Here’s everything you need to know about hip dysplasia in babies — from a mom who has been there done that. I’m sharing hip dysplasia risk factors, warning signs, prevention tips, and honest insight into what treatment really looks like, so you can advocate for your child from day one.
My youngest daughter was diagnosed with a completely dislocated left hip at 15 months old. What followed were years of surgeries, spica casts, braces, and one of the hardest seasons of our family’s life. I wrote through all of it here on the blog, and this page pulls it all together. If you just got a DDH diagnosis, you are in the right place.
Table of Contents
- Quick Overview
- What Is Hip Dysplasia?
- Warning Signs of Hip Dysplasia in Babies
- Our Story: Two Surgeries, One Tough Kid
- How to Reduce Your Baby’s Risk of DDH
- Hip Dysplasia Treatment Options: Harness, Surgery, and Spica Cast
- DDH Resources: Read the Full Hip Dysplasia Series
- Trusted DDH Resources and Support Organizations
Quick Overview
- Hip dysplasia (DDH) is a spectrum condition ranging from mild hip instability to full dislocation, affecting roughly 1 in 10 babies to some degree
- Girls, firstborns, breech babies, and those with a family history of DDH are at highest risk
- Warning signs include clicky hips, uneven leg folds, limited range of motion, and a waddling or limping walk
- DDH is not always caught at birth — some children pass newborn screenings and are diagnosed later, when walking
- Treatment depends on severity and age at diagnosis: options range from a Pavlik harness in infants to open reduction surgery and spica casting in toddlers
- Hip-healthy baby carriers and swaddling practices may help support proper hip development
- The earlier DDH is detected, the simpler the treatment — early detection is everything
We’ve lived all of this. The posts linked below are written from real experience, not textbooks.
What Is Hip Dysplasia?
Hip dysplasia — also called DDH, or developmental dysplasia of the hip — is a medical term for instability or malformation of the hip joint. At its mildest, the hip socket is slightly shallow, and the ball of the hip joint moves more freely than it should. At its most severe, the hip is completely dislocated: the ball is entirely out of the socket.
According to the International Hip Dysplasia Institute, approximately 1 in 10 babies is born with some degree of hip instability. In most cases, that instability resolves on its own as the baby grows. But in some babies, the joint never stabilizes and without treatment, a dislocated or dysplastic hip will not correct itself.
Some children are diagnosed at birth. Others, like my daughter Sara, pass the newborn screening exams and aren’t diagnosed until they start walking. We noticed Sara’s limp shortly after she took her first steps. A specialist confirmed what we feared: her left hip was completely dislocated. She was 15 months old.
Risk Factors for Hip Dysplasia
Not every baby diagnosed with DDH has identifiable risk factors — but these increase the likelihood:
- Female sex — approximately 75% of DDH cases occur in girls
- Firstborn babies — the uterus is less stretched, leaving less room for the baby to move, which can affect hip positioning
- Breech position — babies who spend time in breech position, even if they turn before delivery, have higher rates of DDH
- Family history — particularly if a parent or sibling had DDH
- C-section delivery — associated with slightly elevated risk
Sara’s case didn’t fit the mold neatly. She was my fourth baby. She did spend time in a breech position before turning. She’s a girl, and her cousin (not me) had DDH. She was born vaginally at home without complications. Hip dysplasia doesn’t always follow the rules.
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Pin ItWarning Signs of Hip Dysplasia in Babies
You’ve probably noticed your pediatrician doing a push-up, push-out motion with your baby’s legs at well visits. They’re checking for hip instability — specifically for clicking hips or limited range of motion, both of which can indicate DDH. But there are other signs to watch for:
- Clicky or clunky hips during diapering or leg movements
- Limited range of motion in one or both hips
- Uneven skin folds on the buttocks or thighs — one side looks different from the other
- Uneven leg lengths when lying flat
- A waddling or limping walk — this was our first clear sign with Sara
We have a video of Sara walking with hip dysplasia before her surgery. The limp was unmistakable. If your child walks like that, trust your instincts and ask for a referral to a pediatric orthopedist. Don’t wait for someone else to notice first.
