I see it in chat groups all the time. Someone posts a proud photo with baby in their narrow based soft-structured carrier (SSC) carrier. Almost immediately the comments blow up warning about Hip Dysplasia and leg deformity. Also known as ‘crotch danglers,’ despite this nickname there are still many narrow based carriers out there. Is there any evidence behind these warnings? Can narrow based carriers actually cause Hip Dysplasia? Here’s the DL from the experts.
While the exact cause of Hip Dysplasia, otherwise known as Developmental Dysplasia, is unknown it is thought to be developmental (and the word thought is used because to determine for sure if babywearing causes hip dysplasia someone would have to run a study and subject one group of babies to something that may contribute to the condition…which is terribly unethical and won’t happen.) the true cause is unknown. What does developmental mean? Hip Dysplasia is theorized to occur as a result of the body’s own processes and is typically not caused by something the parents do or did. (1)
The hip joint is a ball and socket joint like the shoulder. When dysplasia occurs the ball portion does not sit securely into the socket portion of the joint displacing it. Make a fist with one hand, and a ‘C’ with the other. Put these two together and you can get a basic idea of how the joint is shaped. The tissue, tendons and ligaments holding this joint together (like the shoulder) create a delicate balance allowing the joint to move in a wide variety of motions. Often part of a baby’s exam at the pediatrician, your doctor should check to make sure babys’ hips are developing properly and free from dysplasia symptoms.
Hip Dysplasia may occur as the result of ligaments, tendons and tissue not being quite tight enough to hold the joint securely together, or may result from a joint that isn’t quite the right shape, or a combination of these factors (1). In most cases, this occurs at birth or within the first year of life and may be symptom-less (1-4), or be accompanied by symptoms including:
- Different leg lenths, one may seem shorter.
- Extra or uneven folds of skin on the inside of the thighs.
- A hip joint that moves differently than the other, may be more or less flexible on one side.
- Walk on the toes of one foot with the heel up off the floor.
- Walk with a limp, waddle or appear to walk like a duck.
- Pain (1-4)
While diagnostically impacting 1 or 2 out of 1,000 babies (1), treatment for Hip Dysplasia may include surgical or non-surgical treatment. The type of care depends on the severity of the dysplasia and a child’s individual factors.Those with hip dysplasia more commonly are:
- females (who have looser ligaments than males, historically known as double-jointedness)
- first-born babies (whose fit in the uterus is tighter than in later babies)
- breech babies (whose constrained position tends to strain the joint’s ligaments)
- children in families where there’s a genetic predisposition for the condition
- Possibly an over-tightening in a swaddle position and or on a papoose board (1-4)
So, back to the question: Does Babywearing Cause Hip Dysplasia? Specifically narrow based carriers or ‘crotch danglers’? The general answer is Uncertain; Can it contribute to it if your baby is already has the predisposition? The answer from experts is Yes. Do you want to find out if your carrier will contribute to an underlying predisposition to hip dysplasia in your baby? I hope not, but that’s up to you.
Why are ‘crotch danglers’ blamed for Hip Dysplasia? Basically the condition or predisposition to have it would already have to exist, allowing the legs to dangle would kind of draw it out. Unlike a Woven Wrap or more wide based soft structured carrier, these carriers allow a baby’s legs to be in a less then optimal position. In a newborn, the hip joint is typically more loose then an infant and dangling the legs may lead to malformation of the joint (1). How so? The weight from baby’s legs pull down on the hip joint…and should your baby be one of the 1/20 full term babies with some instability 1 or 2 out of 1,000 to have Hip Dysplasia…it could possibly make the condition worse or encourage laxity or looseness in the hip joint. (1-4).
“The most unhealthy position for the hips during infancy is when the legs are held in extension with the hips and knees straight and the legs brought together, which is the opposite of the fetal position” (1).
While there are many excellent carriers out there, crotch danglers are still for sale both new and in BST. What about forward facing? The same principles apply. What’s important is the position of the hip, knee and thigh. Wondering about your carrier? If this is a concern of yours, certainly talk to your pediatrician. I personally would not use a narrow based carrier for many other reasons. I personally find them uncomfortable on my back and shoulders, find that baby sways around while I’m moving, and believe that the narrow portion of the carrier that sits in baby’s crotch HAS to be uncomfortable. Think small bicycle seat VS nice wide bicycle seat. Which would you want to sit on for 2 hours?
Local babywearing international chapters are a great resource to try carriers and get advice about positioning. As always your local Occupational Therapist is a great resource, but specialties in practice vary so call ahead of time and ask about knowledge about babywearing positioning. The International Hip Dysplasia Institute has a great resource of knowledge and accepts donations to further their research.
So what type of carrier is best? Here are two of my favorites! A quality soft structured carrier like a Lillebaby and a Woven Wrap! Each should support the thigh, bottom and back of your infant or toddler and encourage the “frog” position mentioned by the institute. If baby’s legs are dangling in space…obviously the carrier is not recommended.
Disclosure: This is not a sponsored post, these are my thoughts and information from several references (see below) and opinion. Please check with your pediatrician and Occupational Therapist for your child’s individual needs. This is not meant to diagnose, replace medical advice, treat any condition and is simply food for thought. These are not my images, they are used with permission from the International Hip Dysplasia Institute which is a very well put together and quality resource. Being a visual person myself, I collaged them to give you an at-a-glance idea of positioning for babywearing and hip health and the writing beneath the photos is by Mama Banana’s Adventures.
The information presented above is NOT to replace the advice of your physician and is for informational purposes only. Please speak with your physician or other medical providers prior to engaging in any routine concerning your baby’s hip health. Please follow all manufacturers instructions for baby carriers. This disclosure is done in accordance with the Federal Trade Commission 10 CFR, Part 255 Guides Concerning the use of Endorsements and Testimonials in Advertising. Links enclosed may contain affiliate links. If you have any questions or would like your product or company featured on Mama Banana’s Adventures please contact MamaBananasAdventures@gmail.com