Your baby’s hips undergo rapid growth and development from birth to 6 months of age. As a parent, there are some practical things you can do to promote your child’s hip development. But before we get into the practical stuff, let’s discuss why babies have clicky hips.
Clicky hips in babies is very common. There are a number of ligaments, muscles and tendons that live within and near your baby’s hip joint. When your baby moves their legs, these structures (ligaments, tendons and muscles) often slide and move across one another, causing that clicky sound in their hip. It’s not always the case that clicky hips is nothing to worry about, and in some rare instances, clicky hips might indicate something else*. However, it is more than likely that your baby’s clicky hips is nothing to worry about! Now that we’ve got the clicky business out of the way, lets discuss the hip joint.
The hip is made up of 2 bones, the pelvis and the long thigh bone, known as the femur. The alignment of these 2 bones is important for hip development. And in the vast majority of babies, this alignment is nothing to worry about at birth. And even if there is some small degree of ‘misalignment’, the good news is that over 90% of these cases resolve themselves without parents even knowing there was an issue in the first place**. In some cases however, this issue of hip misalignment can persist, or even develop within the first few months after birth. If left unresolved, your child may not seem like they have a hip issue. However, later in life, this small hip issue can lead to issues later on in life***.
The reassuring this is, there are practical things you can do for you baby that will promote good and healthy hip development. The first is how you wear your baby carrier.
For the 1st 6 months, your baby should be facing towards you in the carrier. Whilst in the carrier, the ideal position for your baby’s legs is the ‘M-Position’ (see image above). As you can see from the image above of a mother wearing a sling with her baby in it, if you drew an imaginary line from your baby’s heels, up to their knees, down to their hips, over to the other knee and down to the other ankle, it would make an M shape. The important thing to remember for the M-Position is that your baby’s knees should be higher than their hips.
The M-Position is particularly important for the first 6 months. Once your baby is 6 months or older, you can either continue to use the ‘M-position’ in the carrier, or turn your baby around so they are facing out (see image below). Turning your baby to face out after 6 months gives them an opportunity to see the world and what’s going on around them.
Another practical tip is how you swaddle your baby. Whether you swaddle or your baby has a sleep suit, ensure that it’s loose from the waist down so that bub can bend and move their legs freely. The reason being is that when your baby is in the womb, their knees and hips are bent (see picture below) for the whole pregnancy. Therefore, for the first 6 months after birth, it’s important to continue to allow your baby to bend up their knees. If your baby’s legs are stretched out too soon and for long periods, such as during sleep (to the lucky parents out there who can use words like ‘long periods’ when describing their baby’s sleep), it is less ideal than allowing your baby’s knees and hips to bend and move freely. If your baby is facing out in the carrier, it’s more difficult to bend the hips above their knees, which means their legs stretch out and dangle. This is why when wearing a carrier or sling, the M-Position is more desirable for ‘healthy hips’ in the first 6 months than baby facing out.
The International Hip Dysplasia Institute (IDHI) has a great resource on their website, where they have listed products that are ‘hip-safe’ such as baby carriers and sleepsuits****.
In summary, those first 6 months are very important for your baby’s hip development. Using baby carriers and slings, with your baby’s legs in the ‘M-position’, as well as swaddling and using sleepsuits that allow for leg movement, particularly bending of the hips and knees.
**According to the International Hip Dysplasia Institute, 1 in 10 babies are born with some degree of hip ‘instability’, which means the 2 bones in the joint don’t align exactly as they should. However, the vast majority of these babies do not need treatment and often goes undetected.
***According to the International Hip Dysplasia Institute, the leading cause for hip arthritis under the age of 50 is undiagnosed hip dysplasia from childhood.
******this is not medical advice. If you’re concerned about your child’s health and/or development, please see a healthcare professional.
References:
- Cho, S., & Kim, C. (2019). Ergonomic Differences between Baby Carriers by Certain Wearing Positions. Journal of International Academy of Physical Therapy Research, 10(2), 1774-1778.
- Frost, H. M. (2004). A 2003 update of bone physiology and Wolff’s Law for clinicians. The Angle Orthodontist, 74(1), 3-15.
- Clarke, N. M. P. (2014). Swaddling and hip dysplasia: an orthopaedic perspective. Archives of disease in childhood, 99(1), 5-6.
- Price, C. T (2008). Infant Carrier Design Considerations Criteria for “Hip-Healthy” Designation. International Hip Dysplasia Institute.
- Fettweis, E. (2010). Carrying babies or toddlers in baby carriers or shawls. Orthopädische Praxis, 46(2), 93-98.
