Paediatric Orthopaedics Ipswich Hospital
Contact telephone numbers:
Mr Carlile’s Ipswich secretary Direct tel: 01473 707373
Specialist paediatric orthopaedic physiotherapists Direct tel: 01473 702185 or Via Switchboard: 01473 712233 and ask for bleep 923.
Looking after your baby and his/her Pavlik harness
A Pavlik harness is a soft, lightweight device worn by children with developmental dysplasia of the hip (DDH). The harness keeps the hips in a ‘frog’ position which is good for hip development.
The hip is a ball-and-socket joint. In order for the socket (acetabulum) to develop normally, the ball (femoral head) should be within the socket.
DDH is a term used to describe babies’ hips that have a shallow socket, or hips that are dislocated (ball out of socket).
The harness will be put on in clinic by your baby’s consultant or physiotherapist.
Your baby will need to wear the harness until his or her hip is as it should be. This can take up to six weeks, and sometimes longer.
An ultrasound scan will be performed two weeks after the harness is fitted, to monitor that your baby’s hip is responding to treatment, and at regular intervals after that.
Initially, your baby should wear the harness 24 hours a day and it should not be removed except in an emergency.
Once your baby’s hip shows signs of getting better, the consultant will tell you if the harness can be removed for short periods and you can begin weaning’ your baby out of it.
In scientific studies that have examined treating DDH with a Pavlik harness, the quoted success rates are around 80%.
This means the failure rate is 20%.
In other words, one in five babies will not get better by using the harness and four in five babies will.
The main risk is that Pavlik harness treatment does not guarantee your baby’s hip will get better, and further surgery may need to be considered. Your baby’s consultant will explain what happens next in more detail if this treatment is not successful.
Pressure ulcers and rubbing around the harness are another complication, but this is rare. Your baby’s consultant and physiotherapists will check him or her regularly for this. We will give you details of whom to call if you are concerned that this is happening.
Another rare complication is a femoral nerve palsy. This is when one of the nerves in the leg stops working and is usually temporary. It can occur if the harness does not fit correctly.
Your baby should be able to kick his or her legs and bend their knees in the harness. If he or she stops doing this, you should contact your baby’s consultant or physiotherapist.
Marks & Spencer have a range of clothing designed to fit over a harness – search ‘hip dysplasia’.
Your baby’s nappy will need changing more regularly than usual to avoid soiling of the harness.
Once the harness can be removed for short periods, dress your baby in a vest and long socks to protect his or her skin and stop it from getting sore. All your baby’s other clothing can be worn over the harness.
Areas to pay close attention to are your baby’s knee creases, groin creases, under his or her arms and the sides of their neck.
Use talcum powder sparingly and avoid using this and other lotions in areas which are covered by the harness, as they can clog and cause skin problems.
Do not bathe your baby in the harness, as you will be unable to dry the harness and it will cause sore areas on your baby’s skin.
Once you are able to remove the harness and bathe your baby, make sure your baby’s skin is completely dry before replacing their harness.
Sponging the harness with a disinfectant, such as Savlon®, can help to keep it clean while your baby is wearing it. All harnesses get stained – this is normal. If the harness gets heavily stained, it can be replaced by the physiotherapists.
Once the harness can be removed, make sure the harness is fully fastened before cleaning it.
Let the harness dry naturally and make sure the fitting marks are still visible or, if necessary, re-mark the harness at the fastenings.
For sleeping, position your baby on his or her back.
It is very important for your baby to have time on his or her tummy to play. Try placing a rolled-up towel under your baby’s chest so that their arms are over it.
This encourages normal development and takes the pressure off their back.
Once your baby is not wearing the harness during the day, support their legs together with towels when he or she is sitting in a chair or car seat.
Gently hold your baby’s legs together when carrying him or her, to encourage them back together.
There are no limitations or guidelines as to what your baby should or should not do.
He or she can play and develop like any other child.
Your baby will have regular check-ups, alternating between their consultant and physiotherapists.
Check-ups are to make sure your baby’s harness size is still appropriate and that it is holding their legs in the correct position.
Your consultant will tell you when your baby’s harness can be removed. Initially, it should only be removed when he or she is being bathed.
You will be taught how to take the harness off and how to put it back on again by your physiotherapist.