Latest news with #InternationalHipDysplasiaInstitute
RTÉ News
23-05-2025
- Health
- RTÉ News
Hip surgery at the heart of audit explained
The release of an independent audit of bone surgeries carried out on children with hip dysplasia between January 2021 to December 2023 was much anticipated, not least by the parents of children who had had these surgeries in that time. The audit was looking at the basis on which decisions were made to perform a pelvic osteotomy or bone surgery on a child. Or, to put it more bluntly, whether it was necessary for the surgery to be carried out. To understand the concern around all of this, it is first important to look at what these surgeries are used to treat, and just what the surgery in question involves. The condition is called developmental dysplasia of the hips, or DDH, and it occurs when the "ball and socket" joint in the hip does not form properly in babies and young children. "It's a very common condition that we see, and in its simplest form it is a mismatch between the shapes that make up the component of the hip joint," Dr Pablo Castañeda, Medical Director of the International Hip Dysplasia Institute explained. There are a number of treatments, including non-operative and surgical interventions. An osteotomy or bone surgery is arguably the most extreme. This is a bone surgery undertaken to "correct" or "reshape" the hip joint. "When we talk about doing a pelvic osteotomy it is a cut of the bone, that's what the word osteotomy means, a cut of the bone, so we cut the pelvic bone to essentially make that socket deeper and match the ball in a better way," Dr Castañeda said. According to information published by Children's Health Ireland (CHI), there are two possible options: to reshape or reposition the thigh bone or femur, called a femoral osteotomy, or to deepen the hip socket, and this is a pelvic osteotomy. It was decisions to perform the later, pelvic osteotomies, that were examined in this audit. As previously mentioned this procedure involves cutting the bone, and it usually involves the use of bone grafts and pins. After a pelvic osteotomy "most children are treated in a hip abduction brace or a cast after pelvic osteotomy," according to CHI literature. A foam hip abduction brace immobilises both legs, a hinged hip abduction brace immobilises the operated side only, and a hip spica cast. Hip spica casts can be on for 12 to 16 weeks, with plaster changes under anaesthetic every six to eight weeks. If pins are used, they may be dissolvable or the child may need a second surgery to remove them eight weeks later. Children will need also need a special car seat which is compatible with the brace or the cast. Parents are also warned that a child "may be limp for weeks after their osteotomy". Archie 'had to learn how to walk again' Áine Gladney-Knox's son Archie had the surgery on both hip joints in 2022 when he was aged three. An already difficult procedure was made even more so when Archie suffered complications and needed to be re-admitted to CHI Crumlin where he spent almost two weeks recovering. When he got home, Ms Gladney Knox described how Archie had lost a lot of muscle density in his legs. "He had to learn how to walk again," she said, adding: "They don't recommend physiotherapy, but children are resilient." She described how Archie's hip spica cast needed to be cut off due to the swelling when he experienced complications, and afterwards he wore a "brace". "There's a lot to it, its very very intense and it has a big impact on a family," she said. "This is a tough tough surgery for any child to go through, and surgery is always going to be the last option," Ms Gladney-Knox said. Dr Castañeda said that a pelvic osteotomy "is not a procedure which is done all too commonly because fortunately we have very good non-operative means to improve the congruency of the joint, as long as hip dysplasia in infants is detected in a timely way, which typically is done by screening of neonates (a baby who is four weeks old or younger), then hip dysplasia, in the vast majority of cases can be treated non-operatively". As for some of the alternatives, babies diagnosed early with DDH are usually treated with a fabric splint called a pavlik harness. Children can also wear hip abduction brace, which is a bit sturdier. And then there are reduction procedures, where the "ball" is manipulated back into a "socket", and these can be closed (under anaesthetic but without surgery) or open (surgical). Both of these procedures also require a child to wear a hip spica cast. Ms Gladney-Knox, who is a member of Sinn Féin and was a general election candidate last year, was among the parents contacted by CHI Crumlin in March about the audit. We now know that it found a number of the surgeries carried out in CHI Temple Street and the National Orthopeadic Hospital Cappagh were unnecessary, but that similar issues were not identified in CHI Crumlin where Archie's surgery were carried out. Ms Gladney-Knox said that while she was "relieved" she still had questions. "Definitely I will be ringing the helpline and I will be looking to see was (Archie) reviewed in that audit," she said. She also expressed concern for the parents whose children were did undergo the procedure in CHI Temple Street and NOHC, who she believed were now "under a cloud of anxiety and worry and stress and... anger".
