The Pavlik Harness

Part 3 of Our DDH Journey

In this post, I have described a sensitive personal experience and emotional ups and downs we experienced when my son was diagnosed with DDH.

We thank all the doctors and express our gratitude toward the creator for helping us toward a full recovery through a prompt detection and initiation of appropriate treatment. We thank them for all the support and strength they gave us.

I shared a love-hate relationship with the Pavlik Harness. How it pained to look at my baby, all tied up in the stiff harness! I always felt that the harness created a distance between me and my baby. When I held him to comfort him, I could not touch his skin; he was no longer a wobbly little newborn; when I wanted to burp him, I could at best rub the harness, not the baby really. Yet the rational part of my brain knew that it is a great solution that will let the hip develop naturally, without any medication or surgery!

What does a harness look like?

We had a harness by Trulife. It is a 4-piece set of velcro straps that start at the shoulders, go around the chest and back, extend to the thighs and finally wrap at the legs, placing the foot in a loop. The harness is always put on for both hips, even for unilateral DDH. The material is quite soft especially where it touches the tender skin of the baby.
The harness was applied by the doctor to place his legs in a frog-like position. He also made marks on the harness, indicating the lengths of the adjustments, in case they slipped out of place.
It meant that the baby could no longer stretch his legs fully. The harness was supposed to be kept on 24*7 until the ultrasounds showed normal hips....which also meant no baths L (I was eagerly looking forward to giving him oil massage and bathe him myself, right from the first month)

There were many everyday life challenges, learnings, adaptations and adjustments - some petty some not so easy to deal with that we encountered. I am capturing a gist of those here, to help DDH-parents get an idea of handling those. If you have some other ideas / suggestions, please leave your comments.

#1

No marks for guessing, the very first learning for new parents was to “Accept and live with the harness”.

#2

Lift the baby with a firm support under the buttocks, never holding by thighs or legs even when burping. Holding him upright against shoulder was easier thanks to the firmness provided by the harness straps. It did get easier soon. Diapering is quite easy with knees flexed.

Feet kept slipping out of the loop. Place the foot back in the loop when noticed, be alert, else the harness will not work at its best.

#3: Sponge baths

There may hardly be any visible surface areas to be cleaned!
No massage, no baths! Must clean under belts where accessible, without damaging the harness and without affecting the lengths a bit. Powder to keep the harness from sticking to the skin owning to any moisture. Use a cotton ball to puff the baby powder under belts.


Keeping the skin in hip folds dry is a bit of a challenge, as it may not be exposed to air and moisture accumulates. We used moisturizer with a finger and wiped it clean with cotton before powdering. The powder was meant to absorb the moisture. Repeated twice or thrice a week.

Reflux!

#4

Bibs are not only for solid-food eaters. Pukers get them too! A folded (multi-folds) handkerchief tucked around the neck along the collar portion works better though. If not cared for, the shoulder velcro will harden by drying of absorbed milk and may hurt the skin.

#5

Sometimes the milk that was brought up went straight inside the chest band. We slipped folds of soft tissue paper inside the chest belt for a while to soak the milk and keep it as dry as possible. Eventually the insides of the belt did get a bit rough and black. Fortunately, it never affected the skin.

#6: Skin care with pavlik harness

Keep an eye on the skin under the harness. Peek! Most parts will be visible from under the harness. Watch out for any cuts, although very unlikely. (only once my son got tiny injury which healed on its own, behind the knees)

#7: Clothing

The boys can no longer wear pants. The girls still have skirts and pretty frocks as their options. Fortunately it was summer when the harness was applied. He was mostly in a cotton jhabla and nappy.

Mostly at nights and when it became cold in monsoons, the best clothing was a Onesie or a Sleepsuit. We had a few gifted by my aunt which were of thick and stretchable material.

#8: Keeping the harness clean

We were very careful about keeping the harness clean, not letting it get soiled. However, at the end of 4 weeks, the harness had started looking darker (it was all white when new). It was a bit late to realize.... if you want it to look cleaner most of the time, wash your hands (even if apparently clean) every time before touching the harness. Better yet, keep it covered with a onesie! Cleaning the harness is really not possible when on for 24*7

#9: Nappies

Yes, cotton nappies can be used (hooray!)! Switch to disposable nappies in case of any risk of soiling. You’d be lucky if you can predict the potty-days or timing. Use disposable ones around that time to protect the harness.

