If a child is diagnosed with DDH early enough (up to age three months) generally the first treatment that is tried is the use of a Pavlik Harness.
This is a soft, fabric brace that has straps that are fastened around the baby’s legs and held up by shoulder and chest straps. The harness comes with ‘booties’ that prevent feet slipping out and socks can be worn beneath the lower leg straps and booties.
The Pavlik harness means your baby will be encouraged to rest in a position where the hips are bent (flexed) up to 90 degrees and relaxed out to the side (abduction). In this position the head of the ball (femur) can hopefully deeply mold into the socket (acetabulum), thus stabilising the hip in the correct position for healthy development.
The image below (CA International Hip Dysplasia Institute) clearly shows what a Pavlik harness looks like and is worn by a child.
The harness is typically worn 24 hours a day but in some cases a baby will be allowed time out for a bath and your consultant will let you know what is right for your child.
It might seem mean to have both legs in the harness but because the pelvis is a ring of connected bones; one hip cannot be correctly positioned on its own.
You will need to adapt how you look after your child whilst they are in the harness and we have tried to answer some of the most frequently questions below:
Will the harness hurt my baby?
No. It might take a few days for your baby to get used to the harness and they may cry more than usual, but in time it will get easier and they will settle. If you have any concerns, contact your consultant and nurse and discuss the issues with them.
How do I know if the harness in on properly?
The chest strap needs to be firm but you should be able to fit four fingers between your baby’s chest and the chest band so their chest can expand properly when they are breathing. The ankle and lower leg straps need to gently secure or hold the legs but they must not be too tight.
How do I keep my baby clean?
Bath times is one of the fundamental activities of looking after a baby and when it is taken away it can be really difficult but you will find a way to deal with it. If you can’t bath your baby then go back to basics and opt for a simple sponge bath. Use a soft cloth or sponge and using warm water clean their skin with special care taken behind the knees, on the shoulders and neck and in the groin areas. These will all be in contact with the harness and it is key to keep them clean and free of irritation and sores. Please don’t use creams or talcum powders and if you do find red areas then get in touch with your consultant.
Can my baby wear normal clothes?
You might have to be a little creative when it comes to dressing a baby in a harness but it isn’t impossible.
How will we know if the harness has worked?
Whilst your child is in the harness you will have ongoing appointments and scans with your consultant and should know at each meeting what progress is being made. In some cases the Pavlik corrects the problems in other situations further intervention and surgery are needed.