Below is a guide to familiarize families with caring for children in the Pavlik harness. Please call the Division of Orthopaedic Surgery at 312.227.6190 with any questions you may have.
Frequently Asked Questions About Pavlik Harness
Hip dysplasia includes a broad range of developmental hip problems sometimes found in infants and children. Your child may have been given the following diagnosis by his/her physician:
- Congenital hip dislocation
- Congenital dislocatable hip
- Congenital subluxatable hip
- Acetabular dysplasia
- Developmental dysplasia of the hip
Physicians are very careful about checking for hip dysplasia at birth. When hip dysplasia is found, treatment is recommended to prevent long-term consequences.
The harness uses your child’s normal active hip movement to direct the ball of the hip into the hip socket and promote the development of the socket. The goal of this treatment is to keep the natural position of bending and movement of the hips. We believe this is the best position for hip development.
Your physician has made the necessary adjustments to the shoulder and leg straps to hold the hips in the best position for proper hip development. You should not make any adjustments to the harness without first checking with your physician. Markings are placed on the straps so that you can adjust the straps if they come off or you are told to take them off. Your physician may adjust the straps during treatment as your baby grows.
Your baby needs to wear the harness at all times unless your physician directs otherwise. The harness is not to be removed for any reason other than in an emergency or with physician instructions. Your baby will need regular clinical evaluations with your physician, which include hip ultrasounds and/or X-rays to determine hip development.
When the hip is stable and the hip socket has properly formed, your physician will begin to reduce how often your baby wears the harness (also called weaning). You will be given a schedule of the weaning process at that time. Most infants need to be in the harness for about 6–12 weeks. The length of treatment and the number of hours per day that your baby needs to be in the harness is specific to his/her needs and is determined by your physician.
Active movement of the hip joint is most important. Your baby should be able to extend both legs at the knees while in the harness. If you notice that your baby is not able to extend one or both legs, please contact your physician. Improper or lack of movement of the legs while in the harness can cause nerve damage. Harness wear may need to stop and then restart when the nerve function has been recovered. When your baby is awake, position him/her to encourage kicking activity. Do not position your baby on his/her side. Your nurse will show you safe ways to position and carry your baby.
It is important to remember:
- Mothers who are nursing can find a comfortable position for themselves and their baby. Your baby can be propped sideways with the help of pillows to keep the hips moved away from the body
- Tummy time is acceptable
- Babies may be carried in a baby carrier (e.g., BabyBjörn®) while wearing the harness
- Bundling and swaddling of the lower extremities are not allowed. The legs should be free
- Do not place tight-fitting clothes on your baby that could restrict the straps
- Do not sit your baby in infant seats, swings or jumpers unless your physician says it is okay to do so
- When riding in the car, your baby must be safely belted in a car seat
Sponge bathe your baby instead of giving a tub bath while wearing the harness. Bathe under the chest and shoulder straps carefully. If your physician allows you to take off the harness to give a bath, remember where the markings are on each strap when putting the harness back on to ensure the correct position of the harness. A good way to tell if the chest strap is positioned correctly is if your fingers can snuggly fit under the strap. You do not want the chest strap too tight or too loose.
Lotion may be used on all skin areas. Do not use ointments or powders unless they are ordered by your physician. Contact your physician or nurse if your baby develops a skin rash. Skin areas that need special care are the creases at the neck, in the diaper area and behind the knees. Look at these areas daily and keep them clean and dry.
Use a bib or cloth under your baby’s chin to keep milk from getting the shoulder straps wet. Washing the harness can be done by hand using a gentle detergent. The harness can air dry or be placed in the dryer by itself on air dry with no heat.
All clothing should be worn over the Pavlik harness. The only exception is if your physician allows you to put on a t-shirt or onesie under the harness. It is important to remember:
- Harness straps are always outside the diaper. If you use cloth diapers, use a plastic protector with side openings. Lift your baby from the buttock, not by the feet, when changing a diaper.
- Pants are not to be worn. Pants pull the front and back straps together, which moves the hips away from the best position for development.
- Large toddler-size socks may be put on over the boots to protect the harness from urine and stool during diaper changes and to provide warmth.
- Blanket sleepers or gowns are recommended for outerwear during cold weather.