Pavlik Harness for Developmental Dysplasia of the Hip (DDH)

A Pavlik harness is a soft brace that is used to treat infants 6 months old or younger with hip dysplasia. The harness holds the ball of the joint in its socket. By placing the ball and socket in the right position, both the ball and socket can develop more normally and achieve stability in the process. The brace is typically worn 23-24 hours a day for 2-3 months followed by 6-8 weeks of night-time wear only.

A Pavlik harness has straps that are fastened around the baby’s shoulder, chest and legs. This holds the hips and knees in a flexed position with the legs apart, which is the best position for the hip joint to develop normally. It allows contact between the thigh and hip bones and helps rebalance the muscles and ligaments of the hip while it is developing.

Your baby may cry a little or seem unsettled for the first couple of days after the harness is first fitted. This is normal, and your baby will adjust to this new position within a couple of days.

Your doctor will arrange regular appointments to monitor the progress of your baby’s growth, repeat ultrasounds to ensure that the harness is working properly and adjust the harness as required.

How to Put the Harness On

1. Open all the straps and lay your baby on the harness with the chest strap across the chest. Fasten the chest strap. The top of this strap should be at the nipple line. You should be able to fit 2 of your fingers underneath it when it is fastened. This will ensure your baby can breathe properly in the harness.
2. Fasten the shoulder straps to the chest strap. You should be able to fit 1 of your fingers underneath the shoulder straps when they are fastened.
3. Place your baby’s legs into the leg portion of the harness so that the his/her feet are in the foot straps. Secure the leg straps snugly, but not too tightly.
4. Finally, thread the flexion (front) and abduction (back) straps through the leg portion of the harness and secure them. If these are tightened appropriately, your baby’s hips will be flexed no more than 100 degrees, and your baby’s knees will be just able to almost touch if you push them toward each other. Your child’s doctor and orthotist will mark the straps at each visit so that you will not have to guess how tight or loose these should be.

At-Home Care

Monitoring Motion

It is important to monitor your child’s ability to kick his/her knees straight. The flexed position of the hips can cause irritation to the nerve that extends the knees. If your child is not straightening his/her knees when you stimulate his/her feet, this may be a sign of nerve irritation. The harness should be removed, and your child’s physician should be called.

Diapering

Your baby can wear a diaper under the harness. Do NOT double diaper. During diaper changes, keep your baby’s knees apart as much as possible.

Dressing

You can place a onesie underneath the harness, but all other clothing should be worn over the harness. Make sure clothes are loose enough so they do not put pressure on the straps.

Bathing

Typically, you can remove the harness for up to one hour TOTAL a day. You can give your baby a bath during that time. If your child’s doctor prescribes 24-hour a day wear, you will need to sponge bath your baby. Try to keep the harness as dry as possible.

Feeding

You may feed your baby as you would normally.

Holding

Support your baby with your hand between their legs, allowing their legs to remain in a wide position.

Breastfeeding

You may breastfeed as you would normally; however, when positioning your baby to feed, please keep the legs wide and apart.

Sleeping 

Your baby should sleep on their back, as is the recommendation for all babies.

Playing and Moving

During play time, stretch and move your baby’s legs within the confines of the harness. It is good exercise and helps with digestion and your baby’s mood. When your baby is ready, encourage tummy time if your doctor says it is okay to do so. This is very helpful, as it forces the hips into a wide position.

Cleaning the Harness

If your baby must wear the harness 24 hours a day, you can spot clean it with a damp cloth and mild detergent. If your baby is allowed 1 hour per day out of the harness, hand wash it in cold water and a mild detergent, but only if it is dirty. Do not put the harness in the dryer as it may shrink.

Using Car Seats

Adjust the straps of the car seat to accommodate your baby’s position in the harness. Limit drives to less than 1 hour. For longer drives, give your baby a 10- to 15-minute break out of the car seat. This will help to remove any tension in the straps.

Follow up

You’ll need to go to regular doctor appointments so that your child’s doctor can monitor the progress of your baby’s growth and adjust the harness as needed. While in the harness, ultrasounds will be obtained every 2 weeks up until age 6 months to monitor the hips’ progress. At age 6 months, X-rays are recommended. Your child will be followed every 1-2 years until they are skeletally mature (age 14-16 years old) to ensure the continued maintenance of healthy hips during childhood.

Being in the harness may slow the rate of development of your baby’s motor skills. Don’t worry. This is a short-term problem, and your baby will catch up. For the next 4 to 6 months avoid baby walkers or baby bouncers since they can strain the hip joint.

See more information

Hip Disorders 

Marfan Syndrome 

Orthopedic Rehabilitation