Forbes
16-04-2025
- Health
- Forbes
The 6 Best Baby Carriers To Keep You Hands-Free And Your Baby Cozy
As a mom to three kids who prefer to be touching me at all times, I have a lot of experience babywearing. The best baby carriers are comfortable and ergonomic for both adult and baby, keep your baby's legs in an 'M' position to help prevent hip dysplasia along with adjustable features that are convenient for multiple caregivers. After extensive research and testing, our top pick is the Ergobaby Omni Breeze Baby Carrier because it's healthy for baby's hips, allows for a wide variety of carry positions and has features designed for added comfort like padded straps and a supportive hip belt. The best baby carriers are comfortable, ergonomic and help keep baby's hips properly aligned. 'Deciding which is best for you and your little will definitely require consideration including your personal preference as well as your baby's size, weight and age and the longevity you're hoping to achieve with carrier use,' says Dr. KC Rickerd, a New York-based pediatric physical therapist and founder of Milestones & Motherhood. Parents looking for a carrier for their newborn may like the Baby K'tan Original, a ready-to-wear wrap. For caregivers looking for a fashionable pick that's an extension of their style, the Artipoppe Zeitgiest Baby Carrier comes in various styles and high-end fabrics. Amazon Material: Mesh, polyester | Child weight limit: 7 to 45 pounds | Carry modes: 4 | Hip-healthy designation: Yes The versatile and user-friendly Ergobaby Omni Breeze Baby Carrier remains a perennial favorite among parents. 'I used the Ergobaby Omni Breeze with my last baby and it was a life-saver. It was super easy to put on, fit my smaller-than-average infant well, and kept her nice and cozy in there for naps while also not leaving me feeling stuffy thanks to the mesh panels," says Forbes Vetted editor Esther Carlstone. One of our testers found the padded shoulders and wide, supportive hip belt comfortable, and it was easy for her to place her baby in the carrier. You can carry your baby facing you, facing out, on your side/hip and on your back. It's also designated a hip-healthy carrier by the International Hip Dysplasia Institute (IHDI). The carrier supports your baby's legs to get them into an 'M' position, which is ideal for hip health. Our tall, broad male tester found the carrier very comfortable while the petite female did have a bit of trouble getting the carrier tight enough. When your baby has a blowout or spits up all over the carrier (or, let's face it, when you spill some of your lunch on it), the entire carrier is machine washable. Breathable mesh makes this a great pick for warmer climates or parents and babies who tend to run hot. Another helpful feature is the storage pocket, which our tester found large enough to hold essential objects like a phone and keys. The carrier also has a hood for privacy and coverage and is available in seven gender-neutral colors. Amazon Material: Cotton, mesh and polyester | Child weight limit: 7 to 45 pounds | Carry modes: 6 | Hip-healthy designation: Yes Whether you're babywearing your newborn around the house or taking your toddler out in the cold, the Líllébaby Complete 6-In-1 All Seasons is designed to help you be hands-free for all occasions at a value price. The carrier can be used for babies as small as 7 pounds and toddlers as heavy as 45 pounds. For younger babies, a built-in pad provides additional head support. Other carry positions include inward with narrow seat, inward with wide seat, front-facing, hip/side and back. Our tester's baby loved being carried in any position, and she found it easy to get her baby in. The front features a zip-down panel to reveal mesh for air flow when it's hot. When zipped up, it acts as a wind breaker. It features lumbar support and wide hip belt making it very supportive and ergonomic, according to our tester. Rickerd recommends extra lumbar support for people with back pain. The Líllébaby Complete is quite padded, which our tester found made it a bit bulky and not as easy to just toss in a backpack as some of our other top picks. This is another carrier that has a hip-healthy designation from IHDI, and allows you to adjust the seat to support your baby's hips as they grow. Designed to fit various body types, the waistband extends to 52 inches, and you can also purchase a waistband extender if you have a larger frame. The fabric is machine washable, and available in various colors and patterns. Other features include a sun hood and a storage pouch. Baby K'Tan Material: Cotton | Child weight limit: 8 to 35 pounds | Carry modes: 5 | Hip-healthy designation: Yes Babywearing with a sling or wrap can be a bit tricky, especially with a new baby. The Baby K'tan Original makes babywearing a bit easier with a soft pre-wrapped carrier that's a cross between a structured carrier and a traditional wrap. Because it's ready-to-wear, you don't have to worry about learning how to tie the wrap; all you need to do is slip your baby in. There are five different ways for baby to sit in the carrier: kangaroo (fully wrapped in carrier), hug (facing you with legs hanging out), explore (facing sideways with legs tucked in), adventure (facing out) and hip (facing sideways with legs out). Rickerd used this carrier with her babies and appreciated that it was easy to achieve the 'M' position for her babies' hips and that she could get them in and out without a second set of hands. The machine washable material can trap in some heat, however. 