Breech birth and hip dysplasia: how big is the risk?
Written by Dr. Mutasem Aldhoon, pediatric orthopedic consultant · Medically reviewed by the Baby Hip Center pediatric orthopedic team · Last reviewed September 1, 2026
Breech position is the strongest single risk factor for hip dysplasia. Most breech babies have entirely normal hips, but the chance is several times higher than after a head-down birth — high enough that a hip ultrasound at around six weeks is recommended even when the newborn examination is normal.
Why breech position matters
In the frank breech position the hips are folded tightly and the knees held straight for weeks. That combination stretches the capsule at the back of the hip and levers the femoral head towards the edge of a socket that is still soft cartilage. The socket then grows around a head that is not sitting in the middle of it. Position matters most in the last weeks of pregnancy, which is why babies who turn early are at lower risk than babies still breech at delivery.
How the risk factors compare
| Risk factor | Why it matters | Scan recommended? |
|---|---|---|
| Breech in the third trimester or at delivery | Strongest single factor | Yes |
| Family history (parent or sibling) | Clear genetic component | Yes |
| Female | Several times more common than in boys | Only with another factor |
| Firstborn | A tighter uterus and less room to move | Only with another factor |
| Oligohydramnios (low fluid) | Less room, more constraint | Usually yes |
| Twin pregnancy, torticollis, foot deformity | Other signs of crowding in the womb | Often yes |
| Tight straight-leg swaddling after birth | Recreates the position that harms the socket | Not by itself |
A caesarean does not remove the risk
The risk comes from the position the baby was held in during pregnancy, not from the delivery itself. A baby who was breech and delivered by planned caesarean should still be scanned.
What to do if your baby was breech
- 1Check whether a hip ultrasound has actually been booked — a normal newborn examination is not a substitute for it.
- 2If nothing has been arranged by four weeks, ask your family doctor or midwife to request one at around six weeks.
- 3In the meantime avoid tight straight-leg swaddling and narrow-based carriers, and let the legs sit bent and spread.
- 4If the scan is borderline, make sure the repeat scan is booked before you leave, not left to be arranged later.
If the scan is normal
A normal six-week scan in a breech baby is genuinely reassuring, and no further imaging is usually needed. It is still worth mentioning the breech history at later checks, since the rare late-presenting case is picked up by a change in leg movement, creases or gait rather than by another scan.
Want your own baby's images read by a consultant?
Upload the ultrasound or X-ray you were given and our pediatric orthopedic team sends you a written report within 48 hours — findings, assessment, what to do next, and what to ask your own doctor. One flat fee of $89.
Start a reviewSources
Read next
- Swaddling, carriers and car seats: hip-healthy positioning
Tight straight-leg swaddling and narrow-based carriers are linked to hip dysplasia. How to swaddle and carry your baby safely instead.
- Reading your baby's hip ultrasound: Graf types I to IV explained
What 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 means
The 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.
This page is general information about developmental dysplasia of the hip, not a diagnosis of your own baby. It does not replace examination by your baby's doctor, and it is not for emergencies.