Morning. Today I’m handing over the blog to Laura who has kindly offered to share the journey she has been on since discovering her little girl has hip dysplasia and the treatments and help they have been receiving.
Hi! I’m Laura, mummy to Poppy who is now 5 months old. I wanted to talk about developmental dysplasia of the hip (ddh) as this is something Poppy has recently been diagnosed with and I actually didn’t even know existed! I’m not by any means an expert on this but thought that sharing my experience may help others to understand a little more about hip dysplasia.
So it all started at our 6 week checkup where the GP identified that Poppy had a clicky left hip. She reassured us that lots of babies go for the ultrasound scan that she would refer us for, so 6 weeks later, off we went for what we thought was just a routine scan. However, it turned out that it wouldn’t be quite that simple! The sonographer told us that he could see Poppy had an ‘immature hip’ and would contact the physiotherapist who would tell us more about this. Luckily we were able to go straight to the children’s department to see a physio. Here’s a good point to say that throughout this process, the care and treatment we have received from the RUH in Bath has been fantastic! Again, we happily trotted off to see the Physio thinking that perhaps we would need to start doing some exercises or stretches. But this is where reality really started to hit home as we were told that Poppy has hip dysplasia. In crude terms, this is where the ball and socket of the hip joint do not fit together correctly, for example, if the hip socket is too shallow. Although lots of babies may have immature hips, lots will resolve by themselves as baby develops but about 2 in a thousand require intervention as in Poppy’s case. Without treatment she would likely need a hip replacement sooner than most people and would develop a limp and osteoarthritis. What a shock!! As we looked at our baby it was really hard to equate this big news with the tiny baby in front of us. We were then shown a pavlik harness which she would perhaps need to wear 24 hours a day for 12 weeks. This would hold her legs in a froggy position. I think this is probably where the enormity of the situation hit us. We needed to wait for the consultant to decide whether he felt this would work so left the hospital with a lot of new information and unsure of exactly what would happen next. I must confess that we had a bit of a cry as we sat in the car park munching on M&S sandwiches. As a parent, I think we’re automatically programmed to have a guilt response! I was immediately wondering whether this was something I had done? I had several extra growth scans whilst pregnant due to my bump measuring small. Was she too confined whilst in there? Had we held her wrong? We were later told that this wasn’t something we had caused. There are several reasons why babies may have DDH. The majority are female. It is also more common in first borns and more likely if there is a family history. Being breech later in pregnancy also increases the chances. However sometimes it ‘just happens’ like in our case.
A few weeks later we were called back to see the consultant who told us that he didn’t feel the harness would work so instead Poppy would need a closed reduction. This is where she would be put under general anaesthetic and have her hip manipulated into the right place and held in a plaster cast for 12 weeks with the hope that the hip would then develop normally. The cast would cover her from her abdomen and down both legs, like a pair of fixed trousers. This would make nappy changes interesting as a big hole is left for this and she would not be allowed a bath! Our very wriggly little girl would be unable to move her legs. She would also no longer fit into her usual car seat as her legs would be held in a wide position. If this didn’t work, an open reduction would be needed later on which would involve more invasive surgery. This was a lot to take in. Me and my husband both work in healthcare but this time we were the ones who needed guidance and input from healthcare professionals. However, we knew it would be for the best in the longer term and were reassured that babies are generally pretty unbothered by this procedure.
Poppy’s closed reduction was scheduled for 12th June and so the countdown began! In the meantime, being research queen, I set about finding out more information. Some useful information came from a charity called Steps and I joined a couple of fantastic support groups on Facebook. These showed me stories and photos of families going through the same process and were an invaluable source of information, hope and inspiration. Kids and their families really are amazing with their ability to adapt to changes. I also found out that Maxi-Cosi run a fantastic scheme which allows you to hire an adapted car seat. As we’re already maxi cosi customers, we were entitled to pay a fully returnable deposit so in essence, would borrow this for free. The customer service was also exceptional throughout.
So the 12th June arrived – procedure day! Armed with 50 nappies (I’m not even kidding, we didn’t know which sizes Poppy may need!), and lots of tissues, we went into hospital. I was dreading the fact she would be nil by mouth from 3.30am that morning but she coped with this remarkably well. One of the hardest moments was handing her over to the anaesthetist and walking away. It was the longest time I had been away from her since she’d been born. We were called to recovery a few hours later and greeted by a very sleepy baby who after a feed settled down quickly and soon dozed off again in our arms.
We were then given some amazing news by the surgeon – they had found that her hip wasn’t completely dislocated but was easily dislocatable (if that’s a word?!) so instead they had cut a tendon in her thigh to allow her muscle more movement. Rather than a cast she would wear a brace for 6 weeks and then would hopefully be weaned off of this for a further 6 weeks. Best of all, we could remove it for nappy changes and bathtime!! Yay! Poppy is currently in this brace and as usual, constantly astounds us with her ability to adapt. Babies are way tougher than us parents!!
We have been incredibly lucky as other people’s stories are nowhere near as simple. However, through our journey there have been a few things that have struck me. Most people seem to fall into 2 camps – those who know nothing about hip dysplasia (hands up, this was me a few weeks ago), and those who know somebody who has had treatment for this. I hadn’t realised that although we can’t prevent hip dysplasia, there are a few things we can do to promote good hip health. I had heard of these before but hadn’t known that these are actual recommendations by the international hip dysplasia institute. These include making sure baby’s legs don’t dangle down when in a carrier but are held in a more supportive froggy position, ensuring seats and other devices like walkers and bouncers don’t push legs together or hold hips in an unhealthy position and making sure swaddling is not too restrictive on baby’s hips.
Also, I had no idea that there are signs of hip dysplasia to look out for. We were lucky that Poppy’s was picked up early, before she started crawling or walking, however others start their hippy journey a lot later. Signs to look for are uneven fat rolls on their thighs or under their bottom, legs may be slightly different lengths (we later realised that Poppy’s tendency to pick up her left leg slightly when he held her in a standing position was not actually a flamingo impression but linked to hip dysplasia). You may also notice restricted movement in one leg. Older children may drag a leg when crawling or walking or have an unusual gait. Any concerns should be checked out by a GP.
I really hope that this post has given people a little bit more knowledge and awareness of hip dysplasia. We are now keeping our fingers crossed that in a few weeks time, Poppy will have her brace removed and life will continue as usual. Her hip will be regularly monitored to ensure healthy development continues. I am sure she will be running around before we know it!