) and then you would pay for the ultrasounds, however sometimes these are bulk billed.
I don't know from experience but I had been told the wait to go public was about a month.
Thank you so much everyone for your quick replies.
MummyNaomi it sounds like our situations are very similar. I went back to the DR today who amazingly had the results (ultrasound was a 4pm yesterday, got results at 10am today) an it has come through that DD has good coverage but that her actebular is not good, it is at about 60 degrees when it should be about 80 - 85 at her age. What is the degrees and angle of you LO? My DD is almost 7months.
I also have great news, in that after a lot of ringing around today, to the RCH orthotics dept I have an aptmt at 2pm Monday. She will be x-rayed, have an ultrasound and see the pedeatric orthotic surgeon. This is such a relief as now I just want treatment to begin so that I can avoid the need for surgery if possible. The pedeatric osteo I spoke to said it is fairly likely that she will be put in a brace on Monday, which is kind of sad, but also at least that means she will be getting the treatment that she needs.
Thats all I have for now anyone who has had similar issues with the actebular I would love to hear your experiences.
Thanks, for your support, this forum is a true God-Send and such an invaluable support.
Hi Wiggs - it does indeed sound that our situations and the ages of our LO is almost the same - Bailey was 7 months last monday and I was just looking at some of our paperwork and his DDH is described as 'mild', however that was before our recent xray which was 2 months after the original one so I must ask him what he considers Bailey to be next appt (in early Jan). Our surgeon talked to us with different numbers though - he said that they normally 'brace' babies if the angle is over 30 degrees (both Baileys hips are over this but the right is worse), so not sure if your doctor is measuring from a different angle to mine? I know he said that it can take a number of months to even have an improvement of say 5 degrees. I understand the aim of the brace was to correct the angle so its below 30 degrees.
Anyway, good luck with your appt tomorrow and best of luck with things if your DD is put in a brace, its seems like the denis browne brace is commonly used for babies at this age. I wont lie, this past week has been very tough and emotional for my DH and I (and of course Bailey) - but we are here for you to support you through it no matter what happens. I think the things that I have struggled with the most is not being able to cuddle my baby properly and constantly discovering clothes that wont fit, toys we cant use etc, and seeing Bailey in the brace for the first time upset me quite a bit - so I guess be prepared for that. Hopefully if your DD hips are stable she will get some free time out of it each day - be sure to ask about that - Vic (Wyswig) gave me great advice there as initially we were told 24 hours, but we have 30 mins off per day seeing as Baileys hips are considered stable which may not sound like much but makes all the difference when you can bath your child properly.
Well it looks like the journey has offically begun for us. We spent 4 hours at the RCH in Melbourne yesterday and by then end of it finally have some concrete answers. Chloe has moderate displaysia in both legs with her actebular being the main prob. The right leg is worse than the left but both hips are stable, which is obviously a great thing. Her angles were about 30 degrees but given her age they decided it was def. necessary to brace her. We got back in 6 weeks for another x-ray and then our dr. thinks they will do another x-ray about 3 months after that with it being very likely she will be in the brace for at least 6 months. They haven't rulled out surgey, but I guess they can't and thats why they have to monitor how everything goes.
I can't believe how emotionally exhuasting the whole thing is, I thought I'd done heaps of research, looked at lots of pics of bubs in braces and spicas etc etc but the reality really hit home as soon as I walked in my own door. Everything is just so much harder!
Chloe is adjusting to the whole thing a lot better than me. Today my DH and I went and bought a new car seat, pram, bean bag and have worked out nappy changing, clothes and that sort of stuff which makes me feel a lot better. My DS was in childcare today which was wonderful as we could then just focus on getting everything kind of set up.
Tomorrow will be a dif. case with DH back at work and DS at home with Chloe and I.
But we shall see how we go, as always have a group to go to in the morning but I don't think I will make it I think I just need to get my head around this whole brace business for a couple of days.
Anyway sorry about my massive rant. We are incredibly fortunate to be able to have 1 hour off each day, which is so wonderful Chloe was so excited today she rolled straight over and was kicking her legs frantically when we took the brace off.
I hope everyone elses bubs are going OK and you mums too.
MummyNaomi sp glad to hear that things do get easier, looking forward to that
Ooooh Wiggs, I have been wondering what your DD outcome was - so sorry to hear about poor Chloe. There is really nothing I can say other than it just plain sucks and I know exactly what you are going through and feeling, feel free to vent, rant, rave, I have certainly been doing enough of it in the last week!
Some practical advice (now that I am old hand being the mother of a braced baby for a whopping 8 days now LOL)
Bailey developed blisters about 6 days in - a downside of bracing an active child - they still move and the skin may rub on the brace cuffs - WYSWIG gave me excellent advice re socks under the cuffs - I went and bought some long socks from target and cut them about 3 times the width of the cuff and stretched them around the cuff - I find this helps keep Bailey cool by not adding extra layers on his legs, but adds extra protection. Also, I had some nappy covers (and bought some more) from KrystieLove (another BB member with her own business) and I find they protect Bailey from the bar behind his bum - just a bit more cushioning than the disposable nappy, Here is the link Off Your Perch
Also - family has been doing my head in with their well meaning (but suffocating) support and silly comments. If I hear - 'it will be worth it in the end' one more time I will shove Baileys brace up that persons you know what and see what they think of it then hehehehe, anyway, sometimes its easier to say you are fine so they back off and just let you deal with it all.
So glad to hear you guys get an hour off - thats awesome, so glad to hear Chloe enjoys it! We skipped a bath today and went to our 30 minute swimming lesson instead - Bailey LOVED it, and so did I, it was nice to see him looking like all the other babies!
Hugs honey - it DOES get easier, hang in there. Feel free to PM me if you need to talk
While googling like mad to find out everything I could about Hip Displicia and Pavlic Harnessess etc, I came across this forum and felt so much better for just reading through everyones posts. I took my daugther Natalie (9 weeks old) for an ultrasound 2 days ago just to check her right hip as it seemed maybe a little clicky (and she was breech). I walked out of that ultrasound confused and overwhelmed. It wan't just her right hip it was both, and quite bad in both. Within 24 hours I have seen a peadatrician and physio and Nat has had a Pavlic Harness put on and honestly, I am just devestated. I am happy with the decision to do it, I understand why etc etc and certainly want her to be in it, but on the otherhand everytime I pick her up the harness makes her feel like this little solid brick rather than the soft flexable cuddly baby that I have. I feel like all our mother daugther intimacy has been violated and I can't cuddle with her like I would usually. She has had a bit of colic since she was born and now I am struggling to hold her in a position that I feel I can help her. Anyhow, that is my winge I guess, I am sure you all have gone through this, but I just needed to get it out somehow..
Hip Dysplaysia Support Group #2
. As you said you are over the moon right now. Congratulations on such good progress.
but we'll see how we go.
. I've been getting about 15 minutes every two weeks. 
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