I’m not here to say I am some sort of expert on parenting a babe with developmental hip dysplasia. HOWEVER, my daughter has gone almost as far as you can go in the depths of treatment for such a condition so- I’m pretty darn close. We’ve been through the Pavlik, the Rhino, the Spica, the ultrasounds, the x-rays, the surgery, the recovery… wow. Though we still have a long road ahead of us, I feel so proud to have made it this far.
If your little one is in or about to go into a Pavlik harness, I know your anxiety in reading that first paragraph. “What if the Pavlik doesn’t work for us? It didn’t work for her baby.” These were my exact thoughts when reading advice from someone who experienced Pavlik failure. “Success rates with mildly dysplastic hips are approximately 98%” in the Pavlik harness. So don’t worry- it will work! And if it doesn’t, I can tell you from experience, you and your family will carry on.
So IF your baby is diagnosed with DDH and is under 12 months, an orthopedist will likely prescribe either 23 or 24 hours a day in a Pavlik harness. Could be 4 weeks; could be 16. It really depends on how displaced or dislocated the hips are and how quickly they are moving into the sockets. If there is no progress in 4 weeks, the orthopedist will likely move on to an alternative treatment- which is good! DDH recovery can be a long journey- there is no need to waste time on something that just isn’t working for your babe.
Our poor Stella had all the odds against her- breech position in Utero, first born, and female. DDH is also commonly inherited. So, after a hip ultrasound which concluded her testing positive in both hips for DDH, we were ordered 24 hours a day in the Pavlik harness at 2 months old. I know this is such a scary time. You don’t want your baby to have a medical condition or to have to wear some velcro contraption all hours of the day. Again, you will get used to it and you will carry on.
You will notice that babe won’t fit in certain things like they used to. You will have to modify a few of their favorite things in order to keep them happy and to avoid holding them ALL the time.
- Swing/ bouncy seat- place a small pillow or folded blanket in the seat if it sinks super deep (most do). This will allow you to keep baby’s legs ‘up and out’ as they should be at all times.
- Boppy- the regular U-shaped Boppy does not work with the ‘up and out’ rule when it comes to babe’s legs. This was sad for us as it was Stella’s favorite. However, the newborn lounger is a great alternative if you don’t already have one.
- Crib- roll up a two receiving blankets and place them under each of babe’s legs to relieve some tension from the harness holding them in the air.
- Bath time- if you are ordered 23 hours a day then proceed as normal with bath time. If you are ordered to never take it off then you must resort to a sponge bath. Still, do this in the bathroom. I liked to make this time as spa-like as possible. I turned the shower on to steam the room and keep it warm. Made a nice, comfy padded area for baby on the floor. Had my giant mixing bowl filled with warm water and a squirt of baby soap. Plus, the white noise machine blasting. Bath time was once a favorite for my hip baby so when it was taken away from us, I was devastated. With a genuine effort in making bath time just as enjoyable, she truly loved it just as much as before.
- Car seat- baby should still be able to fit in their regular car seat with the Pavlik. However, it is important to remember to keep the legs ‘up and out’. If you notice babe’s legs are squished in towards each other, I would avoid long car rides.
Holding and cuddling is going to look a lot different in the Pavlik harness. Whatever works for the two of you is the only advice I can give here. Your baby will let you know if the way you are holding them is uncomfortable (as they have always done). As long as you a cognizant of their leg positioning and they are happy- you are good.
There is one major tip I can offer when it comes to diaper changing- do not tug on babe’s legs! You don’t want to be pulling the hips out of their sockets here. Lift their bum up by slipping your hand under their back. This will take some getting used to but is very important.
As for clothing, onesies and leg warmers all the way! The onesies allow for easy access to the already difficult diaper changing situation while leg warmers hide the hideousness of the contraption. There are websites that offer specially made clothing for the Pavlik which are also great (if you can afford an entirely new wardrobe for your baby).
The first night is always the worst in any of these treatment methods. Baby is just getting used to having something constricting their movement and probably doesn’t understand why it is on them. Give it about a week. It will get better. You will still notice the harness every single day and things won’t ever seem like your previous idea of “normal” but it will get better. You will carry on.