Can baby carriers cause hip dysplasia in babies?

Can baby carriers cause hip dysplasia in babies?

Baby carriers are all the rage now, but can they cause hip dysplasia in babies? Find out here.

hip dysplasia in babies

What type of baby carrier do you use?

Like most baby products, there are many types of baby carriers.

Baby wraps, baby slings, mei-tais, soft-structured carriers, front-facing carriers, back-facing carriers and frame backpacks are some of the most popular.

Baby carriers are in many ways a blessing for mums on-the-go and a convenient alternative to bulky strollers. “Babywearing” is also a good way of promoting parent-child bonding and interaction.

However, did you know that the type of baby carrier you choose may contribute to a condition in your child known as hip dysplasia?

hip dysplasia in babies

The types of hip dysplasia in babies
Image from the International Hip Dysplasia Institute website

Hip dysplasia

Dr. Siow Hua Ming, an orthopaedic surgeon at and Medical Director of Providence Orthopaedics at Mount Elizabeth Novena Specialist Centre, explains that hip dysplasia in babies is a condition where there is a poor fitting of the hip joint.

In other words, hip dysplasia is the medical term for a hip socket that doesn’t fully cover the ball portion of the upper thighbone, which may allow the thighbone to slip out of the socket, partially or fully (hip dislocation).

Because hip dysplasia is usually not painful to young infants, experts caution that it could go undetected until the child starts walking. What’s more, it may lead to painful adult arthritis.

Dr. Siow says that hip dysplasia occurs in around 1% of babies. The risk is increased by being first-born, female and having less amniotic fluid than normal in the uterus.

hip dysplasia in babies

An infant’s hips are very pliable, making them naturally susceptible to hip dysplasia

Causes of hip dysplasia in babies

According to the International Hip Dysplasia Institute, the exact causes of childhood hip dysplasia are not known. However, they’ve identified a few possible reasons in addition to what Dr. Siow points out, including:

  • Genetics: Hip dysplasia is approximately 12 times more likely in a child when there is a family history of it.
  • Position in the womb: A baby’s position in the womb can cause pressure on the hip joints, contributing to hip dysplasia following birth. A baby in the breech position is more likely to have hip instability than babies positioned normally.
  • The pliability of an infant’s hip joints: A young baby’s hip socket is made up of soft, pliable cartilage, which may make it easier for an infant’s hip to dislocate.
  • Infant position in the first year: Cultures that keep babies’ hips rigidly extended (e.g. using a papoose board) have high rates of child hip dysplasia. This is in contrast to other cultures where children are carried with their hips held apart.
hip dysplasia in babies

Note how rigidly straight this papoose-board keeps the child’s hips and legs, increasing the risk of hip dysplasia
Image from the International Hip Dysplasia Website

As a parent, there is not much that you can do about the first three possible causes of hip dysplasia in babies mentioned above.

However, you can certainly educate yourself about correct infant positioning immediately after birth, when the risk is highest, and through the first year.

With this in mind, the type of baby carrier (and swaddling method) you use and how you choose to position your baby can definitely assist with reducing the risk of hip dysplasia.

hip dysplasia in babies

Some baby carriers, such as this forward-facing one, may promote unhealthy positioning of a baby’s hips

A baby carrier can either reduce or increase the chance of infant hip dysplasia

According to health professionals, it takes several months for a baby’s joints to stretch out naturally following birth.

During a baby’s first few months of life, the “ball” of the hip joint is generally loose within its soft cartilage socket.

If the baby’s hips are forced into a stretched-out position too early, then the ball may permanently deform the edges of the socket (hip dysplasia) or completely slip out of the socket (dislocation).

Some baby carriers may promote such unhealthy hip positioning in a baby.

hip dysplasia in babies

Unhealthy positioning of a baby’s hips in a carrier
Image from the International Hip Dysplasia Institute

The unhealthiest position for an infant’s hips

If a baby’s legs are extended with the hips and knees kept straight and the legs brought together, there is a greater risk of hip dysplasia occurring, especially if this position is maintained for a long time.

Healthy hip positioning

Dr. Siow explains that the healthiest position for a young infant’s hips is when they are flexed and abducted. In other words, it’s when your baby’s hips fall or spread naturally apart to the side, with his thigh supported and hips and knees bent.

This position is also known by the following terms:

  • Jockey position
  • Straddle position
  • Frog position
  • Spread-squat position
  • Human position
hip dysplasia in babies

Healthy hip positioning
Image from the International Hip Dysplasia Institute

Dr. Siow explains that if a baby carrier does not allow sufficient flexion and abduction, it may increase the risk of hip dysplasia through the unhealthy positioning of a child’s hips.

This risk has more often than not been associated with forward-facing baby carriers.

hip dysplasia in babies

Choose a carrier that positions your baby’s hips and spine correctly

What should parents look for when choosing a baby carrier?

A backward-facing baby carrier, according to Dr. Siow, tends to promote the bending and movement of the hips by virtue of the baby being pressed against the parent’s abdomen or trunk.

It is recommended that parents think about choosing a backward-facing carrier when selecting one for their baby. It is also important to have a carrier that is comfortable for both the parent and baby.

What’s more, the carrier should provide good support for the baby’s spine and minimise flopping of the head, while not being too restrictive and uncomfortable for the baby.

hip dysplasia in babies

A good carrier should ensure the comfort of both mum and baby

Signs of hip dysplasia in babies

According to the International Hip Dysplasia Institute, the following are the most common signs of hip dysplasia in a child:

  • Asymmetry: Asymmetrical buttock creases may be an indication of hip dysplasia in babies, but it will need to be confirmed with an ultrasound or x-ray.
  • Hip clicks: A snapping or clicking sound from the hips may be an indication of this condition, but once again, it’s best to investigate further with an x-ray or ultrasound.
  • Limited spread of hips: You might find it hard to change your baby’s diaper because the hips can’t fully spread.
  • Pain: While infants and young kids with hip dysplasia typically don’t have pain, it is the most common symptom of hip dysplasia during the teen years or as a young adult.
  • Swayback: After a child learns to walk, an exaggerated waddling limp or difference in leg length are the most common indicators of hip dysplasia. Limping with a marked swayback is a common symptom when both hips are dislocated.

What to do if you suspect your child has hip dysplasia

Dr. Siow advices that if parents suspect any problem with their child’s hips, they should see a paediatric orthopaedic surgeon as soon as possible. Hip dysplasia has the best treatment outcomes when detected and treated early.

theAsianparent would like to thank Dr. Siow for his valuable contribution to this article. 


What kind of baby carrier do you use? Do you think it correctly supports your baby’s hips? Let us know by leaving a comment below. 

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Any views or opinions expressed in this article are personal and belong solely to the author; and do not represent those of theAsianparent or its clients.
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