Thursday, 7 April 2011

Hip Hip Hooray!

Mads has always been a little monkey, even before she was born.

She was observed as breech in our 20 week scan, the sonographer said that she was only the size of a cantaloupe and would move head down when she was ready.  (Why do they always compare babies in the womb to fruit and veg?!)

I went for an antenatal appointment at 24 weeks and from them feeling my tummy they said she was still breech but not to worry because 97% of babies had turned by the end of pregnancy.

At 28 weeks I went back and she was still breech....and so on and so on until 36 weeks when I was booked in for a scan to check her position.  While there we discovered that our little terror was not only the wrong way up, but measuring rather large and also in the footling breech position (where their feet are poised to come out first) meaning that she was very unlikely to move round on her own.  We were not offered an ECV (External Cephalic Version) where they try and manipulate the baby to turn on their own using their hands because of the position her legs were in.

So we were booked in for a C-section on Christmas Eve.  While at the pre-op appointment we were told that it was routine for breech babies to have an ultrasound hip examination at around 6 weeks and it was very rare for there to be anything wrong.

Caught up in the excitement (and tiredness!) a new baby brings we completely forgot about the hip appointment until the letter came through when Mads was 6 weeks old.  We weren't worried in the slightest having been told that it was very unlikely there would be an issue and it was just routine.

Off we went to the appointment and popped her on the bed to have the ultrasound done.  The sonographer was the lady who did my 12 week scan!  After completing the procedure she noted to us that Mads hip joints were very shallow and she believed her to have Developmental Dysplasia of the Hip (DDH) or 'Clicky Hip Syndrome,' and that we needed to go downstairs where the paediatrician would be waiting to talk to us.

In a nutshell DDH is a condition in which the hip joint fails to develop properly in the womb.  It is more common in girls, breech babies and those who have hip problems running in the family.

We went to talk to the paediatrician who examined Mads and explained that she would need to be fitted with a Pavlik harness for at least 12 weeks for 24 hours a day.  This would help keep her hips in place in order for them to have a chance at growing and forming properly.  This would be fitted the following week.

We came away feeling upset, confused and having strange emotions.  First of all the paediatrician hadn't even seen her ultrasound photos as for some reason the machine wasn't transmitting the images down to him.  He hadn't explained about the harness or what DDH actually was.  I felt guilty for being so upset when there were babies that were seriously poorly- at the end of the day this was something that could be treated and she wasn't in any pain from it.

I got talking to a friend of a friend whose daughter was diagnosed with DDH and she recommended two things to me.  Firstly to try and get an appointment with a different Orthopedic Specialist based at a larger hospital near me and secondly to take a look at the Steps Charity website.

I did what she suggested and I found a vast amount of information on the website about DDH and other lower limb abnormalities.  There was case studies of children who had worn the Pavlik harness and other Hip Spica's and it put me at ease somewhat.

We got referred to the specialist and Mads has now been under his care for the last couple of months.  I am so glad we received a second opinion as it turns out that her hips are not as bad as the other hospital made us think originally.  He has advised at the moment that it would do more harm than good putting her in a harness as her hips are shallow but stable (i.e they are not dislocating) and so he advised us to put her in two nappies to push her legs out a little and see how we get on.  It is a rather unorthodox treatment that isn't medically proven but we decided to give it a go and trust his judgement.  
We just wear her normal Pamper's nappy and then just have a bigger Pamper's nappy over the top to push her legs out a bit more.

And it seems to be working.  We have been back twice now and each time her hips have improved more each time.  We went yesterday and one hip seems to be classed as normal, her right one still has a little way to go but we received the good news that he doesn't think that she will need to wear a harness.  

She still has to wear the double nappies for another two months and then we go back to see if it has completely stabilised but hopefully it has fixed itself without further treatment.  The only downside is it is costing us a fortune in nappies!

The condition is a lot more common than I originally was led to believe, about 1 in 100 babies can suffer with some form of DDH and Mads is one of the lucky ones who seems to only have a mild form.

So after yesterday all I can say is Hip Hip Hooray!

For more information about the fantastic work that the Steps Charity does click here.

1 comment:

Mummy and the Beastie said...

Poor Mads, that must have been so upsetting when you were given the news. How fantastic is that the double nappy approach has worked for you, much nicer than the alternative, I can only imagine the cost of nappies! But well worth the price though! Glad you got the good news you were waiting for :-)

Ps. Thought of you today when my son's poo exploded down his leg and it was all between his toes, the foot he has rested on my lap before I realised!