As a parent, you want to do everything right for your baby. To that end, you may have followed the recommendations from the American Academy of Pediatrics (AAP) to engage in “babywearing,” a practice in which you frequently carry your baby with you in a wrap or device that leaves your hands and arms free.

Babywearing, according to the AAP, helps prevent crying, promotes parent-infant attachment, and encourages baby’s healthy development. Recently, however, there has been concern that carrying baby frequently in the wrong type of product could increase the risk of hip dysplasia, a condition in which the hip joint is improperly formed and may easily dislocate.

Baby carriers made by Graco, Evenflo, Chicco, Infantino, Baby Bjorn, and others may not be designed in a way that promotes healthy joint development in babies. Many parents using these products are unaware of the potential risks, as the manufacturers have allegedly not provided adequate warnings on the products or their advertising materials.

Chaffin Luhana is currently investigating cases in which babies frequently carried in potentially defective baby carriers developed developmental hip dysplasia (DDH).  

What Is Babywearing?

Babywearing seems like a fairly new trend in the Western world, but it has been around for thousands of years. It is simply the practice of wearing or carrying a baby close to one’s body in a sling or other form of carrier.

Nomadic tribes were known for carrying their babies next to them while they worked in the fields or villages, as moms had to have a way to tend to their babies while still making sure the tribe had food and clothing. Baby carriers in those days were initially made of animal skins, and later from pieces of cloth tied close to the adult.

As humans learned more about making fabrics, carriers became more elaborate, but they were always made for one purpose—to keep baby close to mom while she went about her daily activities. Over the centuries, babywearing went out of fashion in the industrialized world, but it remained common practice in some countries.

In the late 1960s, an American woman working for the Peace Corps in West Africa noticed that African women carried their babies on their backs. Intrigued by the idea, she invented the Snugli baby carrier. Other similar inventions followed, and in the 1980s, a man in Hawaii invented the “ring sling” for his wife and later sold his idea to Dr. William Sears in the U.S.

Dr. Sears, a pediatrician, had coined the phrase “attachment parenting” about that time to describe his philosophy of “immersive mothering.” Building on the work of pediatrician Benjamin Spock and others, he wrote and published a book called The Baby Book that served as the “attachment parenting bible.” In it, he advised parents to follow seven practices meant to keep them in tune with their babies’ needs—one of which was babywearing.

The thinking goes that when carrying a baby so close, a parent gets to know the baby better and becomes more sensitive to his or her needs. The baby cries and fusses less, and can spend more time in an alert state while learning about the surrounding environment.

“Babywearing is a great way to continue to bond with your baby,” Dr. Sears’ website states. “By carrying your baby in a wrap or sling, you are able to hear every sound. Babies that are carried in this manner tend to nurse more which also helps maintain mom’s milk supply.”

The site goes on to note that babywearing soothes a baby since the parent’s heartbeat and body warmth are so close. It also allows the baby to have more interaction with the parent and the surrounding environment, potentially encouraging faster cognitive development.

The AAP agrees, stating that holding baby close helps her feel safe, cry less often, improve parent-infant attachment, and “enhance her learning.”

What Are Baby Carriers?

Baby carriers are products parents use to carry their babies close. There is a wide variety of them available, but in general, they come in five types:

1. Baby Carrier: Also called a wrap-and-buckle carrier or a soft-structured carrier, this is a padded carrier that the parent wears on the front of the body, though some have adjustments so they can be adapted for back or hip carrying as well. It usually has padded shoulder straps and a padded waistband, buckled straps, and soft fabric that creates a pouch for the baby. It’s most often used for babies 4-5 months old and older.
2. Wrap: This is fashioned after the traditional baby carriers used in other cultures, and is simply made of a long piece of fabric the parent wraps around her own body and the baby. By tying the ends, she creates a snug place for baby to rest. It’s typically used for younger babies and can be positioned in a variety of places on the parent’s body, including the front, hip, or back.
3. Sling: This is a pouch or strip of fabric typically secured over the shoulder and worn across the front of the body, attaching to the opposite hip. It often comes with two rings at one end that allow for easier tying. Otherwise, it is similar to the wrap and is usually made with woven fabric. It’s most suitable for newborns.
4. Hybrid: Often called the Meh Dai or Mei Tai carrier, this option combines features of the wrap and baby carrier. It looks similar to the baby carrier but has two long pieces of fabric meant to be tied around the parent’s body. It also has two shoulder straps and two waist straps. It can be worn on the front, back, or hip, and is suitable for infants 6 months and older.
5. Backpack: This usually has the rigid frames of a typical backpack, and is meant to be worn only on the back. It’s mostly designed for older babies and toddlers that can sit unassisted and have good neck control, and is suitable for long periods of babywearing.

Parents usually choose a baby carrier based mainly on personal preference, but due to recent concerns, it’s now advised that parents be more cautious about the products they purchase, as some may increase the risk of DHD.

What is Developmental Hip Dysplasia?

Developmental dysplasia of the hip (DDH) is a condition where the ball and socket joint of the hip doesn’t properly form in babies and young children. Also called congenital hip dislocation, hip dysplasia, or “clicky hips,” it can increase the risk of hip dislocation and if not treated early, may lead to pain with walking and hip arthritis at a young age.

It helps to remember that the hips are ball-and-socket joints that allow movement and provide stability to the body. The ball part of the joint is the round bony part at the top of the thighbone, and it fits inside the socket part, which is inside the pelvis.

About one or two babies in every 1,000 will be born with DDH. Typically, the socket of the hip is too shallow for the ball, so the ball doesn’t fit tightly in place. Instead, it sits loosely inside the socket and can easily come out of it—which causes dislocation.

