Wednesday morning I met with Karen Hahn at the Iowa City Public Library’s Children’s Room. She has three children, her eldest son was at school during our interview, but brought along her middle son, who is three years old. He immediately busied himself with the train tables. Snuggled into an Ergo on Karen’s chest was 11-week-old Rynn, short for Katheryn. Without prior knowledge of Rynn’s condition, I would have never noticed anything different about her, or the way the Ergo was being used.
As we sat down, Karen took Rynn out of the Ergo, revealing the soft, cloth and velcro brace, a pavlik harness, that held Rynn’s legs in a ninety-degree position out to her sides– the classic M shape we encourage infants to take when in an infant carrier. Karen explains to me that Rynn started wearing the brace when she was two-days-old, “The first time she was in it, it was on her bare skin, for twenty-four hours a day… for four weeks we had to wash her around it, like a sponge bath… but then after four weeks we went to twenty-three hours, so we could take it off her to give her a bath, change her clothes.”
During Rynn’s neonatal tests the pediatrician manually manipulated Rynn’s legs. There was a tell-tale “click” that alerted the doctor to hip dysplasia. Rynn was diagnosed with Developmental Dysplasia of the Hip, “What they explained to me is that is the diagnosis that they use for all of it.” There was no family history of hip dysplasia, neither of her older children had the condition nor was Rynn a breech birth– which is a risk factor. Karen shrugged, “Girls are more prone to it.”
“At first, when she was born, we went in every two weeks, because they grow so quickly and she had to keep getting readjusted. And they would just readjust the harness and that was all the appointment was, really.”
“We go in on Friday and get an X-ray, prior to that we had done an ultrasound on her hips, so now she’s old enough to get an x-ray. So we get an x-ray this time and we’ll see, hopefully, we’ll be out of it. But if not, I know- I’ve known people who have been in it for a year, but a lot of time it’s only twelve weeks.”
What would be the risk if the pediatrician hadn’t caught the hip dysplasia and Rynn hadn’t been put into a brace?
“She could have had surgery later on in life. … So it moves [the hip] into the right place and allows it to develop where it grows.” The brace itself is a strap around the chest and shoulder straps with tapes that hang down in front and back. The tapes connect to straps around her lower legs, with stirrups and sock-like covers over the toes. The tapes behind her thighs keep her legs open and the tapes in the front keep her knees bent. “So it gives her full range of motion, except not letting her knees go down. It also doesn’t allow her legs to cross. So it keeps her in an ideal position. It’s a natural baby position.” Karen later added that “the harness helps her support her head better and she’s less floppy when she’s wearing it.”
Which carriers have you tried?
“First I used the moby because I used it with my boys and I actually wore her to her first appointment, like when she was two days old, and [the Moby] squished her hips too much if you do the traditional small-baby– the one with the pocket. It squished her hips in… the doctor said that if you could get her upright and she’s wearing the brace… then her hips will always be in the right position.”
So you just wore her in the legs-out position in the Moby?
“Yeah, Just like this.” I take a photo, then remind her to smile as I snap another one– and just my luck, both are blurry.
As Karen and Rynn posed for some photographs, Karen demonstrated how the brace allows for normal baby movements: “So what the brace does, you can see her kicking right now, it lets her do her normal baby stuff, but it never lets her hips leave that position. She is supposed to be at ninety, but she’s a little higher than what she should be at right now.” Rynn seems to be voluntarily holding her knees higher than the brace does. Considering that she has been in the brace since she was two days old, I asked if stretching her legs out a big deal for her, “No, but she really really likes it now when she gets her brace off and is in the bath. So that is really nice for her. She pitches a bit of a fit when we get her back in it.”
At this point, a very insouciant Rynn gives a giant yawn as she leans back against her mom’s chest. A perfect time to demonstrate how Karen places her into the Moby and the Ergo carriers.
“I haven’t used the Moby in a while because it wasn’t supportive–she’s getting bigger.” Baby Rynn has a bemused grin as she lays on her side on the cushioned bench, legs splayed, one l foot jutting up, supported by the brace. She’s entranced by the bold primary colored polka dot pattern on the cushion. Karen finishes winding the Moby wrap around her and picks up Rynn, demonstrating that getting her legs into the X of the wrap was slightly more difficult with the harness because the other leg sticks out, blocking the other pass. Karen holds Rynn’s bottom high on her chest, slipping Rynn’s left foot under outer pass of the wrap, then sliding Rynn’s right leg into the inner pass. Once Rynn was settled into the seat of the X, the carrier hugged her legs, fully supporting the shape the brace held her legs in. The modification was that Karen did not pull up the “cumberbund” or horizontal pass over Rynn’s feet, “I can’t pull that part up, it’s just too hard to get it up over her feet.”
After getting Rynn out of the Moby, and laying her back on the cushion, Karen pulls out the Ergo. Rynn shakes her arms and kicks her feet, smiling at her mama. “Even if she is really fussy, she sees me getting it and she’s like, ‘Okay, it’s alright, cool'”.
Karen’s Ergo has one of the back straps crossed, she throws the fastened cross strap over her head, “I just had to criss-cross the straps, because my back was hurting way too much, right here,” she points to the center of her spine. Inside the body of the carrier she situates pillow portion of the Ergo’s infant insert, “I tuck it waay down in there, like get it really down in there… So that way it kinda just sits, and I don’t have to fiddle with it anymore.” With one shoulder strap loose, she slides Rynn into the carrier, placing Rynn’s butt squarely on the pillow, noting, “The hardest part is making sure to get her leg over that strap,” she turns and shows me Rynn’s foot clearing the strap that connects the side body of the carrier to the shoulder strap. Once everything is buckled and tightened, there is no outward sign that Rynn is wearing a brace. The width of Rynn’s knee-to-knee span is shorter that the width of the Ergo, the pillow creating a smaller seat within the carrier, allowing Rynn to keep her knees bent as the harness holds her. Her feet rest on the inside edge of the body of the carrier, or at least one foot does, the other sticks out, but is still supported by the brace. She is just in-between sizes, not quite big enough to sit in the Ergo, with her brace on, without the pillow but not able to fit both feet inside with it.
To me it seem that everyone with a narrow-base carrier should get a hip dysplasia harness. Save that most of them are harness style and it would be impossible to get a braced baby in one.
Nursing in the Carrier:
“I think I have one photo, I was able to take one picture where I was able to feed her, nurse her [in the Ergo]. But it, uh, that was like a rolled blanket, carrying her way down low, and — yeah. That has been more complicated than it was with my boys. I have noticed it is a little harder.”
Breastfeeding with a Harness in General:
“I would think with a first time mom it might have been more difficult because she doesn’t get tummy-to-tummy with me, and so I’ve just kind of, get a different position. But, I have been doing it three times, looking back I think it would have been more difficult for me [as a first time mom].” Karen lies Rynn down on the cushion, “And as you can see, when she’s on her side, this is what I see,” she points to her foot sticking straight up, “It cracks me up.” Baby Rynn smiles, Karen speaks to her in a sing-song voice, “Yeah, that leg is always up in the air.”