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STEPS Charity Worldwide

Registered Charity No 1094343. A Not for Profit Company Registration No 4379997

The STEPS National Office Help-Line is open Monday-Friday, 9.30am - 4.00pm (calls charged at national rate)

Address: STEPS, Wright House, Crouchley Lane, Lymm, Cheshire WA13 0AS

Helpline: +44 (0)1925 750271

Admin Telephone: +44 (0)1925 750273

Fax: +44 (0)1925 750 270

Email: info@steps-charity.org.uk

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Baby Hip Health Awareness

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In the UK alone, up to 2000 children a year are diagnosed with Developmental Dysplasia of the Hip (DDH), which describes a range of conditions from mild instability to total dislocation of the hip. Early detection means DDH can often be corrected by a simple outpatient treatment, but a later, or missed diagnosis can leave a child requiring hospital stays, operations and potentially a permanent disability.

Each year, STEPS organise a Baby Hip Health Awareness Week to continue to raise awareness amongst parents and health professionals of the vital need to check babies' hips during the first few weeks of life to prevent unnecessary pain and disability in later years.  In 2016 our week will be from the 7th to the 11th of March 2016.

Commenting on the work undertaken by STEPS, Professor Adrian Davis, Director of the NHS Newborn & Infant Physical Examination Programme (NIPE), said:

“It is unacceptable that children are still being diagnosed late with conditions such as DDH, leading to more severe and traumatic treatment and a higher risk of long-term disability.  STEPS plays a key role in raising awareness amongst parents and healthcare professionals and together we must stop this unnecessary distress.” 

Baby Hip Health - The story so far

As part of our 2009 Baby Hip Health Week, STEPS published a Baby Hip Screening Report which revealed alarmingly that 57% of Primary Care Trusts (PCT's) had no formal hips policy or guidelines in place, despite a national screening policy being introduced over 40 years ago.

Thanks to the hard work of parents, health professionals, MPs and our wider team, the research was presented at the Houses of Parliament in London. An Early Day Motion (EDM) was launched (received 118 MP signatures) which urged the Government to meet STEPS to investigate how these shortcomings could be overcome.

However, lack of consistent, robust policies without clear referral timings is only part of the problem. Overwhelmingly many parents' felt that there was a lack of information about Developmental Dysplasia of the Hip (DDH) and if they expressed concerns to health professionals, they felt they were not taken seriously; this was not only frustrating and distressing for the parents but delayed diagnosis. Parents' also reported that there is a lack of awareness about risk factors such as family history.

Despite battling 'red tape' and a sluggish system, we have, with the support and dedication of many STEPS families, achieved the following:

  • Raising profile of STEPS and DDH with the Department of Health via a letter writing campaign with MPs.
  • Raising awareness of DDH and screening with general public through national and regional press coverage in newspapers across the country plus local TV and radio.
  • Downing Street Petition - which closed with over 2,500 signatures (including many leading Paediatric Orthopaedic Surgeons in the United Kingdom) which awaits formal response from 10 Downing Street.
  • Parent and STEPS Representation on the Newborn Infant Physical Examination (NIPE)  Implementation Group
  • Opportunity to speak about DDH with NIPE at the Royal College of Midwives Annual Conference 2009
Baby Hip Health Awareness Week 2016

Date for the diary: STEPS Baby Hip Health Week from 7th – 11th March 2016

As part of the newborn infant physical examination programme every baby gets their hips checked at birth and the six to eight week check. However, most parents and health professionals do not realise the implications if a problem with the hips is not picked up. 

Dislocated hips are not visible or painful and can go undiagnosed as the hip tests are not 100% accurate. Even if the hips appear to be normal it is important to be aware of signs that might mean there is a problem. The signs parents should look out for include:

  •          one leg appearing shorter than the other
  •          an extra deep crease on the inside of the thigh or buttocks
  •          crawling with one leg dragging or walking with a limp or a waddle.   
  •          one leg does not seem to move outwards as fully as the other or both legs seem restricted.

Whilst these signs are not conclusive, they may indicate the need for further investigation.

Chloe was only diagnosed at 3 and half years old, her mother says, "I was told there was nothing wrong with Chloe's hips even through she had different leg lengths. But I persisted - call it a mother's instinct - and the condition was finally diagnosed."

