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• Your baby was examined for loose or dislocated hips by your Pediatrician around the time he or she was born. If your Pediatrician had a question about the status of your baby's hips, then he might send you to see an Orthopaedic Surgeon.

• You may have heard your Pediatrician say he or she felt "hip clicks" during the examination. This may or may not be a normal finding and that is what the Orthopaedic Physician is asked to determine. Soft tissue clicks around the hip are a common finding and do not require treatment. However, unstable or dislocated hips require treatment. Dislocated hips are usually seen in first born, female babies with a breech presentation at delivery.

• As part of the exam, the orthopaedic physician will move your baby's legs around to feel if the hips are stable in the sockets. He may also ask that a hip X-ray or ultrasound be taken. These tests can show how shallow the socket of the hip is and how loose the ball of the hip is.

• If the Orthopaedic Physician finds that one or both of your baby's hips are loose or that they come out of the socket, than he will probably ask that your baby be place in a "Pavlik Harness" (this is a cloth, Velcro-strap harness that holds the legs in a frog leg position). This treatment is normally used for children under 6 months of age.

• The Pavlik harness is worn under the clothes. Your physician will decide how often the harness is to be worn. Commonly the harness is worn at all times until the hips are felt to be stable in the socket. Once the hip is stable and the sockets are deep enough, your physician will begin "weaning" your baby out of the harness (e.g., 4 hours out per day one week, 8 hours out per day the next week).

• Typically, treatment in the Pavlik lasts 4-6 months if started shortly after birth. However, longer treatment may be required if the discovery of the hip problem is made later. In any case, your physician may want to follow your baby until one year of age to be sure that the hip development is normal. We will teach you how to take your baby in and out of the harness.

• During the weeks that your baby is wearing the harness full time, you may be asked to come once a week or once every other week to the clinic. During these visits, we will give you supplies to bathe your baby. Also during those visits the physician will re-examine your baby and he may order ultrasound (special type of imaging) to check the hips.

• As stated above, the harness is worn under the clothes but not right against the skin. We suggest that you place a long undershirt or a “onesie” on underneath the harness. We also suggest that your baby wear thick, long socks on his feet. The long socks seem to stay up better than the thin short socks, while the feet are in the stirrups of the harness. We suggest putting rubbing alcohol on any areas of the baby's skin that are being rubbed by the straps of the harness (e.g., around the neck or on the legs). The rubbing alcohol makes the skin more calloused (hard). The use of lotions on these areas would not be suggested because the lotions would make the skin too soft.

• In some cases even with the use of the harness, the hips do not remain in the socket. In these circumstances, the physician may suggest surgery or placement of a cast to keep the hips in place. However, the Pavlik successfully treats the vast majority of cases where treatment is started shortly after birth.