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Pavlik Harness

DDH is when the femoral head ("the ball") at the top of the femur ("thighbone") is not stable within the hip socket and the ligaments of the hip joint may also be stretched and loose.

Treatment

Babies with DDH often need to wear a brace called a Pavlik Harness. It has straps that are fastened around the baby’s legs and held up by shoulder and chest straps. This holds the hips and knees up with the legs apart. This is the best position for the hip joint to develop its normal depth. It allows contact between the thigh and hip bones and helps rebalance the muscles and ligaments of the hip while it is developing. 

When does my baby need to wear the brace?

Your Orthopaedic provider advises that your baby wears the harness:

  • All the time except when bathing, harness can be worn over clothes
  • As specified by your care provider

Follow Up

The provider will arrange regular appointments to monitor the progress of your baby’s growth and adjust the harness as required. An ultrasound is recommended for diagnosis at 6 weeks of age and typically every 6 weeks until age
6 months or dysplasia has resolved. At age 6 months, xrays are recommended. Child will typically be followed up through 6 months after they begin walking. 

Putting the harness on

The harness will be adjusted to your baby’s size and typically small pen or marker lines will be drawn to help with putting the harness on. Use those lines as a guide or where to adjust straps to.

  1. Open all the straps and lay your baby on the harness with the chest strap across the chest. Fasten the chest strap. The top of the chest strap should be at the nipple line. You should be able to t 2 of your ngers underneath the chest strap when it is fastened. This will ensure your baby can breathe properly in the harness.

  2. Fasten the shoulder straps to the chest strap. You should be able to t 1 of your ngers underneath the shoulder straps when they are fastened.

  3. Place your baby’s legs into the leg portion of the harness so that the toes are in the “socks.” Secure the leg straps snugly, but not too tightly. 

  4. Finally, thread the exion (front) and abduction (back) straps through the leg portion of the harness and secure them. The straps on the harness will be marked to help you fasten them. Babies may cry a little or seem unsettled for the rst couple of nights after the harness is rst tted. This should settle down within a couple of days.

Try to avoid things that push the knees together, such as sling carriers (although it is ok for the baby to push his/her knees together). Do not forcefully pull apart your child’s legs, but encourage your baby to keep legs apart. 

 

Diapers

Your baby can wear a diaper under the harness. You do not need to double diaper. When changing your baby’s diaper, keep your baby’s knees apart at all times. Ensure the diaper is under the straps. If it is not, urine will soak through and cause burns and decrease the effectiveness of the harness. During diaper changes, NEVER pick up the baby by his/her feet. 

Holding/Feeding your baby with the Pavlik harness on

Support your baby with your hand between the legs. 

When breastfeeding your baby

Keep your baby’s feet away from you with pillows to support the hips. If your baby has one-sided (unilateral) hip dysplasia, hold him with the affected side away from your body. Try the football hold. You can use child carriers for your baby because they keep the legs apart. Don’t swaddle your baby’s legs together. 

Playing and moving

Normal play time is acceptable. During play time stretch and play with your baby’s legs within the con nes of the harness. It is good exercise and helps with digestion and your baby’s mood. Activities on the oor and sitting are promoted. High chair is also a good activity. Never lay the baby on their side. 

When your baby is ready, encourage tummy time. This is very helpful, as it forces the hips out and back. 

Keeping the harness clean

Have your baby wear a one-piece sleeper over the harness and bib during feedings and for spit-ups or drooling. If the harness is soiled, hand-wash it in cold water and a mild detergent. DO NOT tumble dry the harness as it may cause the harness to shrink. 

Car seats

Adjust the straps of the car seat to accommodate your baby’s position in the harness. Limit drives to less than 1 hour. For longer drives, give your baby a 10- to 15-minute break out of the car seat. This will help to remove any tension in the straps. 

Sleeping position

Your baby should sleep on his back. Make sure there is ample leg room for them to spread apart. 

After the treatment is done

Being in the harness may slow the rate of development of motor skills of the baby. This is short term consequence, and the baby will catch up. For the next four to six months avoid baby walkers or baby bouncers to ease strain on the hip joint.