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.