Understanding Hip Development in Infants with Breech Births

Proper hip development in the earliest months of a baby’s life is crucial, as the hip joints are still forming and stabilizing. Any disruptions or abnormalities during this vital stage can lead to lifelong issues if not promptly addressed. One condition affecting hip development in infants is hip dysplasia, a disorder in which the hip joint doesn’t form correctly, causing instability or potential dislocation. This article explores how hip development issues in infants—particularly those linked to breech births—can arise, what signs parents should look for, and the importance of early diagnosis and treatment.

What Is Hip Dysplasia in Infants?

Hip dysplasia, or developmental dysplasia of the hip (DDH), occurs when the ball and socket joint of the hip doesn’t form properly, leading to misalignment. In this condition, the “ball” of the joint can slip out of the “socket,” resulting in pain and limited mobility as the child grows. Unfortunately, hip dysplasia may not be obvious at birth, making early detection critical. Common signs of hip dysplasia in babies include a noticeable “hip click,” uneven leg lengths, or restricted movement in one leg.

Breech babies—those positioned feet-first or buttocks-first in the womb—have a heightened risk of hip dysplasia. In these cases, the position creates additional pressure on the hips, which can prevent natural joint formation.

Frank Breech Baby Abnormalities and the Link to Hip Dysplasia

A frank breech baby refers to a fetus positioned with the buttocks down and legs extended upward in front of the body. This position places unique stress on the hip joints, and studies show that babies born in this position are at greater risk of developing hip dysplasia. Limited movement in the womb, especially as the pregnancy progresses beyond 28 weeks, can restrict the baby’s range of motion. By 38 weeks, if a baby remains in the frank breech position, the prolonged pressure on the hip joints may compromise their natural development.

Closely monitoring breech babies is essential to catch any potential hip abnormalities early. Many doctors recommend a hip ultrasound for babies in breech positions shortly after birth to ensure no developmental issues are present.

Identifying Hip Dysplasia: Signs for Parents to Watch

Early detection of hip dysplasia is essential for effective treatment. Some typical signs of hip dysplasia in newborns include:

• Asymmetrical skin folds on the thighs
• Limited leg movement on one side
• A hip click in newborns, an audible click or pop during leg movement, which could indicate instability
• Uneven leg lengths, noticeable during diaper changes

If any of these signs are present, parents should request further evaluation, often through ultrasound imaging, since x-rays are not suitable for infants.

Preventing Hip Dysplasia in Babies

While not all cases of hip dysplasia can be prevented, certain measures may reduce the risk. Swaddling techniques play a significant role; tightly wrapping a baby’s legs can place undue pressure on the hips, so experts recommend a “hip-friendly” swaddle that allows for leg movement.

Prenatal factors also contribute to hip health. Ensuring the baby’s head is down around 30 weeks of pregnancy can minimize the chance of a breech position, reducing strain on the hips. Additionally, expecting mothers are encouraged to monitor fetal movements and consult their healthcare provider if they notice any reduction in movement around 38 weeks.

Treatment Options for Infant Hip Dysplasia

When diagnosed, the treatment for hip dysplasia depends on the infant’s age and the severity of the condition. Early intervention is key to restoring hip alignment and preventing long-term complications. Common treatments include:

• Pavlik harness: This is typically the first treatment option for newborns with hip dysplasia. The harness keeps the hips in a safe position, allowing proper joint development over time.
• Closed reduction: If a harness does not work, closed reduction may be recommended. This involves repositioning the hip joint under anesthesia, followed by casting to hold it in place.
• Surgical intervention: In severe cases or when treatment is delayed, surgery may be required to realign the hip joint.

Performing an ultrasound for babies born in a breech position allows doctors to detect dysplasia early, ensuring timely treatment.

Risks of Undiagnosed Hip Dysplasia

When untreated, hip dysplasia can lead to significant mobility issues as a child grows. Undiagnosed dysplasia often causes early-onset arthritis, chronic pain, and limping. In extreme cases, untreated hip dysplasia may even require hip replacement surgery later in life.

To avoid these outcomes, parents should seek regular follow-ups, particularly if their baby was in a breech position or if there were any indications of hip clicking in the newborn assessment after birth. With advances in diagnostic imaging like ultrasound, doctors can identify and treat these conditions early, improving outcomes.

Malpractice Concerns in Cases of Hip Dysplasia

Although some cases of hip dysplasia arise naturally, there are situations where medical malpractice may lead to a missed or delayed diagnosis. Healthcare providers are responsible for assessing newborns, especially those born in a breech position, for any signs of hip dysplasia. If a doctor fails to order an ultrasound for a baby in breech, or does not inform parents of potential risks, it may be considered negligence. In some cases, medical professionals fail to recognize clear indicators of hip dysplasia, delaying necessary treatment and worsening the child’s outcome.

In any breech birth, the attending physician must take all steps necessary to monitor the infant’s hip health. Failing to detect hip dysplasia during a newborn examination can result in severe consequences for both the child and family.

When to Consult a Malpractice Lawyer

Parents whose children suffer from untreated or undiagnosed hip dysplasia may feel helpless and frustrated. In such cases, consulting a medical malpractice lawyer can be beneficial. An experienced lawyer, like Joseph M. Lichtenstein, can evaluate whether healthcare providers met their duty of care. With his recognition as New York Malpractice Lawyer of the Year in 2019, 2023, and 2024, Lichtenstein has established a strong record of advocating for families impacted by malpractice.

When a child faces long-term disability due to medical negligence, families deserve justice and financial support to cover ongoing medical needs. Consulting a lawyer early can help parents navigate this challenging situation.

Final Thoughts: Prioritizing Hip Health and Recognizing Malpractice Risks

The earliest stages of a baby’s life lay the foundation for future health. Careful attention to hip development, especially for breech-born infants, can prevent severe long-term complications. Recognizing and addressing signs of hip dysplasia in babies enables parents to seek timely medical intervention. However, if diagnosis or treatment is missed due to medical oversight, families should consider consulting a skilled medical malpractice lawyer. By taking action early, parents can help ensure their child receives the best care and avoid unnecessary suffering.