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Hip dysplasia in babies, explained by the people who treat it
Everything below is written by Dr. Mutasem Aldhoon, pediatric orthopedic consultant, for parents, not for doctors — the numbers on your baby's scan, what each treatment involves, and the questions worth asking at the next appointment.
Start here
If you have just been handed an ultrasound report and a set of unfamiliar terms, read the Graf types first — it explains most of what is on the page.
Reading your baby's hip ultrasoundUnderstanding the diagnosis
What the scan, the letters and the numbers on your baby's report actually mean.
- Reading your baby's hip ultrasound: Graf types I to IV explainedWhat Graf type I, IIa, IIb, IIc, III and IV mean on your baby's hip ultrasound report, and what each type usually means for treatment.
- What the alpha angle on a hip ultrasound meansThe alpha angle measures how well formed your baby's hip socket is. Here is what a normal value looks like, and what a low number means at each age.
- The Ortolani and Barlow tests, explained for parentsWhat the doctor is feeling for during the newborn hip examination, what a positive Ortolani or Barlow means, and why the tests stop working after about 3 months.
- Hip ultrasound or X-ray: which one does your baby need?Ultrasound is used up to about 4-6 months, X-ray after that. Why the cut-off exists, what each test shows, and what radiation exposure really means here.
- My baby's hip clicks: when it matters and when it does notMost hip clicks in babies are harmless ligament sounds. Here is how a benign click differs from the clunk that needs an ultrasound.
Treatment, step by step
What each treatment involves, how long it lasts and how well it works.
- The Pavlik harness: week by week, and what to expectHow the Pavlik harness works, the usual 6-12 week timeline, bathing and skin care, sleep and clothing, and what happens if it does not work.
- Do double nappies treat hip dysplasia?Double nappying is widely suggested and rarely effective as a treatment. What the evidence shows, and what it can and cannot be used for.
- Hip dysplasia treatment by age: newborn to walkingTreatment depends far more on your baby's age than on the severity alone. What is usually offered at birth, 3 months, 6 months, and after walking age.
Risk and prevention
Who is more likely to be affected, and what genuinely helps.
- Breech birth and hip dysplasia: how big is the risk?Breech position is the strongest single risk factor for DDH, which is why a breech baby should be scanned even when the examination is normal.
- Swaddling, carriers and car seats: hip-healthy positioningTight straight-leg swaddling and narrow-based carriers are linked to hip dysplasia. How to swaddle and carry your baby safely instead.
The questions parents ask at 2am
Pain, walking, late diagnosis and how to ask for a second opinion.
- Signs of hip dysplasia in newborns and babiesUneven thigh creases, one leg that seems shorter, limited spread on one side, and the later signs at crawling and walking age.
- Is hip dysplasia painful for babies?Untreated hip dysplasia is almost never painful in infancy — which is exactly why it gets missed. When pain does appear, and what it means.
- Diagnosed late: hip dysplasia found after 6 monthsScreening does miss cases. What treatment looks like when dysplasia is found at 6, 12 or 18 months, and what the outlook is.
- How to get a second opinion on your baby's hipsWhat to bring, what to ask, and how to request a second opinion without damaging the relationship with your baby's own doctor.
Reading about it only goes so far
Upload your baby's own ultrasound or X-ray and our pediatric orthopedic team sends you a written report within 48 hours — findings, assessment, and exactly what to ask next. $89, one flat fee.
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