As I lay in a hospital bed a few hours after my C-section, the resident pediatrician was standing nearby, moving my newborn daughter's legs in slow circles. The process, I later learned, was called the Barlow Maneuver — a common practice to check hip stability in newborns.
"Her hip joints are making a slight clicking noise, especially on the left side," the pediatrician said suddenly.
"So, what does that mean?" I vaguely recall asking.
"There's a possibility of hip dysplasia, but we'll need an ultrasound to know for sure," was the response.
I didn't know what any of that meant, and, in my groggy state of mind, I don't remember asking any follow-up questions at the time. However, I recall frantically Googling the condition as soon as we were home from the hospital while my daughter, Elodie, slept on me.
A few weeks later, we had an appointment at the Baby Hip Clinic — the orthopedic division at SickKids in Toronto — for an ultrasound. Elodie was eventually discharged wearing a full Pavlik Harness, which, to her hyper-sensitive mama, resembled some sort of velcroed medieval device that held her in a perpetual frog position.
As it turns out, it's a relatively common condition. The International Hip Dysplasia Institute states that one in 10 infants are born with some level of hip instability, while one in 100 babies are treated for actual hip dysplasia.
It's essentially an umbrella term for any of the following: infantile hip instability, dislocation or shallowness of the hip socket. It's when the femoral head (the highest part of the thigh bone) doesn't fit correctly with the pelvis at birth. If left untreated, it can result in damaged cartilage, limping, joint pain, hip dislocation and, later in life, osteoarthritis.
According to the International Hip Dysplasia Institute, the exact causes are unknown. However, most medical professionals agree that it happens around birth when a baby's hip sockets are at their shallowest so they can pass through the birth canal. After delivery, those loose ligaments typically recover without incident. However, that's not always the case.
A few factors — outside of family history — can contribute to hip dysplasia in newborns. As it turned out, Elodie met three of the main markers:
Firstborn. Check.Female. Check.Breech birth. Check.
So, she came by it honestly.
I asked Catharine Bradley, a physiotherapist practitioner who co-supervises the Baby Hip Clinic at SickKids, why these three factors, in particular, tended to result in hip dysplasia.
"The thinking around the firstborn is that the uterus is pretty tight, so it's a packaging thing, whereas, with moms who have had multiple [kids], their uterus is not quite as snug," she explains. "[It] girls because they are more susceptible to their mom's hormones at birth, and so their hips tend to be a bit more lax. And then the breech [birth] is positional, so they're further down into the womb and bum-down, so their hips are being held in tight."