A soft click during a diaper change. Uneven leg creases. These subtle signs can point to a common condition in infants: Developmental Dysplasia of the Hip (DDH). Although the name might sound intimidating, DDH simply means the hip joint hasn’t formed quite right - ranging from mild looseness to full dislocation. With early detection and the right support, babies can move through treatment and continue developing their motor skills with confidence. Timely care is key - not just for healthy hips, but for a strong foundation in movement.

Let’s dive into what hip dysplasia is, what warning signs parents should look for, how it impacts development, and what treatment options exist.

What Is Hip Dysplasia?

Hip dysplasia occurs when a baby’s hip joint doesn’t form properly. In a healthy hip, the ball at the top of the thigh bone (femoral head) fits securely into a rounded socket in the pelvis. In cases of dysplasia, this socket may be too shallow, allowing the femoral head to slip out partially or completely. Hip dysplasia is most often congenital, meaning present at birth. 

Why Does Hip Dysplasia Happen?

Several factors can increase the risk of DDH:

• Breech positioning in late pregnancy or at delivery
• Family history of hip dysplasia
• Being the first-born child (due to tighter uterine conditions)
• Female babies are more prone due to the effects of maternal hormones on joint laxity

Sometimes, there’s no clear cause—just a matter of the baby’s unique anatomy and how they were positioned in the womb.

Warning Signs for Parents

Hip dysplasia isn’t always obvious at first. In fact, many babies don’t show outward signs and they’re not in any pain. But here are some flags parents and caregivers can watch for:

• Asymmetrical leg creases in the thighs or buttocks
• One leg appearing shorter than the other
• Difficulty spreading the baby’s legs apart during diaper changes
• A “clicking” or “popping” sound when moving the hips
• Preference to bear weight on one leg more than the other when standing with assistance

Pediatricians typically check for hip dysplasia at routine well-visits, but if you notice any of these signs, it’s important to consult with your pediatrician or a pediatric physical therapist as soon as possible. The earlier we identify it, the better the outcomes.

How Hip Dysplasia Affects Motor Development

The hip joint is central to a baby’s ability to move, bear weight, and explore their environment. When the hip is unstable or misaligned-

• Babies may be delayed in their motor milestones.
• Instability can cause compensatory movement patterns, which may lead to asymmetries or muscle imbalances.
• Without early treatment, long-term issues like limping, chronic pain, and early arthritis can develop.

Diagnosis and Treatment Options

Diagnosis typically starts with a physical exam- your pediatrician may perform the Barlow and Ortolani maneuvers to check for hip instability. If there’s concern, an ultrasound is used to confirm the diagnosis.

Treatment varies depending on the baby’s age and severity:

• Pavlik Harness (0–6 months): A soft brace that holds the hips in a flexed, abducted position to encourage proper socket development.
• Closed reduction and casting (6–18 months): If the harness is ineffective or the child is older, a procedure may be needed to reposition the hip, followed by casting.
• Surgical intervention (>18 months): In severe or untreated cases, surgery may be necessary.

Throughout treatment, physical therapy plays a key role in:

• Promoting symmetrical motor development
• Preventing muscle tightness
• Educating families on safe positioning and play

What Parents Can Do

• Don’t skip well-baby checkups—this is often when early signs are first detected.
• Support your baby’s hips in the “M” position—when using a baby carrier, ensure your baby’s knees are higher than their bottom, with legs spread comfortably to the sides, forming an “M” shape.
• Observe your baby’s movements—any asymmetry or delay is worth mentioning to a professional.

Trust your instincts—if something feels off with how your baby is moving, it's always better to check it out.

Bottom Line

Hip dysplasia is more common than many parents realize, and early signs can be subtle, but they matter. Things like uneven leg creases, hip clicking, or movement asymmetries shouldn’t be brushed off. With early detection and proper treatment—often guided by pediatricians and physical therapists—most babies go on to develop strong, healthy movement patterns. Trust your instincts, ask questions, and know that support is available every step of the way.