Which Baby Carrier is Best for Preventing Hip Dysplasia?

Developmental dysplasia of the hip (DDH) is a medical condition that affects babies and children whose hips don’t form as they should. It’s most often present at birth, but it can also develop within the first few months of life.

With the increasing popularity of “babywearing,” there is now some evidence that extensive time spent in some types of baby carriers may increase the risk of DDH.

When Baby Carriers May Increase Risk of Hip Dysplasia

The hip joint is made up of a ball and socket, with the ball portion at the top of the thighbone fitting into the socket in the pelvis. In a child with DDH, something goes wrong. Either the socket is misshapen or the ball is malformed so that it easily comes out of the socket, causing hip dislocation. Without treatment, DDH can lead to a limp when walking, legs of different lengths, and early-age arthritis.

The International Hip Dysplasia Institute (IHDI) recently released a statement on baby carriers, suggesting that in certain instances, they may negatively affect normal hip development: “Some types of baby carriers and other equipment may interfere with healthy hip positioning. Such devices include but are not limited to baby carriers, slings and wraps. These devices could inadvertently place hips in an unhealthy position, especially when used for extended periods of time.”

When a baby is first born, her bones and joints are still soft and pliable. They continue to develop and harden during the first several months of life and can be easily damaged if the child is placed in an unhealthy position for extended lengths of time.

The unhealthiest position for a baby’s hips is one in which the legs are straight and together. When the baby is growing in the womb, he is normally in a fetal position, with the knees drawn up toward the belly. Some wraps, slings, and carriers, however, if used incorrectly, can trap a baby’s legs in a straight position. If held there for hours at a time, this position can put undue force on the hip joints, potentially damaging them.

Baby carriers that carry baby on the front of the parent’s body, too, can cause problems if they are designed without adequate support. When looking at the baby, if you see the legs pointed straight down, that indicates the carrier doesn’t provide enough support under the thighs.

“If the hips are forced into a straight stretched-out position too early,” the IHDI says, “then the ball may deform the edges of the socket or slip off the socket altogether (hip dislocation).” Such dislocation is surprisingly painless for most infants because their cartilage and bones are still so flexible, so it can go unnoticed.

How to Find a Safe Baby Carrier

The healthiest position for a baby is one that allows the knees to be level or higher than the bottom and splayed out naturally to the sides. This position has been called the spread-squat position or the “frog” position and promotes free movement of the hips without forcing them together or allowing gravity to pull the legs down.

“Any device that restrains a baby’s legs in an unhealthy position should be considered a potential risk for abnormal hip development,” the IHDI notes, advising parents to carefully research the products they’re considering before purchasing them. “Swaddle type” slings and wraps, for instance, are more likely to increase the risk of DDH because they encourage carrying a baby with the hips and legs together. Narrow-based baby carriers, too, can force hips and legs to be too close together.

The best baby carrier will have the following:

• A wide, adjustable seat that provides adequate support to the bottom and thighs.
• The ability to position baby in the healthy “frog” position, with knees bent and legs apart.
• An open space for the baby’s lower legs so they can be free to move.
• Padded leg holes (where applicable) that are loose enough not to constrict baby’s thighs, but still provide support to the thighs so the legs remain bent.