HealthInfo Waitaha Canterbury
Treating DDH using a harness
Te whakarauora i te DDH mā te hānihi
Some pēpi (babies) may need to be treated for developmental dysplasia of the hip (DDH) using a harness. The harness may be called a Pavlik harness.
The harness is a brace used to help the your baby's hips develop in the most normal way. It has straps that are fastened around the legs of your pēpi and held up by shoulder and chest straps.
The harness holds the hips and knees of your pēpi up with their legs apart, which is the best position for their hip joints. It means their thigh and pelvic bones are in contact and helps to strengthen their hip muscles and ligaments while they're developing. The harness weighs around 120 grams.
Wearing the harness
Your surgeon may say your pēpi should wear the harness 24 hours a day without removing it at all. The medical team will talk to you about how to care for your pēpi in the harness.
How long your pēpi wears the harness depends on how bad their DDH is. Usually, they will have to wear it full time for eight to 12 weeks.
Your pēpi can wear normal nappies under the harness. Their clothes should be loose-fitting and should go over the harness.
Potential problems
Femoral nerve palsy is a very rare problem that can happen with a harness. If your pēpi stops kicking, ring for advice as soon as possible.
In Christchurch, contact the DDH Coordinator in the Orthopaedic Outpatient Department by phoning 021-951-261.
You can also contact the DDH Coordinator for other issues such as the harness getting dirty or if the harness has got too tight.
Checking if the harness is working
You'll have regular appointments with the consultant and the orthopaedics outpatient team. They will check the harness to make sure it's fitting correctly. How many appointments you have, and how often they are, depends on how severe your child's DDH is. At first, you'll have appointments for hip ultrasound scans every two weeks so doctors can check how the hips are developing.
If your baby's hips do not get better
At each appointment, the consultant will discuss progress with you. If they feel your baby's hips aren't developing in the normal way even with the harness, they will discuss other treatment options.
Care at home
When your pēpi wears the harness:
- the chest strap should be firm, but you should be able to fit two fingers underneath it. This allows the chest to move properly as your pēpi breathes
- the ankle and lower leg straps should be firm enough to hold the feet, but not too tight.
It takes some pēpi a couple of days to get used to the harness. Some pēpi may cry a little more or seem unsettled for the first couple of nights. This should settle down after a few days.
Hygiene and skin care
If your doctor says your pēpi must wear the harness 24 hours a day, you cannot take it off to bathe them. You'll need to clean your pēpi with a sponge bath. Nurses will show you how to do this. Always try to keep the harness dry.
Check your baby's skin every day. Take care to clean their skin creases and take note of any redness or irritation.
Nappies and clothing
Your pēpi can wear normal nappies under the harness. When changing their nappy, do not hold their feet together as this will move their hips from the correct position.
Your pēpi should wear loose-fitting clothes that do not pull their knees together. The clothes should go over the harness.
Feeding
You can continue breastfeeding when your pēpi is in the harness. You'll need to find a comfortable position for you and your pēpi.
HealthInfo recommends the following pages
- Canterbury DHB – Hip abduction brace
This factsheet has information about another type of brace that can be used to treat DDH.
- International Hip Dysplasia Institute – Child treatment methods
This page has information about treatment methods for DDH including using a harness.
Written by HealthInfo clinical advisers. Last reviewed June 2022.
SourcesReview key: HIBOW-85151
