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How to Encourage Optimal Hip Development

The International Hip Dysplasia Institute recommends that babies adopt the M shaped position whenever they are held in Baby Carriers.  This means that the legs are allowed to fall out freely like a frog optimising the hip joints which are ball and socket joints.  During the first few months the ball is more likely to be loose within the socket due to stretching in the birthing process and also due to babies being more flexible naturally and the edges of the socket can bend easily.

If the legs are kept in the straight stretched out position with knees together in the early stages (0-6 months) then the ball of the hip joint may deform the edges of the socket or cause a slip altogether (Hip Dysplasia).  This issue almost never causes any pain so may go unnoticed until walking age.  Studies have also reported that 90% of young adult hip joint replacements for dysplasia were not diagnosed during infancy and that healthy hip positioning during early infancy can reduce the risk of adult hip arthritis.

By adopting the M-shaped position it promotes natural hip development.  Slings, Pouches and Wraps if legs are enclosed and not able to freely fall out should not be worn for extended periods of time or avoided altogether to help with this early optimal hip development.

The optimal M- Position applies to all types of Baby Carriers.

There are a list of Baby Carriers that have been recognised as safe for Hip Development by the International Hip Dysplasia Institute – Find Out More Here

Inward Facing Versus Outward Facing

A number of studies recommend Inward Facing for optimal Hip Development and to prevent chance of Hip Dysplasia for at least 6 months when there is rapid hip development and additional benefits can come from keeping them inward facing until 1 year when there is further hip development but at a slower rate.  The reasons that inward facing up until at least 6 months and if possible to one year includes:

    • Easier to maintain the effective M position in Forward Facing – when Outward Facing the legs are more likely to hang down
    • Muscle activity in the Forward Facing ‘clinging’ position further presses the ball of the hip joint into the hip socket and this type of muscle activity is beneficial for healthy joint development
    • Recommended by many babywearing consultants to have heart to heart (inward facing) along with clear visibility of their mothers face
    • Young infants take comfort and cues from seeing their parents face instead of the outside world alone
    • The inward facing infant will instinctively bend their hips and knees and spread their thighs in preparation for being placed on their mothers body

International Hip Dysplasia Institute.  Babywearing.  https://hipdysplasia.org/baby-wearing

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Heegaard J, Beaupre GS, Carter DR Mechanically modulated cartilage growth may regulate joint surface morphogenesis. J Orthop Res. 1999;17:509-517. https://pubmed.ncbi.nlm.nih.gov/10459756/

Ipach I, Mittag F, Syha R, Kunze B, Wolf P, Kluba T. Indications for total hip arthroplasty in young adults – idiopathic osteoarthritis seems to be overestimated. Rofo. 2012 Mar;184(3):239-47 https://pubmed.ncbi.nlm.nih.gov/22274871/

Sewell M, Eastwood DM. Screening and treatment in developmental dysplasia of the hip – where do we go from here? Intl. Orthop. 2011;35(9):1359-1367. https://pubmed.ncbi.nlm.nih.gov/21553044/

Thallinger C, Pospischill R, Ganger R, et al. Long-term results of a nationwide general ultrasound screening system for developmental disorders of the hip: the Austrian hip screening program. J. Child Orthop 2014; 8:3-10 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935031

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