The Pavlik Harness - what you need to know

A Guide to the Pavlik Harness

The following film is not intended to encourage parents to interfere with their child’s Pavlik Harness. The received advice is that a Pavlik Harness MUST ONLY be applied or removed by a specialist.
The purpose of this film is to assist in the training of healthcare professionals, and to familiarise and reassure parents whose children are affected by Hip Dysplasia.

Hip Dysplasia is a condition that is often treatable and most children treated have no long term problems. The definition of the condition is when the ball and socket of one or both hips does not fit snugly together.
The severity of the condition varies from the hip joint being underdeveloped, to the ball being somewhat loose in the socket, to having the ball fully dislocated from the socket.

How long a baby will have to wear a Pavlik harness depends upon how severe the hip dysplasia may be. Usually the wear time will be between six to twelve weeks and sometimes a little longer. The Harness is normally worn for twenty-four hours a day, every day.

A Pavlik harness is composed of a light and soft fabric; and has a chest strap, two shoulder straps and four leg straps. If your harness looks slightly different form the one show, please don’t worry, harnesses do vary.

This video shows the correct application of the harness. The harness is opened and laid flat. The baby is placed on top of the harness. The chest band is fastened across the nipple line just below the shoulders.
Next the shoulder straps are fastened so that 2 to 4 fingers width can be placed between the chest band and the baby’s armpit. This is for their comfort.

Then the baby’s legs are placed into the bootees on each side. The front leg straps are adjusted to allow 90 degrees of hip flexion. The back leg straps are fastened so that they cannot be brought completely together in the middle. The positioning of your baby in the harness is an open frog position.

The shoulder and the leg straps will be marked or taped to denote the position they need to be in.
Note that clothing worn should not constrain the baby’s legs or make it difficult to access nappies. If using trousers then they need to be extra large or if for baby grow, then get one the next size up.

To remove the harness undo the chest strap, then each shoulder, then undo the leg straps at the lower leg and foot.
Do not remove the Pavlik Harness to change a nappy. Instead, lift up the baby’s bottom by placing you hand underneath it so you can remove the nappy. Do not use the child’s legs to pull up. If the nappy is dirty you may want to cover the legs with a sock to keep the harness straps clean. In addition, a vest can be worn underneath the harness

When taking the vest off, lie the baby down and loosen the chest band. Then, undo one of the shoulder straps, and take the baby’s arm out of the vest. Take the vest over the baby’s head, and re fasten the first strap. Undo the second strap, and then take the left arm out of the vest. Remove the vest, and then re fasten the second shoulder strap.
Keep the skin clean and dry. Talcum powder is not recommended as it can clog.

Breast feeding can be achieved in the regular position as can winding.
Parents wishing to swaddle their baby, must be careful to do so in the correct way allowing enough room for their legs to move freely. The baby’s hips should remain up and out in a frog position.

For further information about Hip Display and care, please see the Steps developmental hip dysplasia parents guide book, the Steps and International Hip Dysplasia Website.