We initially shifted to disposable nappies exclusively when we figured that harness needs care too. Fortunately for us, the baby (since EBF) developed a pattern of bowel movements only once in 4 days (if not more), we could use a lot of cloth nappies (in the summer months) when we knew that those were not the days!

#10: The baby will grow

Ensure that the adjustments are re-done every 4 weeks. The baby will outgrow the adjustments and it is better to get them loosened. At all times, the belts should be loose and you should be able to slide one finger under the belts. Keep an eye under the armpits. The chest belt at no point should ride up in the armpits. (It is not advisable, but we had to loosen the chest and shoulder straps once, as they seemed tight, and we were not seeing the doctor for almost a month).

#11: Part time use

When we were allowed part time harness application, we started putting it over a t-shirt. That ensured that skin was protected. It is not possible to put pants on for the baby. Although one can choose to put the harness directly on the skin if desired, that will allow for any t-shirt changes when required.

I know, that’s quite a list! Let me also reassure that you need not stress over these things; we learnt with time. Basically, as parents, you need to be aware and alert.

Please share your experience with DDH. I would also be happy to respond to any of your queries.

A Decision to be Happy

Part 2 of Our DDH Journey

In this post, I have described a sensitive personal experience and emotional ups and downs we experienced when my son was diagnosed with DDH.

We thank all the doctors and express our gratitude toward the creator for helping us toward a full recovery through a prompt detection and initiation of appropriate treatment. We thank them for all the support and strength they gave us.

What was happening to us was completely unheard of - not just to us but to everyone we spoke to. And what is unknown is kind of SCARY!

DDH is extremely rare in Indians. It's occurrence is more likely in babies born in breech position, in girls and in those with family history.... none of which was applicable to our son. The only factor that was relevant, was our son being our first born child - apparently the uterus could not stretch to make enough room for fuller hip joint growth. Statistically our son stood minuscule probability of something like this happening. Then why did it happen to our son?

A feeling of being betrayed had already started creeping in. We arrived home with our lovely baby; my mother welcomed us with traditional custom of washing feet with milk. It was all supposed to be so special. We were supposed to be happy. But we were not..... we were miserable! We cried and we were scared.... most of all we were hurt.... things were supposed to be different.... things were supposed to be perfect! We wanted the DDH to be undone... somehow!

We were in pure denial. (Blinded by the DDH, we could not acknowledge that it indeed was a time to celebrate!)

I was exhausted from the whole childbirth experience and more from the emotional turmoil that we experienced in the past two days. Yet I did not want to sleep that night and the next... hoping that I could think and pray the whole time, wishing the DDH away.

Day 4, we had to take our son out for the specialized ultrasound to the other end of the city. Poor little baby!! He was supposed to be in the cozy nest and warm care of his family. (I also started self-pitying..... it was against the customary period of 1.25 months when the new mother and baby do not venture outside the house and receive specialized care and treatment, all that we had to forsake). The report showed a mild DDH in right hip and a significant DDH in the left one.

Day 5 the Pavlik harness arrives. It started making us less pathetic. We felt that things have started to move along. That evening we met the Ped Ortho again and got the harness applied. It did feel cruel to tie up a 4 day old baby in velcro straps. He resisted like any other child, he cried and screamed, but we had to! :( My better self had started taking over already, so it was easier to accept the situation (although I hated it from the bottom of my heart) and to focus on soothing our baby.

That evening, before we saw the doctor for harness application, we made a conscious decision to change our perspective. We forced ourselves to sideline the DDH and focus on the more important... the more precious... the arrival of our son. We decided to celebrate and not letting each other feel miserable anymore.

Read on for more on Our DDH Journey: Click here Part 3
Please share your experience with DDH. I would also be happy to respond to any of your queries.

What the clunk!

Part 1 of Our DDH Journey

In this post, I have described a sensitive personal experience and emotional ups and downs we experienced when my son was diagnosed with DDH. 