Our Story: Two Surgeries, One Tough Kid
Sara was diagnosed at 15 months old after we brought her to a specialist because of her gait. X-rays confirmed her left hip was fully dislocated. On November 1, 2011, when she was 17 months old, she had an open reduction surgery at the University of Iowa to place her hip back into the socket. After surgery, she went into a full hip spica cast — a hard plaster cast from her chest to her ankles, holding her legs in a frog position for 12 weeks and 5 days.
The open reduction surgery placed the hip correctly, but it didn’t fix the underlying problem with her hip socket. Two years later, at age 3.5, Sara needed a second surgery: a Pemberton osteotomy to reshape her hip socket and a femoral osteotomy to reposition her femur. This surgery was more extensive, more painful, and harder on our whole family than the first. She went into a second spica cast. We got through it.
Sara is our proof that kids are resilient. But I won’t pretend any of it was easy. I documented everything — the fear, the practical challenges, the small victories — because when I was searching for information during the hardest parts, I couldn’t find nearly enough from parents who had actually lived it.
Sara is 16 now. She has no limp. She has no physical limitations. She’s proud of her surgery scars. After long hikes she gets tired, but honestly, so does everyone else. Hip dysplasia is part of her story. I won’t tell you the road to get here was short or easy, because it wasn’t. But this is where it can lead, and I think you deserve to know that.
How to Reduce Your Baby’s Risk of DDH
DDH is not fully preventable, but there are things you can do to support healthy hip development in your baby:
Use hip-healthy baby carriers. Traditional “crotch dangler” carriers — like the Baby Björn in its classic style — hold a baby’s legs in a dangling, knees-down position that the International Hip Dysplasia Institute recommends avoiding. Look for carriers that support the baby in an “M position,” with knees higher than the bottom and thighs supported out to the side. Ergonomic carriers from brands like Boba, Tula, Lillebaby, and Ergobaby are designed with hip health in mind.
Swaddle with hips free. Tight swaddling that holds the legs straight and together can put stress on the hip joint. The IHDI recommends “hip-healthy swaddling” that allows the legs to bend up and out at the hips naturally.
Minimize time in bucket seats. Car seats are essential for safety — but extended time in bouncers, infant rockers, and bucket-style seats keeps a baby in a hip-compressed position. Alternate regularly with floor time and babywearing.
Know your risk factors and speak up. If you have a family history of DDH, your baby was breech, or you notice anything unusual about your baby’s legs, hips, or gait, ask your pediatrician to refer you to a pediatric orthopedic specialist. You are allowed to ask for a second opinion.
Hip Dysplasia Treatment Options: Harness, Surgery, and Spica Cast
Treatment for DDH depends heavily on how old the child is at diagnosis and how severe the dysplasia is. In general:
- Newborns and young infants are typically treated with a Pavlik harness — a soft brace worn full-time that holds the hips in the proper position while the joint develops
- Older infants and young toddlers may need a closed reduction (repositioning the hip under anesthesia) followed by a spica cast, or an open reduction surgery with a spica cast
- Toddlers and older children with more complex dysplasia may need pelvic and/or femoral osteotomies — bone-reshaping surgeries — in addition to casting and bracing
- After casting, most children transition to a hip brace (such as a Rhino or Lorenz brace) worn during sleep
The spica cast is its own world. It requires a completely different approach to diapering, carrying, bathing, sleeping, and daily life. It’s hard. But it is survivable. I have posts for all of it.
DDH Resources: Read the Full Hip Dysplasia Series
These posts cover every stage of the DDH journey, from diagnosis through recovery. If you’re in the thick of it, start wherever you are.
How to Prepare for Your Baby’s Hip Surgery — A top-10 list of practical things to do before surgery day so you’re not scrambling afterward.
What to Expect on Hip Surgery Day — A walk-through of what surgery day actually looks like, from check-in to recovery room.
Tips for Surviving the First Week in the Spica Cast — The first week is the hardest. Here’s what helped us get through it.
