Hip Brace for Babies: When Does Your Child Need One?

Suddenly, during the baby check-up, the term hip dysplasia comes up – and the hip brace is mentioned. For many parents, this sounds frightening at first. However, this aid can help position your baby's hips correctly and support their development. When doctors recommend it and why early action is important.

What exactly is a hip brace?

A hip brace, now more commonly known as a hip abduction splint, is an orthopedic aid used to treat hip joint dysplasia in infants. These modern devices no longer resemble traditional pants. Instead, they are padded splints that keep your baby's hip joints in a spread and bent position. This position promotes the growth of the hip socket by keeping the femoral head in the correct alignment.

There are different types of hip braces, including the Tübingen hip abduction splint and the Hoffmann-Daimler bandage. These splints are individually adjustable and usually need to be worn day and night to achieve the desired effect. Some models are designed to be comfortably worn over clothing and can be easily removed during diaper changes or baths.

The Tübingen hip splint, for example, consists of two plastic shells in which the baby's thighs rest. These shells are held apart by a bridge to fix the legs in the optimal position. The chest-shoulder strap ensures that the splint does not slip, while bead straps do not restrict movement. This allows your baby to continue moving and kicking naturally, which is important for their development.

When does your baby need a hip brace?

A hip brace is typically prescribed when an ultrasound examination during the U3 check – that is, between the third and fourth week of life – shows that your baby's hip joints are not developing appropriately for their age. This examination is part of routine check-ups and helps to detect potential misalignments early on. The earlier a hip maturation disorder is identified, the better the chances of successful treatment.

In mild cases, it may be sufficient to swaddle your baby widely. This means placing an additional layer of fabric between the legs to achieve a slight frog position. This position supports the natural maturation of the hip joints. However, wide swaddling is not sufficient for true hip dysplasia, and a medical hip brace becomes necessary.

It is important to understand that a diagnosis of hip dysplasia is not uncommon, and many parents face this issue. The good news is that most cases can be completely resolved with the right treatment, so your child will not have limitations later on. Regular monitoring by the pediatrician is crucial to ensure that the treatment is making the desired progress.

What is hip dysplasia?

Hip dysplasia is one of the most common skeletal deformities in children. In this condition, your baby's hip socket is too shallow, causing the femoral head to lack a stable hold. This can lead to improper joint development, which may result in pain and potentially the need for an artificial hip joint later on.

It is estimated that up to 4 percent of newborns are born with hip dysplasia. Girls are more frequently affected than boys, likely due to hormonal factors. The most severe form of hip dysplasia is hip dislocation, where the femoral head slips out of the socket. This occurs in about 0.2 percent of affected babies and often requires more intensive treatment.

Causes of hip dysplasia

In most cases, hip dysplasia is genetically predisposed. This means it can occur more frequently in families. However, there are also other factors that can contribute to the development of hip dysplasia:

• Breech position: Babies born in a breech or buttocks position have an increased risk of hip dysplasia. This position can increase pressure on the hip joints and affect their development.
• Multiple pregnancies: When two or more babies share space in the womb, it can lead to restricted movement, which can influence hip development.
• Hormonal influences: During pregnancy, the body produces hormones that loosen tissues to facilitate childbirth. These hormones can also affect the baby's hip joints, leading to looseness.
• Improper positioning after birth: If babies are carried in an extended position, it can impair the development of the hip joints. The frog position is optimal as it supports the natural posture from the womb.

Another influencing factor can be a lack of amniotic fluid during pregnancy, which restricts space for the baby and reduces movement. Genetic predisposition also plays a role, making it important to consider family history when there is a suspicion of hip dysplasia.

How do you recognize hip dysplasia?

As parents, it is often difficult to recognize hip dysplasia as it usually does not cause pain. However, there are some signs to watch for. These include asymmetrical spreading of the legs or uneven gluteal folds. If you notice that one leg cannot spread as far as the other, it could be a sign of hip dysplasia.

In the case of dislocation, the affected leg may appear shorter, and the folds on the back of the thighs may not be symmetrical. If both legs are affected, this distinction becomes harder, and the dysplasia is more difficult to identify. Ultimately, it is the pediatrician's job to diagnose a hip maturation disorder. During the clinical examination, it is checked whether the legs can spread evenly and are of equal length. The symmetry of the gluteal folds is also examined.

The routine hip ultrasound during the U3 check is crucial for early diagnosis of hip dysplasia. The angle of the femur to the hip socket is measured to ensure that the hip socket roof is age-appropriately matured. If the examination shows abnormalities, the pediatrician will refer you to an orthopedist to initiate appropriate treatment.

Prevention and treatment

Congenital hip dysplasia cannot be prevented, but there are measures you can take to support your baby's hip development. The correct carrying position after birth can help prevent acquired dysplasia. When you carry your baby in the frog position, you automatically bring the hips into a favorable position.

Regular check-ups are key to the early detection of hip dysplasia. If the misalignment is detected early, the chances of healing are very good. In mild cases, wide swaddling may be sufficient to keep the hip joints in the correct position. In more severe cases, a medical hip brace is prescribed.

Treatment options

The treatment of a hip maturation disorder depends on the severity of the misalignment and the timing of the diagnosis:

• Mild misalignment: If detected early, wide swaddling and the correct carrying position may be sufficient. Your pediatrician can best assess whether this type of treatment is adequate for your baby. In wide swaddling, a cotton cloth is folded and placed between the legs to promote the frog position.
• Moderate to severe misalignment: In the case of hip joint dysplasia, medical hip aids are necessary. The Tübingen hip splint is particularly common, where the thighs rest in plastic shells connected by bead straps to a chest-shoulder strap. The abduction angle can vary, and the splint allows for natural kicking.
• Severe hip dysplasia or dislocation: In rare cases, treatment with an orthopedic splint is not sufficient. The joint may need to be repositioned under anesthesia and is often fixed with a cast afterward to prevent it from dislocating again. Casting the legs may also be the preferred method without surgery if severe dysplasia is present.

Sometimes, a combination of different treatment methods is necessary to find the best solution for your baby's individual problem. The treating orthopedist will work with the pediatrician to create the best treatment plan and regularly monitor progress.

Everyday life with the hip brace

If your baby has been prescribed a hip splint, it can be comfortably worn over clothing. It is important that the splint is worn day and night to achieve the desired effect. It can be removed during baths or diaper changes.

Here are a few tips for everyday life:

• Your baby should sleep on their back, as recommended during the first year of life.
• When bathing without the splint, you can support the spread position of the baby’s legs with your hand.
• If pressure sores develop from the splint, they can be easily padded. Ask your doctor how to proceed best.

Parents who have experience with hip braces report that babies quickly get used to the splint. It can be helpful to connect with other parents to get tips and tricks for everyday life. Online forums or local parent-child groups can be good places to find support and advice.

Don't worry, your baby will quickly adjust to the hip splint. With patience and the right treatment, they will soon crawl and walk just like other children. And remember: You're doing great!