Most baby carriers accommodate healthy hip positioning if used correctly. Unless there are naturally loose hips, or underlying undiagnosed hip dysplasia issues, then you are unlikely to ever have a problem.
In this article, we will look at the potential risk factors associated with baby carrier use and how you can avoid unhealthy positioning that could influence hip development.
Types of Infant Hip Abnormalities
Hip abnormalities are very common with one in ten infants suffering from some degree of instability after birth.
More severe cases are known as Infantile Developmental Dysplasia of the Hip (DDH). While they are rare, a concerning thing is that there is often no evident cause for the condition.
- Hip instability – 10% of newborns
- Hip dysplasia – 1% of newborns
- Hip dislocation – 0.2% of newborns
Higher Risk Categories
While anyone can develop these hip issues, the risk increases further for children in the following categories:
- Breech babies
- Immediate family history
Can Babywearing Cause Hip Dysplasia
Babywearing is unlikely to cause hip dysplasia where no pre-existing condition is present without severe misuse of a baby carrier for an extended period of time.
However, if your child already suffers from DDH then the tolerance for misuse of the carrier will be lower and the risk of further complications higher.
The condition is hard to detect in the first few months after birth and parents may not know that their child is at higher risk. The condition does not cause direct pain and the abnormal hip development may not be evident immediately.
There are two variables that can potentially contribute to a worsening hip condition. The positioning of the baby in the carrier, and the length of time spent in that position.
Healthy Hip Positioning
The best rule of thumb is that your baby’s legs should sit naturally to the side without challenging the shape of the baby carrier.
With the legs angled around your body, this creates the ergonomic M position which is similar to a natural squat shape.
A healthy bend in the knees is essential to achieve the M shape. If the legs are too straight then this creates stress on the hip joints and can inhibit healthy hip development.
If you observe part of the frame putting pressure on the legs you may find that the hips are not sitting correctly which increases the risk.
However, the biggest risk comes from straight legs. More on this in a moment.
Excessive Time in Baby Carrier
Once you perfect the proper positioning of your baby, you should still limit the time spent in the carrier to one hour or less for a single babywearing session.
It is important to experience variety in the movement of the baby’s hips and to prevent them from over-extending.
This matters less as your child gets older but for the first six months, it is important to keep sessions shorter and take regular breaks.
Baby Carrier Designs
Most baby carriers allow your child’s legs to sit externally to the frame and allow the legs and hips to sit in the hip-healthy M position.
Only some pouch ring sling designs encapsulate your baby allowing them to sit in a straight stretched out position, with their legs extended.
With no bend in the knee joint, the upper thigh bone does not sit naturally in the infant’s hip sockets. This increases the risk for abnormal hip issues to worsen over time.
Are Ring Slings Safe
Ring slings are still safe if you use them correctly. You just need to ensure healthy hip positioning at all times.
For example, if you want to carry your child to the side then you can do this two ways:
- Cradle Hold – Legs are contained in the pouch and can be straightened (not safe)
- Side Carry – Baby sits upright on your hip, legs sit either side of your body, knees bent.
How to Recognize Hip Dysplasia
You can recognize hip dysplasia by looking out for the following symptoms in your child:
Newborns and Infants:
- Unusual skin creases around hips near their butt
- Legs that appear uneven in length
- Unnatural leg movement
- A foot that is turned outward
- Does not start walking within the usual 8-18 month period
- Walks with an unnatural lean or waddle
It can be very difficult for a parent to recognize these symptoms. However, regular checkups should assist in identifying any issues.
Periodic Testing of Hip Joint
Your baby should have a hip examination as part of their regular physicals at the following intervals:
- One week old
- Six weeks old
- Six months old
- When they start walking
If you have noticed anything unusual with their walking action or physical development that does not appear painful or urgent this is a great time to ask questions and get clarity from your doctor.
Hip Dysplasia Treatment
Hip issues will often resolve themselves over time, but in more severe cases medical intervention may be required. Your doctor may recommend one of the following treatments:
- Pavlik Harness – Common treatment for DDH
- Surgery – To place the femoral head back into the socket
You may also need to monitor over time for any signs of arthritic problems developing in the future.
International Hip Dysplasia Institute
You will find some of the best resources for understanding babywearing best practices, and the risk of hip dysplasia at the International Hip Dysplasia Institute.
The risk of developing hip dysplasia through baby carrier use is low. Repetitive use in an unhealthy position can worsen loose hips or an existing development condition but is unlikely to disrupt normal hip development.
Most baby carriers are designed to prevent hip dysplasia and maintain healthy hip habits without any thought from the parents.
By default, your child will have a good spread squat position that holds together the ball and socket joint.