Must-Have Supplies for Spica Cast Life — The bean bag chair, the Boba carrier, the back scratcher (yes, really) — a full list of what made the 12 weeks manageable.
How to Diaper in a Spica Cast — The biggest practical challenge of spica life, explained in detail. This one gets a lot of traffic for a reason.
How to Entertain a Toddler in a Spica Cast — Creative ideas for keeping an immobilized toddler engaged and happy.
Spica Cast Cut-Off Day — Tips and emotional preparation for the day the cast finally comes off.
Walking with Hip Dysplasia (Video) — A video of Sara’s walk before surgery. If you’ve seen this gait, you’ll recognize it immediately.
Preparing for Traction to Treat Hip Dysplasia — Traction is used in some cases to prepare the hip before closed reduction. Here’s what to expect from a British family who went through it in England.
Hip Dysplasia Baby Carriers: What You Need to Know — A deep dive into which carriers support healthy hip development and which ones to avoid.
Preparing for Pemberton & Femoral Osteotomies — The post I wrote when Sara faced her second, more complex surgery. If your child needs osteotomies, this one is for you.
Trusted DDH Resources and Support Organizations
International Hip Dysplasia Institute — The most comprehensive and reliable resource for DDH information, including diagnosis, treatment, and hip-healthy products.
Hip Toddlers Facebook Group — An active community of parents navigating DDH with toddlers.
Hip Dysplasia in Babies Facebook Group — Peer support from parents in every stage of the DDH journey.
Shriners Hospitals for Children — Specialized pediatric orthopedic care, including DDH treatment.
Ronald McDonald House — Lodging and support for families traveling for a child’s medical care.
Parents’ Guide to Hip Dysplasia by Betsy Miller — The resource book you must have.
Hope the Hip Hippo by Gina Jay & Julie Beattie – A great children’s book for kids who are going through hip dysplasia
Frequently Asked Questions About Hip Dysplasia in Babies
Yes. The standard newborn hip screening (the Ortolani and Barlow maneuvers) does not catch every case. Some babies have hips that appear stable at birth but become dysplastic as they grow. This is called late-presenting DDH. Sara passed her newborn exam and wasn’t diagnosed until 15 months old.
If DDH is suspected based on gait, leg length discrepancy, or limited hip motion, a pediatric orthopedist will typically order an X-ray (for children over 4–6 months, when the femoral head is ossified enough to show on film) or an ultrasound (for younger infants). The images show how the ball sits in — or out of — the socket.
A hip spica cast is a full-body plaster or fiberglass cast that immobilizes the hips and holds the legs in a specific position (usually a frog-like pose with knees out) while the hip heals after surgery or reduction. It typically encases the child from the chest down, covering all or part of both legs. Most children wear it for 6–12 weeks.
There is a heritable component to DDH. A family history of hip dysplasia — especially in a parent or sibling — increases a baby’s risk. That said, many children diagnosed with DDH have no family history, and many children with strong family histories are never affected.
Not always. Babies diagnosed very early (in the first weeks of life) can often be successfully treated with a Pavlik harness alone. The older the child at diagnosis, and the more severe the dysplasia, the more likely surgical intervention becomes necessary. Early detection dramatically improves outcomes.
With prompt, appropriate treatment, many children with DDH go on to have full, active lives with no lasting limitations. However, late-diagnosed or inadequately treated DDH can lead to chronic hip pain and early-onset arthritis in adulthood. This is why early detection and thorough follow-up care matter so much.
If you’re in the middle of a DDH diagnosis and have questions, feel free to reach out at [email protected]. I can’t offer medical advice, but I can offer the perspective of someone who has been through it.
A note on this content: This hip dysplasia chapter of our lives is closed, and I’m no longer actively updating or adding to this series. The posts are here, they’re real, and I hope they help you.
But my blogging life has moved on — to travel, from-scratch cooking, hobby farm life, and a lot of other things I love. If you find yourself with time to spare after reading through the DDH posts, I’d love for you to stick around and explore. There’s a lot here worth reading.
