Breast feeding a baby in a Pavlik harness

[Trillian42]

My 13 week old DD has been put into a Pavlik harness for DDH :( www.hip-baby.org/pavlik.html In case you're not familiar with it, her legs are bent at the knee and as far out as they can go - there's a picture at the link above. The ultimate no-no is to have her legs come together because the whole point is that her legs stay apart the whole time.

The consultant assured me there would be no problems breast feeding, but had no practical advice on how, nor did the young physio who also said it was easy but ruled out her lying on her side in any way for the duration of the feed.

We're finding it difficult to do on one side without putting pressure on her 'bad' leg. She mostly fed lying down previously, which is now possible on one side only. We've tried the cradle hold which can sort of work if I suspend her so that there is no pressure on that leg, but it is murder on the arms & she seems to get restless after a few minutes. She screamed when I tried the rugby hold, so guessing that's out too. Any suggestions?

Last night was miserable for all three of us as she was uncomfortable, and though she's fed since the harness has been on, her feeds are a lot shorter and I suspect she's only feeding enough to get by. I'm so worried that she's not getting enough to grow. :( :(

could you try a sling to support her body sort of in mid air, a ring sling that goes over one shoulder.(your shoulder)
just a thought.

It is worth gettin in touch with Steps they were very helpful when my dd was diagnosed with a different hip condition.

Good luck!

this totally might not work but...

do you have a baby boucy seat? I had one that had an adjustable back to sit DS up a bit more. If you could sit in front of her and angle yourself round it you might be able to feed her sitting up. Obviously you'd have to move sides for each breast (unless you're a contortionist).

Alternatively could she lie on her tummy on top of you?

If I were you though I'd ask to speak to another physio who can give advice about it. Good luck.

sumum Just read that slings are not suitable with the harness, but thanks for the suggestion.

weegiemum I'm not in the UK, but I might ring them anyway and see if they can help or have ideas. Thanks

I've been trawling all the old threads I can find here and someone suggested my brest friend as the baby can lie flat and turn their head as they're at the right height and well supported. Might try that though I think she's too old (ie big) for it now. I'm also worried it'll be the same problem as lying down but will try anything.

She won't take a bottle - expressed 4oz before the hospital visit in case there were problems, but no joy. We're using Dr Brown bottles - any better suggestions?

It's an expensive business! New buggy, new cot, new car seat... Obviously will spend any amount of money to make her as comfortable as possible though.

Please keep any other suggestions coming. She's napping at the moment but is stirring and I don't have a huge amount of time for researching as she's very out of sorts and just wants to be held and moving. Thanks all for reading.

GruffaloMama - we think our bouncy chair (baby bjorn) isn't suitable as it comes around her hips putting a little pressure inwards on them so it's one of our questions for the next doctor's visit, but good thinking outside the box! My husband just suggested the lying on the tummy thing too... will try it for the next feed. I think part of the problem is that she wants the familiar at the moment as is frustrated and I can't give it to her :(

I know DDH is something treatable and it's not like she's sick or anything (thank god), but I hate to see her miserable. I know logically she'll adapt in a couple of days, but still worried and really want to make sure she's feeding ok.

I promise you one thing - she will adapt, and fairly quickly. You will too. And yes, "logically" everything is fine and probably will be but please remember that you have just had quite a big shock and will still be worried about the outcome; go easy on yourself.

My DD ended up lying on her back on my knee (I think on a cushion to start with) and just turning her head to my breast. I know I also tried sitting her on my lap, facing me with her legs sort of around my waist and feeding upright until we came to our final feeding position. I can't really remember that much about it being a problem (and she's only 3.7 now) so I can only assume she adapted quite quickly.

Where are you based Trillian?

Just to let you know - my DD was diagnosed at 6 weeks, put in a harness straight away and was in it until 10 months full time with another month to wean her off it. She was in it for longer than any other baby I've heard of but I'm eternally grateful to the consultant who had the confidence to let it work in time. DD is now 3.7, you'd never know she had had DDH, she has just learnt to ride her bike without stabilisers and is the most confident "climber" of all her friends.

I wish you and your daughter well and am happy to try to answer any other questions.

You can access the STEPS forum wherever you are - there may well be mothers on their forum who have bf a baby with a pavlik harness. My SIL did - but I can't remember how! I think she just sort oh held him up on his side, with her arm and cusion under his body but not leg. But I'm not sure, really.