If you are concerned your child has a hip problem please seek advice from your GP or Health Visitor immediately since treatment is usually less complex the earlier it is started.

 HELP US TO HELP OTHER PARENTS LIKE YOU:- 

  • Host a 'Put the Kettle on' fundraising event whereby you hold a tea/coffee morning at home, work or in the community to spread the word about baby hip health and help raise vital funds at the same time
  • Distribute the STEPS award winning leaflet on Baby Hip Health to your local surgery or clinic
  • Get your story featured in a local magazine or newspaper to raise awareness. Alternatively send us your story and we will try and get media coverage for you.

Anyone wishing to get further advice,  tell their story to the media, distribute leaflets or wanting to host a "Put the Kettle on" event, please contact the STEPS Helpline on 01925 750271 or email info@steps-charity.org.uk 

Hip Healthy Positioning

During pregnancy a baby spends a long time tucked in the foetal position, in which both hips and knees are bent or flexed. After birth, it takes several months for the joints to stretch out naturally. Babies that have been in the breech (bottom first) position may need even more time to stretch out naturally.

To promote healthy hips, the baby should be positioned so that the legs are able to bend up and out at the hips. This position allows for natural and proper development of the hip joints. The unhealthiest position for the hips during infancy is when the legs are held with the hips and knees straight and the legs brought together, which is the opposite of the foetal position. The risk to the hips is greater when this unhealthy position is maintained for a long time and could result in hip dysplasia.

Hip dysplasia results when the top of the femur bone is not properly located in the hip socket or is loose in the hip socket. The condition is most common in breech birth babies, firstborn girls and when there is a genetic predisposition or family history of the dysplasia. If diagnosed early and with proper care, this condition can usually be treated. However, hip dysplasia often goes undiagnosed and can lead to early onset of adult arthritis of the hips with hip replacement at a young age.

Some types of baby carriers and other equipment may interfere with healthy hip positioning. For example harnesses and slings, car seats, and moulded seating items. These devices could inadvertently place hips in an unhealthy position, especially when used for extended periods of time.

 

To find out more parent friendly information please download our guide on hip healthy positioning techniques or visit  International Hip Dysplasia Institute where you will find a video and information leaflet about hip healthy swaddling:

For advice about treatment and caring for a child with hip dysplasia please call the STEPS helpline on 01925 750271 or email

Hip Healthy Swaddling

Swaddling is the name given to the practice of wrapping babies in a cloth or thin blanket, with the aim of pacifying or calming them. Not everyone agrees with swaddling, studies have shown that it can be linked to:

·         an increased risk of cot death

·         a reduction in breastfeeding at birth

·         an increase in early weight loss

·         Improper swaddling can also lead to instability and dislocation of the hip, a condition known as hip dysplasia

Hip dysplasia results when the top of the femur bone is not properly located in the hip socket or is loose in the hip socket. The condition is most common in breech birth babies, firstborn girls and when there is a genetic predisposition or family history of the dysplasia. If diagnosed early and with proper care, this condition can usually be treated. However, hip dysplasia often goes undiagnosed and can lead to early onset of adult arthritis of the hips with hip replacement at a young age.

To promote healthy hips, the baby should be wrapped so that the legs are able to bend up and out at the hips. This position allows for natural and proper development of the hip joints. When swaddling baby, avoid stretching out the legs straight or pressing them together. 

Some parents choose to wrap their babies in sleeping bags specifically designed for swaddling, instead of using a simple cloth or blanket. Commercial products for swaddling should have a loose pouch or sack for the baby’s legs and feet, allowing plenty of hip movement. However, even some of these commercial products can confine the legs if they are tightened around the thighs.

It's especially important to allow the hips to spread apart and bend up. In the womb the legs are in a foetal position with the legs bent up across each other. Sudden straightening of the legs to a standing position can loosen the joints and damage the soft cartilage of the socket.

To find out more parent friendly information please download our guide to hip healthy swaddling visit  International Hip Dysplasia Institute where you will find a video and information leaflet about hip healthy swaddling:

For advice about treatment and caring for a child with hip dysplasia please call the STEPS helpline on 01925 750271 or email

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Welcome to STEPS. We are a national charity supporting children and adults affected by a lower limb condition such as clubfoot or a hip condition. Our website is a great source of information but if you would like to talk to someone please call our helpline on 01925 750271 or email info@steps-charity.org.uk.

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