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A Final Trip to the Pediatric Orthopedic for Some News

We’ve had a tremendous amount of stuff going on in our lives since the birth of our daughter.  Most of it on the less than fun side of life.  One thing we had not discussed with many people was our daughter’s diagnosis of hip dysplasia.  It was just one more thing on the list of trying times.

Our daughter had 2 out of 4 factors that led to her being born with a, luckily, mild case of hip dysplasia.  When we first visited the pediatric orthopedic doctor when our daughter was 5 weeks old, they told us that typically in newborns there are the “4 F’s” that are prime factors in newborn hip dysplasia.

The 4 F’s are:

  1. First Born
  2. Female
  3. Foot First (Also known as breech)
  4. Family History

So she struck out with being a female baby in the breech position.  As it was explained to us, being in the breech position holds their legs in an undesirable position since their hips are in the pelvis without having a larger area to move around in.  And what does being female have to do with it?  Well if you’re not familiar with pregnancy, we release a hormone called relaxin to help loosen our ligaments to accommodate our growing bellies and to make the widening of the pelvis non-painful.  Since this is a female hormone, a female baby is more prone to absorb this hormone therefore keeping her ligaments loose around the hip joints.

When she was born, the neonatologist heard a click in her hips and an ultrasound was done the following day.  It confirmed a mild case of developmental dysplasia of the hips.  We followed up with the orthopedic at 5 weeks.  He thought the case was very mild and would correct itself on it’s own because the joints were just immature.  When a baby is born, the femoral head is still only cartilage and has not calcified into bone yet.  The socket of the hip joint is also not fully contoured to fit the ball of the femur.  So he wanted a follow-up ultrasound in 4 weeks to confirm her bone and joint were progressing properly.

After the ultrasound 4 weeks later, the orthopedic was surprised that her hip joints had not developed enough and the femur was still sliding around in the joint.  He explained that 95% of newborn hip dysplasia problems correct themselves within the first year, but obviously it’s not something you want to test since they are a vital joint for movement.  He didn’t want to go to the point of a harness, yes they make a harness that holds their legs in a spread position so the joint develops properly.  The only thing is they are a huge pain for daily activities like changing clothes or even just a diaper.

One more ultrasound was on the calendar for 6 weeks out, but until then we had to triple diaper our daughter.  She basically had 3 diapers on most of the time to hold her legs spread apart.  It’s a really old school treatment, but they told us it works well.

At the follow up appointment for the third ultrasound, the orthopedic doctor gave us the news.

Her hips were exactly as they should be!!

Talk about a relief, because this mama is a worrier.  I try to stay calm and collected with most things but I worry and think about things pretty much nonstop.

Her hips made a large improvement in those 6 weeks just by her wearing 3 diapers.  Without getting too technical, they measure the amount of the femoral head that is above and below the midline point of the hip socket.  They do this while the leg is at rest and with the leg in a knee bent up to the chest position, called a stressed test.  They need to be around a 50/50 ratio to above and below the midline.

In this process I learned a few tidbits of information that I found pretty interesting.

  1. Since a newborn’s hips aren’t fully developed, swaddling is horrible for the hips.  Having the legs held together and normally up are bad for the development.  We were told if she wanted to be swaddled, to not wrap the blanket around her legs tightly.  But you say the swaddle is for the newborn reflex?  Well yes, but just being wrapped around her body tightly kept our daughter snug enough for comfort.
  2. Baby wearing is great for their hips, as long as you are using the right carrier.  Any carrier that holds their legs up and not in a spread “M” position is not good for them.
  3. It’s a relatively slow process for the “bones” that start as cartilage to calcify.  At 3 months, the femoral head only had a small calcified center in our daughter.
  4. There are not a lot of orthopedic doctors for children.

One less thing to worry about, although the Orthopedic doctor told us what to look for when she starts walking to ensure there is not further problems.  He highly doubted that she would have issues, but just to be proactive about knowing what to look for.

So now onto the next thing to worry about. Ha!

What concerns did you have with your newborn?

Enjoy Your Adventure,

FTC Disclosure:  This is not intended as medical advice.  This is just a recap of our personal experience.  Please consult your medical professional for any questions.

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