We thank all the doctors and express our gratitude toward the creator for helping us toward a full recovery through a prompt detection and initiation of appropriate treatment. We thank them for all the support and strength they gave us.

An incredibly beautiful baby was born to us on the due date, everything had gone well .... we thought to ourselves "What on earth have we done to deserve him!"

We were so ecstatic that I hardly thought that the "clunk" mentioned by the doctor who examined him would be anything to be worried about. The doctor said that he felt a click in my son's hips when he maneuvered his legs as a part of routine examination on day 1. He told us that it is nothing to worry about, unless it persisted.

The next day the clunk did persist. It meant that his hips "clicked" when moving. It was followed by an ultrasound on day 2 which showed that the left hip joint was underdeveloped and they were uncertain about the right hip.The condition is called Developmental Dysplasia of Hips (DDH) A pediatric ortho would soon take over the case for treatment. We felt devastated!

Dr. Jayant Sampath, the paediatric orthopedic, visited us on day 3 in the hospital just before our discharge. He said that a much detailed ultrasounds needs to be taken. He explained to us what DDH is all about and the expected course of treatment. Based on the diagnostics available, he ordered us to get something called as a "Pavlik Harness" from an orthotist in Delhi, immediately (It would arrive on Day 5). The doctor reassured us that it is "the most kind and the least invasive treatment" for DDH and that it had good prognosis. (We were too worried to comprehend or assimilate the prognosis part.)

We felt that we were in good hands. We felt a streak of hope!

Thank you Dr. Jayant Sampath for helping us gain the right perspective. You are a great listener. Making yourself accessible to parents is another aspect that is very reassuring about you.

Read on for more on Our DDH Journey: Click here Part2
Please share your experience with DDH. I would also be happy to respond to any of your queries.

the durga-mata mandir

What triggered me to write this was a blog of a friend...

The Durga-mata mandir. Everyone who lives around knows it. It has been there ever since I was born. It was at a stones throw from my home. It used to be a my favorite evening spot. We attended the school in the morning. When I used to return in the afternoon, I used to have lunch, help my grandmother in kitchen, study and go to the playground in the evening. And finally before I came home abandoning all the freedom, I used to enjoy it's last bit at around 7pm at the Durga-mata mandir.

It had a nice wide courtyard, surrounded by Ashoka trees. The half open orange-coloured gate made the mandir noticeable. It had two raised squares at the entrance to sit over. I used to find it strange that the mandir was painted pink from within; and it did go well with the black stone used. The mandir did not have walls, in fact it had low walls and inter-spaced pillars to let in and out plenty of breeze.

The brahmin who was in-charge of the mandir wore a hearing aid and knew all of us. It had it's aarti-time at 7am and 7pm. I think they had aarti at 12pm too, when I used to be in the school. We could hear the huge bells and drums from my house when they played it during the aarti. And the sounds of these bells and drums were an alarm for us to return home if we were nearby.

I never realized how much I loved the mandir until they renovated it. (Yes, like most temples of these days, it is intended to make a good business). They have added idols of all possible gods and goddesses, they have a glass collage on the ceiling which is a good art, but i hate it in the mandir. That makes the mandir glitzy, something a mandir ought not be! The additional constructions in the couteyard makes it look cluttered and unwelcoming (to me at least). I do not understand whether it is about the mentality of people here. Why don't they understand that putting together all that looks good makes it look ugly overall!! But the charm is already gone... The serenity, I feel, has diminished.

I still visit the mandir. I still hope to see the same old pink pillars and black stone. And then  there is disappointment. My heart mourns for a moment and then moves on.

Why do i feel so deeply about the Mandir? Maybe because I have owned it up.. I have made it mine, in my heart. Yes, it is strange how we go on owning up things, even if they don't belong to us... 

Children and emotions

This video has a special memory for me.. My cousin was only 5 then.

I was watching this video and he was by my side. My aunt joined us and we were all mesmerized by the fluent art. At the end of this video my cousin suddenly broke into tears and cried.. I was clueless.. His mother explained "He probably was touched!" I was speechless... only 5 years old and he could understand and experience the feelings... how little do we know about children!







Well, now about the video. This is one of the beautiful works of Ilana Yahav). Enjoy!