Breastfeeding with a Pavlik Harness / Hip Dysplasia

Breastfeeding with a Pavlik Harness / Hip Dysplasia

Caring for a baby with a Pavlik harness has its challenges. One of these is finding a comfortable position for you and your baby while breastfeeding. Here I will go through what exactly a Pavlik Harness is, a brief description of how to care for your baby wearing one and three breastfeeding positions that can make nursing easier.

What Is A Pavlik Harness

The Pavlik Harness is a hip brace or a cast, that is used in a baby who has hip dysplasia, a hip disorder. What happens in hip dysplasia is that the socket cavity is shallow, so articulation of the femoral head is not proper. The diagnosis is confirmed by an ultrasound of the hip. Incidence is 1-2 per 1000, babies. It is often due to a family history of developmental dysplasia of the hip, breech delivery, decreased amount of fluid in mother’s womb during pregnancy, being preterm and having severe foot deformities at birth. It is more often seen in girls.

Pavlik Harness is also used for babies with a femur fracture. The purpose of the harness is to keep the hips and knees flexed and thighs spread outward (abducted).In this position, the head of the femur remains locked in the joint space and the growth of the hip joint is optimum. Your doctor will initially recommend that the baby wear the harness for 6-12 weeks. Depending on your healthcare provider, you may be advised to remove harness while bathing or diapering your baby.

Taking the Harness Off

  • Lay your baby on her back
  • Take the feet out of the foot straps
  • Then undo the chest band and shoulder straps
baby in a pavlik harness
https://www.aboutkidshealth.ca/Article?contentid=971&language=English

In an ideally secured harness, your baby should be able to kick his legs, turn over and crawl, comfortably. In case of swelling on the feet, rash below the harness or restricted movement, consult your doctor immediately.

Home Care with a Pavlik Harness

  • Even though a little awkward at first, with practice it is possible to breastfeed your baby with a harness. Choosing a comfortable position is key.
  • The harness must be kept in place during the early stages, even while sponging your baby.
  • Keep all areas especially to the back of the knees and diaper area clean and dry.
  • Make sure that the diaper is secure under the straps.
  • After each feed, the chest portion of the harness should be loosened so that 2 fingers can be placed between it and the chest.
  • Your baby may be fussy initially, but will usually settle down within a few days.
  • Your baby needs to have supervised tummy time for at least 20 minutes during the day. This will help him from developing a flat spot to the back of the head, known as plagiocephaly.
  • If the harness becomes soiled, wash with soap and water and dry thoroughly before being used again.

How Does A Pavlik Harness Affect Breastfeeding

Breastfeeding and finding the right position can seem awkward initially, but with perseverance, you will be able to find what is right for your baby and you. There is no right or wrong position. As shown below, you may adopt any position and even experiment with different ones to see what is comfortable.

Attachment or latching to the breast is important. A proper latch means your baby will have an adequate amount of breast tissue in the mouth to facilitate effective sucking. Getting the latch right will prevent nipple pain and damage to the nipple. When you first start breastfeeding, this will take time and practice. Feeding may take longer if your baby is in a harness. Sometimes attaching to the nipple may not be complete, and baby may frequently detach. You may need to change positions to relieve shoulder stiffness.

Slings can assist in breastfeeding. If you wear a dress or shirt with front buttons, you will find a front or back sling of assistance while feeding your baby. You could position the baby so that the sling supports her back and shoulders and she faces your breast.

Breastfeeding Positions To Make It Easier For Mom 

Breastfeeding has health benefits for both the mother and child. Also, nursing is a special time for bonding. Certain positions make it easier for a new Mom to Breastfeed when her baby has a Pavlik harness. These include the following:

1. Sitting Straddle Position

breastfeedding position called the sitting straddling position
https://hipdysplasia.org/developmental-dysplasia-of-the-hip/tips-for-parents/spica-cast-tips/attachment/breastfeeding-in-spica-cast-while-sitting/

Place your baby on your lap facing your breast with his legs straddling your abdomen. Support her at shoulder level with one hand while the other hand offers the breast. If your baby is very young or small, you will need to put a pillow or rolled up towel underneath your baby to ensure he is at breast level. When your baby is first latching onto the breast, you may need to tilt his head back a little to position him correctly. This position will not interfere with the harness and can become a comfortable position for you and your baby.

2. Cradle Position

mother and baby in the cradle breastfeeding position
International Hip Dysplasia https://hipdysplasia.org/developmental-dysplasia-of-the-hip/tips-for-parents/spica-cast-tips/attachment/breastfeeding-in-spica-cast-cradle-hold/Institute

Prop your baby across your lap. Cross your legs or place a pillow under your thigh for extra support. Ensure the harness doesn’t dig into you or your baby. Draw your baby towards your breast and support your baby with a pillow or thick rolled-up towel. If your baby is very young, you can hold him across your chest with an arm between his legs and up his back. If your baby is older, try supporting him by placing his lower leg between your knees and supporting his upper leg with your arm and shoulder

4. Laid Back Breastfeeding

This position can be ideal when breastfeeding a baby in a Pavlik harness. It can take some practice for you both to get used to this position if it has not been used since the birth. Gravity will enable your baby to be fully supported with no gaps or pressure points. You also have more space to position you and your baby in the exact way that is comfortable for you both.

Recline yourself in a comfortable chair using pillows for extra support. Your baby will lie on top of you, her torso facing yours. She will be supported by your body. She will make her way to the breast by lifting her head and bob her face over towards the nipple where she will latch. You can help her move closer to the breast or support her as she finds her way. Use some pillows or a blanket if you feel the harness digging into your skin. In this position, your baby can straddle across your body causing no disruption to the Pavlik harness.

Avoid Causing Undue Strain While Breastfeeding

Breastfeeding with a Pavlik harness can feel awkward and you will need to make some adjustments to avoid discomfort or even possibly back and neck strain. Be sure to use the necessary supports such as pillows, blankets or rolled up towels. Parts of the harness can dig into your skin. When breastfeeding your baby avoid sitting in a narrow chair. Space is needed to accommodate you and your baby with the Pavlik harness in situ.

Useful tips while Breastfeeding your baby with Hip Dysplasia in Harness.

In such a scenario, it may seem like starting breastfeeding all over again. Be patient with yourself and your baby. It may take a few days before both of you establish a position and routine that is seamless. Breastfeeding in a wide chair without arms allows extra room for the baby’s cast. Feeding on a lounge chair also offers extra width and cushioning while often being more comfortable than a chair.

In case of soiling of the harness by spit ups or fecal matter while diaper change, it is important to cleanse the areas with soapy water and dry thoroughly. Otherwise, your baby may develop a rash. Always make sure that you dress baby in loose clothes. Do not apply a cream or talcum underneath the harness as this blocks pores and leads to infection. Sleeping on their back is the best for these babies. Do not lie your baby on his/her side as it is not good for your baby’s hips at this stage. It is also not advised to lay your baby face down.

Like all new moms, mothers of babies with developmental dysplasia of the hip may develop difficulty in feeding or milk supply. In such a case your lactation consultant may advise pumping your breast milk to increase supply, offering pumped milk in a bottle until you can resume breastfeeding as before.

DR. RADHA  RAJPAL M.D

Resources

  • https://www.rch.org.au/kidsinfo/fact_sheets/Pavlik_Harness_for_DDH/

file:///C:/Users/hp/Downloads/The%20Parents%20Guide%20to%20Caring%20for%20a%20Child%20in%20a%20Pavlik%20Harness.pdf

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