When I think of hip dysplasia, I think of my aging Labrador or my overweight uncle glued to his recliner with the remote in his hand. I certainly never thought my newborn baby was at risk, nor would I have known what to look for to gauge whether or not my child's hips were healthy and normal. Unfortunately, the signs of hip dysplasia in babies can be hard to recognize, but there are a few distinct symptoms you should be aware of.
Hip dysplasia in babies is known as Developmental Dislocation (Dysplasia) of the Hip (DDH), according to the American Academy of Orthopedic Surgeons (AAOS). While it is frequently present in newborns, the AAOS noted that it can also develop in the first year of life. Thankfully, checking your baby for DDH is a part of the routine well-baby visits during your child's first year. I contacted Natasha Trentacosta, MD, pediatric sports medicine specialist and pediatric orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, and she tells Romper that while the signs are subtle, such as one leg being slightly longer than the other, they are there.
Trentacosta says that this disparity is only noticed "as long as the opposite leg does not have DDH as well. This is because the dislocated hip gets pulled or retracted higher than the normal hip that is in the socket. When changing your baby, you can pull the legs out straight and see if you notice a difference."
If your baby is already walking, it might be easier to tell if they have DDH because the signs of hip dysplasia in babies are actually more pronounced as they start to toddle. Trentacosta says that "the leg with the dislocated hip will have a foot that turns outward more than the other side at rest or when walking. This has to do with the position that the dislocated hip sits when it's out of the socket. It tends to rotate outward."
Anthony Kouri, MD, an orthopedic surgeon at the University of Toledo Medical Center, tells Romper that beyond the physical symptoms, parents also need to be aware of the risk factors for DDH. He tells Romper, "One of the largest risks is having a parent or sibling with hip dysplasia as a child." Kouri notes that "additional risk factors include being the firstborn child," having been born via a breech birth, being female, and having other "packaging abnormalities" such as torticollis — also commonly referred to as "twisted neck" or metatarsus adductus, a condition where the foot turns inward.
Gina Posner, MD, board-certified pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, California, tells Romper that your baby's pediatrician will be looking for hip dysplasia at their appointments, but one thing that you can look at while you play with your baby is the folds of their skin. Sometimes in a baby with DDH, "the hip may turn outward and the folds of skin on the legs may look uneven." It seems a strange thing to look for, but if you think about it, your baby's rolls are usually reasonably symmetrical. Asymmetry can spell problems for your babies' hips.
In the event that you notice any of these signs, Kouri notes that you should tell your pediatrician, and that they will likely refer you to a pediatric orthopedic surgeon who will then order ultrasounds or X-rays (or both) of your baby's hips, as well as perform multiple manual exams to determine if treatment is required. Nonsurgical treatments include different harnesses and braces that your baby will wear to correct the dysplasia, otherwise they'll be referred to for more invasive, surgical treatments.
As parents, we're constantly watching our children, and observing the way they move in the world. If you notice that something is a little more wobbly, a little less symmetrical, tell your pediatrician — they are there to help.