Both my babies have been breech for most of my pregnancies, flipping head down at the last possible moment, tiny stubborn little creatures! But it wasn’t until Lou, my second baby, was four months old, that I learned how common it is for breech babies to have hip issues. No one told me that I should get a hip ultrasound shortly after birth, as breech babies can have dislocated hips, requiring bracing, casting, and occasionally even surgery.
At four-months-old, we noticed that Lou’s little leg rolls didn’t line up. It was the first 100 degree day of the year, and she was laying on her mat in just a diaper. At first I thought it was the position she was in, but upon investigation realized she had one bigger roll on her left leg and one smaller roll on her right. If I stretched her legs out the lines did not match up. I thought it was a cute quirk, but a little Dr. Google let me know that it can mean her legs are different sizes or she has a hip out of place, especially if baby had been breech.
Moments after coaxing her out of a “W” sit position! (Photo by Charming Photography)
I am generally a worrier. But in this case, I wasn’t too worried. Her legs seemed to be the same length to me, and she was meeting milestones on time and early. I read that leg rolls not matching up leads to bracing in about 25% of the babies it happens in. Then at her four month appointment, I mentioned it to her doctor. He flipped her over, studied her legs, and booked us for an ultrasound that same day. Seeing her pediatrician take action so quickly had me suddenly worried! He was concerned because Lou was already past the age that she should have been to get bracing, and we were days away from summer in the desert, which means 110 degree days for 4 or 5 months. Not the best for wearing a brace or half body cast.
The ultrasound of her hips was quick and painless. The tech told me she sees 3 or 4 babies per day for the same procedure. The agonizing part was waiting to hear back! A few days later our pediatrician called to tell us that to his not-as-trained eye, Lou’s hips looked typical. However, he still wanted us to see an orthopedic specialist to be sure she didn’t have any leg size discrepancies. The ortho used some special tools to measure her legs, felt her hips, and declared her to have all around healthy hips, but to come back if she wasn’t walking by 18 months.
The ortho did mention that we needed to keep her legs out of the dreaded “W” sitting position, which, unfortunately is her favorite way to sit. If given the chance, she will sit and play in this position for quite some time. When I see it, I gently tell Lou to “look at her feet,” and I give her leg a little tap. If that doesn’t work, I will reposition her legs for her. The “W” position isn’t always bad, but since she could be more prone to hip or leg issues, it’s better for her development if we stop it when we see it!
As Lou has gotten older and started walking, it does seem like the leg creases are more aligned. She also isn’t a super chunky baby, so almost all of her rolls are gone. Like my first born, this baby hates shoes, socks, or anything on her feet, but unlike Ace, she has started walking at a fairly early age. Her pediatrician thinks her legs and hips are still looking perfect, and I am hoping things continue down that path. Ace, on the other hand, is now four years old, and about to start physical therapy for some walking issues and leg pain. I can’t help but wonder if it is all related to his breech position during pregnancy. We have a few appointments coming up next month and I am eager to learn more. He never had the imaging or assessments that Lou had, so there could still be an underlying hip issue.
If you had a breech baby, did you do any testing after birth to look for hip issues?
wonderful kiwi / 23653 posts
I actually had no clue that hip issues are related to being in breech position!
guest
You totally schooled me! I didn’t know about breech and hip issues… but yes, my babe has some minor hip issues with the w sitting, too. I chalked it up to his plagiocephy.
blogger / apricot / 275 posts
hmm yeah so interesting
apricot / 430 posts
It drives me crazy that these things still go unchecked! Good for you for noticing on your own!
It’s also much more common in girls.
I was diagnosed with hip dysplasia at birth and had a brace from birth to ~3 months. My mom flat-out refused to take me home from the hospital until I was checked. I don’t think I was breech. I had both hips re-checked when I was about 12 and they were nearly 100% corrected.
My mom had severe hip dysplasia that wasn’t diagnosed until she started walking and was then put into a body cast (and my grandmother had just given birth to twins)!
She had life-long arthritis and her first hip replacement at 40 and her second at 50. She was told never to ski or get on a horse. While she has no pain now, she has permanent muscle memory from the arthritis and her mobility was impacted throughout my childhood.
I’ve been able to lead a very active lifestyle, no restrictions (including skiing).
When DS was born, (not breech, but I wasn’t taking any chances) I had him checked by every pediatrician who saw him in the hospital! He also had an ultrasound shortly after birth, but was cleared.
olive / 50 posts
its protocol to do an ultrasound on breech babies, especially girls. My first daughter was breech. Her physical exam was completely normal to both ped and ortho, but her ultrasound showed moderate hip dysplasia. She was in a harness from age 6wks to 4.5months. My second daughter was breech until 32ish weeks. Ortho said she needed an ultrasound. We had to get several ultrasounds since she was ‘borderline’ of needing treatment, but fortunately, she did not end up needing the harness.
pear / 1547 posts
Yes babies that were breech should have a hip ultrasound at 4-6 weeks old. I think that sometimes the babies that were breech and then flipped last minute sometimes slip through the cracks because it’s not something that you think to ask about! But also part of the well baby exam is checking for hip instability each visit until walking. Good for you for advocating. Glad all is well!