Early signs and symptoms of hip dysplasia include:

• Legs of a different length
• One turned-out foot
• The hips make a popping or clicking sound
• One hip or leg doesn’t move the same as the other side
• Skin folds under the buttocks or on the thighs don’t line up
• The space between the legs may look wider than normal
• The child has a limp when starting to walk

Early diagnosis and treatment can help restore normal hip function by correcting the position or structure of the joint.

Why DDH develops in some babies is unknown, but doctors believe the following factors can increase a child’s risk:

• A family history of DDH
• Gender—girls are two to four times more likely to have DHD
• First-born babies—a new mom’s uterus may be tight, increasing risk
• Breech position during pregnancy—babies whose bottoms are below their heads during pregnancy often end up with one or both legs extended rather than folded in the typical fetal position, which can prevent the hip joint from developing properly
• Tight swaddling—wrapping a baby’s legs in a straight position, particularly when they are very young, may interfere with normal hip joint development

It is this last risk factor that may come into play when it comes to using baby carriers.

What Increases the Risk of Hip Dysplasia?

During the first few months after birth, the bones and joints are still flexible and moldable and may respond negatively to long periods in a baby carrier. According to the International Hip Dysplasia Institute (IHDI), baby carriers used for short-term purposes are unlikely to have any effect on normal hip development. Those used long-term, however, such as for babywearing purposes, may cause damage:

“[T]here is evidence that carrying a baby on the mother’s body (or father’s body) is likely to influence hip development during the first six months of life when the baby is carried for many hours each day for purposes of bonding, or infant care.”

The institute explains that after birth, it takes several months for the joints to stretch out naturally. During the first few months of life, the ball part of the joint may already be loose in the socket because of stretching during birth. The socket has soft cartilage as well, which may be easily deformed. Bones are still developing, with some infants being born with softer bones and joints than others. In fact, the joints are typically so soft and pliable at this age that if the hip dislocates, it’s rarely painful to the infant and can go unnoticed.

By the age of six months, the hips are more developed, the cartilage is firmer, and the ligaments are stronger, so hip dysplasia is less likely. But during the first few months, the risks of dysplasia or dislocation are greatest.

The healthiest position for newborns and young infants is one that allows the hips to fall or spread naturally apart to the side, with the thighs supported and the hips and knees bent. Babies often naturally move into this position when held with one arm against a parent’s side. You can also imagine this position as resembling that of a frog. 

The worst or unhealthiest position for young infants is one that holds the legs straight and extended with the hips and knees stretched out and the legs together. The risk is greatest when this position is sustained for long periods, such as what may occur in some types of baby carriers.

How Baby Carriers May Increase the Risk of Hip Dysplasia

Some baby carriers, slings, and wraps may interfere with healthy hip positioning, but most of these products have no warnings alerting parents to the risk.

Any carrier that holds the hips in an unhealthy position (legs straight and together) should be considered a potential risk for abnormal hip development, according to the IHDI. Improper swaddling, when the baby’s legs are stretched out and kept together, has also been established as a risk factor for DDH—one that presents an even greater risk than family history of the condition or breech birth.

The size of the carrier, too, can be problematic if it doesn’t provide enough space for healthy positioning.

In general, a good baby carrier should allow:

• Wide-leg position
• Proper support for the hips
• Support for the natural curve in the back
• Support to keep the knees higher or level with the bottom (no dangling)
• A wide base of support under the thighs
• Baby’s lower legs to move freely

Unfortunately, all products don’t easily allow for healthy positioning. Slings, for example, which often keep baby’s legs inside, can hinder healthy hip development as the legs often end up straight and extended. Wraps and hybrid carriers can easily do the same, keeping the legs trapped together rather than allowing them to separate as they should.

When using these products, parents should wrap baby in such a way that the legs are left out and can bend, with the wrap supporting the bottom and thighs. Manufacturers rarely if ever warn about this.

Baby carriers can cause similar problems, particularly if they don’t have the proper support under the baby’s bottom. If the parent carries the baby on the front of the body and the carrier is not properly supportive, the baby’s legs may end up “dangling,” or extended downward in an unhealthy position—they will look straight. This not only stretches the hip but drags on it, as gravity pulls down on that joints, stressing them and increasing the risk they may dislocate. 

In a proper carrier, there is adequate support under the upper legs so that baby can naturally hold his legs in a bent position, with the knees framing the parent’s body.

Some doctors have warned about specific carriers that can encourage the extended-leg position. Erika Krumbeck, N.D. and founder of Naturopathic Pediatricians.com, stated that she didn’t like the Baby Bjorn because it “makes the legs dangle, putting excessive force on the hip joint.” She notes that there are safer carriers available. 

“The carrier should hold the legs outward,” she states, “with support on the entire length of the thigh all the way to the knee joint.”

The best baby carriers for proper hip development are those that support the baby’s legs in such a way that the baby is sitting in the “frog” or “spread-squat” position, with the legs apart and knees pulled up a little higher than the hip joints. When viewing the baby from behind, parents can also visualize an “M” shape, with the point at the buttocks, the tops of the M at the knees, and the straight lines extending from the knees down to the feet.

Types of Injuries Associated with Defective Baby Carriers

Improperly designed baby carriers may cause the following injuries:

• Developmental dysplasia of the hip
• Hip dislocation
• Loose hips
• Trouble walking
• A limp when walking
• Arthritis early in life

Baby Carrier Hip Dysplasia Lawsuits

Parents who carried their babies in baby carriers who later had children diagnosed with developmental hip dysplasia may be eligible to file a baby carrier hip dysplasia lawsuit to recover damages. Chaffin Luhana is now investigating these cases and invites you to call today at 888-480-1123.