'If they look like they are breathing quickly or flushed, take them out immediately,' says Dr. Gina Posner, a pediatrician at MemorialCare Medical Group in Fountain Valley, California. One important caveat with the Baby K'tan Original carrier is that it's not one-size-fits-all. Available in sizes XXS to XL, you may need to purchase multiple carriers if you're planning on using it with differently sized caregivers. If you want a one-size-fits-all wrap that you tie yourself, check out the Solly Wrap, which Forbes Vetted deputy editor Rose Gordon Sala liked using with her babies. Amazon Material: Polyester and acrylic, 100% polyester, or 100% polyurethane (material varies by color) | Child weight limit: Up to 45 pounds | Carry modes: 4 | Hip-healthy designation: No When you want something that helps you carry your baby (or toddler) but don't want a traditional baby carrier, the Tushbaby Hip Seat Carrier meets you in the middle. The carrier straps around your waist and provides an anti-slip memory foam lined seat for your child to sit on. This can help make it easier to carry your baby without having to get them in and out of a carrier, and for older babies and toddlers, your arms won't fatigue as easily as they would without the hip seat. The waist belt fits up to a 44 inch waist, and you can also purchase a waistband extender for larger builds. The Tushbaby Hip Seat Carrier is available in a variety of colors. My sister-in-law has the black carrier and loves that it's easy to clean and has plenty of compartments and pockets. 'I wore it all day at Disney with my son, and it was so comfortable,' she said. When it comes to storage, this carrier can almost act as a mini diaper bag with a front pocket, a phone pocket, a storage pocket, a bottle holder, a side zipper pocket and two loops to hang things like toys, keys or hand sanitizer. It's important to note that this is not a hands-free carrier, and you'll still need to use a hand or arm to support your child. The company does offer a hands-free version for extra support, though this option is not suitable for newborns. Amazon Material: Cotton; mesh; or 45 % linen, 55% cotton (material varies by color) | Child weight limit: 7 to 45 pounds | Carry modes: 3 | Hip-healthy designation: Yes With a waistband that extends to 57 inches, the Baby Tula Explore Baby Carrier is designed to fit caregivers up to size 4XL. You can also get an additional 10 inches with the waistbelt extender. In addition to fitting a wide variety of body types, the carrier is also built to be comfortable for the wearer with a padded hip belt and shoulder straps. Our tester found that the carrier was comfortable for their baby, who settled in and wanted to nap. It's also an IHDI hip-healthy carrier. Available in cotton, mesh, or a cotton/linen blend, you can choose the right fabric for your climate. For warmer climates, mesh will likely be your best option. The carrier is also machine washable and available in a variety of colors and patterns, so you can keep it looking nice even after it gets covered in spit up. You can wear your baby facing in, out or on your back, and the thigh support can be adjusted to better fit your baby as they grow. Other features include a detachable sun hood, a storage pocket and an adjustable neck pillow for baby. Artipoppe Material: Organic cotton blend, denim, linen blend, cotton, cashmere and silk blend, hemp blend, tussah silk, vicuña and cashmere blend, or organic velvet (material varies by color) | Child weight limit: 7 to 45 pounds | Carry modes: 3 | Hip-healthy designation: Yes A baby carrier isn't just something to put your baby in—it's an accessory that you'll likely frequently use for a year or more. If you want something to truly be fashionable and not clash with your wardrobe, consider investing in the Artipoppe Zeitgiest Baby Carrier. Available in a wide variety of colors, prints and fabrics, the brand takes style so seriously that each carrier has a note from the designer describing the fabric. Because there are so many different materials available, it's important to follow the specific instructions for your chosen carrier, but many of the styles are machine washable and vegan. The carrier isn't just great for the wearer, either. It's a designated hip-healthy carrier by IHDI, has padded leg openings for baby and an adjustable neck cushion. You can also use it from birth, and the carrier allows for three carry positions: facing in, facing out and back carry. For parent comfort, you'll find padded, crossing shoulder straps to help distribute your baby's weight more evenly and hopefully prevent future back aches. At Forbes Vetted, we're dedicated to recommending the best kids and baby gear through testing, research, and tapping into expert advice. From the best gifts for new moms to the best high chairs, we cover a wide range of products. To choose the best baby carriers, we considered features, carry positions and comfort. We tapped into our own experience as well as advice from experts. Ultimately, a baby carrier needs to be comfortable for both you and your baby, otherwise you probably won't use it. When it comes to comfort for the parent or caregiver, look for padding and lumbar support. If you live in a hot climate or if you get hot easily, you'll also want breathable fabrics like mesh or linen. 