Pavlik Harness
Important information:
The Pavlik harness is used to treat babies with developmental dysplasia of the hip (DDH). The hip joint is made up of a ball (femur) and socket (acetabulum) joint. In DDH, this joint may be unstable with the ball slipping in and out of the socket. The harness helps keep the baby’s hips and knees bent and the thighs spread apart. This guides the ball into the socket and helps the socket to develop. The harness prevents the baby from bringing the legs down and together. This keeps the hips in line to promote normal development of the hip joint. Babies will have some lower extremity motion in the harness.
Image used with permission from The Hospital for Sick Children. ©AboutKidsHealth.ca
Patient instructions:
The harness
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Your baby will wear the Pavlik harness as directed by your healthcare team. Be sure that you understand your provider’s instructions about how your baby will wear the harness.
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The chest strap that goes from left to right should be around the level of the nipples. You should just be able to fit 2 fingers underneath the strap.
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The front leg (flexion strap) straps and the back straps (abduction straps) keep the hips in position. These are set by your healthcare team when your child is fitted with the harness. These should not be adjusted or changed by the family. They may be taped in place and are marked at the appropriate setting.
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The shoulder and bootie straps keep the harness in place. The bootie straps should be snug but not tight.
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Moleskin®, a material of soft felt with a sticky underside, can be placed on areas of the harness that are causing skin irritation.
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Even though your baby’s motion is limited, they should be able to move their legs, bending and straightening at the knees.
Clothing and diapering
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If your healthcare team says you can remove the harness, a onesie snapping at the diaper is a good choice under it. No pants or tights should be worn over the harness. Large loose fitting sleep sacks are OK over the harness. Dresses and loose shirts are OK over the trunk/chest part of the harness.
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Socks or thigh high leggings can be worn inside the boot/foot part of the harness.
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You can change your baby’s diaper with the Pavlik harness in place. Make sure that the harness straps are kept outside of the diaper.
Bathing
If necessary, you can sponge bathe your baby if the harness is not permitted to be removed.
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Wash around the harness.
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You may gently wash with a damp cloth or baby wipe under the straps.
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Clean the creases behind the knee with a damp cloth or cotton swab.
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Use a soft cloth to dry the skin well.
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Check the skin under the straps and behind the knees at least once a day. Look for skin irritation, redness or blisters.
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Do not use lotions or baby oil on the skin under the straps. This can increase skin irritation.
Positioning
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Babies can have tummy time while in the harness, some may need a small roll under the chest and trunk.
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We do not recommend wearing your baby in a baby carrier or sling while your child is in the harness.
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You may swaddle your baby’s arms snugly, but keep their legs loose, so that the harness can keep the hips in position.
Cleaning the Pavlik harness
You can clean the harness while it is on your baby. Follow the steps below:
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Use a baby wipe to rub the soiled area. Allow the harness to air dry.
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You may also use mild detergent on a damp washcloth. Allow the harness to air dry.
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Do not wash the harness in the washing machine. It cannot be dried in the dryer. It will shrink; and it will take too long to air dry.
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You may not be able to keep the harness perfectly clean. Remember that this is temporary. The goal is for your baby to develop a normal hip.
Call your CHOP orthopedic team with questions, concerns or if:
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Your baby is not moving a lower leg (kicking it out).
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You see a change in your child’s position in the Pavlik harness (the hips and knees are not bent; the legs are not spread out to the side).
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The Pavlik harness seems too tight or is badly soiled.
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Your baby’s skin becomes irritated, and it does not improve after you apply Moleskin to the harness.
Weekdays:
215-590-1527
Nights, weekends, or holidays:
Call 215-590-1000 and ask the operator to page the orthopedic resident on call.
Reviewed April 2024 by Meg Morro RN, Kate Easby ATC