Backing new babies promotes healthy hip development

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ACROSS Africa, women can be seen carrying sleeping or sometimes giggling babies on their backs, swathed in cloth. The babies move to the sway of their mothers’ hips, synchronised throughout the day, bending with them as they carry out their house chores or carry out their trade.

When it is time for feeding, the food is right there as a mother shifts her child to the front of her body, nestling the infant to her breast. Quite often, there is the physical need to be in close contact with the mothers and this need is also met.

Certainly, every woman’s preference can be influenced by cultural norms, age of the baby, fashion and convenience. But positioning the newborn baby’s lower body to make an “M,” the thighs are fully supported and they’re in a squatting position facing the body promotes healthy hip development. It can decrease the risk of developmental dysplasia of the hip.

Developmental dysplasia of the hip (DDH) affects the hip joint in babies and young children. It is a condition when the ball of a baby’s hip doesn’t sit properly in the hip socket. This means the hip is unstable.

Usually, only one hip is affected, most commonly the left hip. But sometimes both hips are affected. It can happen at birth or develop in the weeks or months after birth. Also, it can vary from mild to severe. But it isn’t painful for babies.

Experts say that approximately one in 10 infants is born with loose hip ligaments from stretching during the birth process. Keeping their hips in a natural position is the best way to correct this issue, especially in the first few months of life when their ligaments are recovering.

DrAjibolaOladiran, a consultant orthopaedic and trauma surgeon at the University College Hospital (UCH), Ibadan, said that incidence of developmental dysplasia of the hip is low in countries that back their babies.

“The reason why we are not finding many cases of developmental dysplasia of the hip is because the position of the leg when the baby is on their mothers’ back is the same that they put a child who is being treated for developmental dysplasia of the hip.

“So backing the child inadvertently treats dysplasia of the hip in babies who had it that were not diagnosed. They were being treated without any diagnosis made.

“I remembered somebody into competitive football who presented at about 22 or 23 with pain in his hip. The X-ray found that he had an incomplete dislocation of the hips at the age of 23. The conclusion was that he probably had developed dysplasia of the hip.

“But being carried on the back corrected it up to a significant extent and it was only manifesting now at 23 because he was putting pressure on the hip because he was into competitive football. So, backing a baby has its good side and we actually encourage mothers to carry their babies on their backs.”

He declared that incidence of developmental dysplasia of the hip is also lower in communities where babies that are backed compared with those that carry their babies on their chest or use baby carriers like the Eskimos that strap their babies straight to the chest.

For instance, in Malawi, no infant presented with, or underwent surgical intervention, for symptomatic DDH over a 10 year period in a review of the diagnosis and management of all infants seen at the Beit CURE International Hospital, Malawi and its mobile clinics, from November 2002 to September 2012.

The systematic review of the role of back-carrying as a potential influence of prevalence of symptomatic DDH in this population group had included a total of 40,683 children aged less than 16 years were managed at our institute over a 10-year period, of which 9842 children underwent surgery.

The researchers, in fact, declared back-carrying a public health initiative that should be promoted to prevent developmental dysplasia and its sequelae. It was in the Journal of Pediatric Orthopaedics.

However, they stated that there is established evidence indicating that swaddling, the opposite position to back-carrying, causes an increase in the incidence of DDH.

DrOladiran, however, stated that mothers should ensure the neck of a new baby that is backed is well supported because they lack neck control.

A newborn baby should be able to open his hips fully; if the hip is stiff, then something is wrong. Also, a baby or young child with developmental dysplasia of the hip (DDH), might have one of the legs looking shorter than the other; the baby’s legs are tight when trying to open them to change the baby’s nappy and might be limping when they start walking.

The International Hip Dysplasia Institute says that there is ample evidence showing that holding a baby’s legs together for long periods of time during early infancy can cause hip dysplasia or even lead to hip dislocations.

But if children with hip dysplasia are not treated in infancy and early childhood, such children can develop a limp and a serious case of arthritis as adults.

In the end, backing babies is both culturally appropriate and a beneficial choice for both infants and parents. In fact, carrying the baby on the chest or back has been shown to increase the health and happiness of babies, among other positives.

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