'Carriers should be comfortably fitting, ideally with padded straps and adjustability for differences in caregiver's size who may be using the carrier as well,' says Rickerd. If you have any sort of back pain, Rickerd recommends looking for a carrier that has additional lumbar support. When it comes to comfort for your baby, you want something that is going to support them well. This includes head and neck support for newborns and a carrier construction that allows for their legs to be properly positioned (they should look like an 'M'). Safety for baby carriers is largely about how you wear the carrier—making sure it fits you properly and that you know how to use it. When shopping for a carrier, be sure it can fit your size and body type and read all of the instructions before using it. It's also important to make sure your baby can breathe in the carrier and that they're not getting too hot. The American Academy of Pediatrics (AAP) provides some tips for baby carrier safety, including making sure your baby's neck is straight and above any fabric, frequently checking that you can see their face and that nothing is covering their mouth or nose, making sure the carrier fits correctly and that your baby can't slip out and regularly checking for ripped seams or broken components. They also recommend that you bend with your legs and that you don't lean over or bend at your waist so your baby doesn't fall out. Certified nurse midwife Denise Castellanos recommends following the TICKS acronym for babywearing safety. T: the baby should be wrapped tightly, high and upright; I: the baby should be in view at all times; C: the baby should be close enough to kiss; K: keep baby's chin off their chest; S: supported back—always support the baby's back when bending over. As a mom to a child who was born with hip dysplasia, I know how important it is to keep baby's hips properly aligned. 'In general, 'hip-healthy' refers to features in baby carriers that support the hips to be in what's called the 'M-position', which is when legs are spread wide apart across the caregiver's body with knees aligned slightly above hips and thighs fully supported,' says Rickerd. Some carriers offer adjustable hip support so you can achieve optimal positioning as your baby grows. Many carriers have a hip-healthy designation from the International Hip Dysplasia Institute (IHDI), which tells you that the product promotes healthy hip development. Rickerd explained that putting a baby in the 'M' position while in a carrier not only helps with alignment of the hip joint, but also helps your baby use innate reflexes that cause them to squeeze with their thighs, thus activating muscles that promote stability and proper hip development. Think about how you want to carry your baby. Typically, newborns and younger infants should face toward you. Recommendations on when you can turn your baby to face out vary, but many manufacturers say that babies can face out once they have strong head and neck control and are more interested in their surroundings. Often, this is around six months old. Look for carriers that offer various carry positions, such as hip and back carry, if you want the carrier to be versatile as your baby gets older. If your baby has a medical condition or complicated health history, talk to their pediatrician before using a baby carrier. The AAP does not recommend upright baby carriers for babies who were born prematurely because they may struggle to breathe when placed in that position. Other conditions, like torticollis and plagiocephaly, can actually be helped with babywearing. 'Babywearing can be an excellent option for not only keeping the neck muscles mobile by alternating which direction baby's head is facing during baby wearing, but also in getting the pressure off the flattened part of their skull, allowing pressure redistribution, and avoiding contributing to worsening of the flat spot,' says Rickerd. Consider your own medical conditions as well. For example, if you had a c-section or a difficult delivery, talk to your doctor to make sure you are cleared to babywear first. Additionally, if you have a condition that could make you stumble, fall or get off balance easily, consider whether you can safely stay upright with the baby carrier you choose. In general, you want a soft and comfortable fabric. 'Thicker fabric baby carriers in warmer climates and weather can be tricky, as there will naturally be more body heat passed between parent and baby,' says Rickerd. For more breathability and to reduce the risk of overheating, look for breathable fabrics like cotton, linen or mesh. The best baby carrier is one that is comfortable, can be worn safely and keeps your baby's hips in a properly aligned 'M' position. The Ergobaby Omni Breeze Baby Carrier is the best baby carrier because it can be configured into various carry positions, is made of breathable mesh and can be easily adjusted for multiple caregivers. The best carrier for newborns keeps them snug and close and aligns their hips properly. Many parents prefer a wrap or sling for newborns, like the Baby K'tan Original, because the wrap can provide head and neck support while allowing baby to cozy up to you. The Ergobaby Omni 360 (also known as the Omni Classic) is one of my favorite baby carriers. It's easy to use, comfortable and adjustable for various caregivers and as your baby grows. The carrier has four different carry positions, and can last well into the toddler years, making it a worthwhile investment.