Oh Trillian it must be awful to see such a little one struggling. My dd2 has something called Perthes disease, a hip problem for older children, adn spent 2 years in a wheelchair and although she is up and about again she still can't jump or hop or anything (she can, she's just not allowed to) and now we have been told she might need hip surgery next year with 2-3 weeks in hospital in traction then a spica cast (A frame plaster) for 4-6 more weeks to reshape her hip sockets. She's 6 and a half.

I know its not life threatening and she's not actually in pain or anything (well, not much) but its still not easy for her (though I do often think it is worse for me!!)

Hi robino, saw your story on another thread. We're in Ireland. The thought of 10 months is scary (!) but the consultant said she hopes it'll be a maximum of 3-4 mths. They actually put her in a brace the first day, but we had to take it off so I could take her home (it didn't fit in our car seat) and they gave us detailed instructions on how to put it on. When we tried to put it back on at home she screamed and screamed, so we went back and it turned out not to be suitable as her tendons are too tight.

The brace was terrifying - the harness seems so much more comfortable for her, though it was heart-breaking to watch her wake herself up from sleep crying as she tried to straighten her affected leg :( :(

What a difficult situation for you both :(

It must be so upsetting to see your baby reacting to her new equipment and she is far too young to understand how necessary the equipment is for her long term health.

I am surprised that slings can not be used with the harness. As the position the babies are in the photos you linked to,is the froggy position in which I carry my daughter on my front in a ring sling and mei tai. I can understand not being able to use a crotch dangler type like a baby bjorn but surely a soft material sling would work ?

If you could use a ring sling/mei tai you can lower the baby in a froggy position to nurse whilst she is sitting up on your tummy.

Breastfeeding wise without a sling, I would try again with the rugby hold it might take several attempts to get baby use to a new position and this hold is very good for keeping a baby on their back.

Or you could try the dangle feeding position at home. Baby on her back on the bed and you kneel over her body on all fours and lower breast until she can latch on. Recommended to help unblock ducts due to the gravity but might work whilst you are at home to keep the milk feeds going and keep her comforted whilst you both adjust to everything.

We are waiting for an ultrasound appointment about our DD2's hips. The harness has been mentioned to us as a possibility, so I might be CATing you for advice in a few weeks time.

How about a bean bag - you might be able to shape it enough to support her back but without pressuring her hips? Big hug (to you both).

Could you use a reclining chair and have her tummy-to-tummy?

Sorry to hear you're struggling. Sounds awful all round...so sorry.

Thank you all for the lovely words. It's been a tricky day so haven't had a chance to come on until now.

Babieseverywhere I'll check again about the sling - it was to do with the vertical straps as far as I know. I tried the dangle feeding and it worked! The only problem is that it starts to get very uncomfortable after 6 minutes (I timed it!). I'll try the rugby hold again too. Good luck with your Ultrasound... we ended up with an X-Ray because she was too old for ultrasound (long story... delays from the hospital's end made it necessary, but I'd get bolshy if you don't get an appointment soon as the earlier it's diagnosed the better).

weegiemum That sounds awful. The thing that stopped my tears was the thought that she is so little & hopefully it'll be resolved before she knows about it. Fingers crossed surgery won't be needed for your daughter.

GruffaloMama A bean bag is a great idea anyway, even if it doesn't work for feeding.

japhrimel I don't have a reclining chair, but have thought I might try that position propped up on pillows.

Blu Checking out forum now, thanks :)

Trillian, you have my sympathy, DD was in a Pavlik from 8-18 weeks old and I was so upset at first, so stressed about everything not being normal anymore but she WILL get used to it and so will you.

I have to confess I'm not very clear about your usual feeding position (you or DD lies down?) or the physios advice (I assume she was saying you mustn't push or press the leg out of the frogs leg position that the harness holds it in?)

I EBF DD for the 10 weeks her harness was on. It's difficult to describe to be honest but it wasn't very different to the "traditional" hold I used to use before the Pavlik. I think the physio would only warn against her being on her side of it squashed her leg inwards. I put DD so her tummy was against my ribs/side, one leg near my armpit, the other down by my bum/hip. Her legs were still wide apart so no problem with her being on her side.

I've posted on mn before about coping with a Pavlik see here in case any of the advice from me and the other mums is of use.

The good news is that Pavlik harnesses have a 90-95% success rate and your DD will soon have got used to it (in fact my DD still prefers to sit (ahem) legs akimbo and she's not been in the harness for about 30 weeks!

How has feeding gone today?

herethereandeverywhere my DD still has very flexible hips and I occasionally get people checking that she's not hurting herself with the weird positions she sits in! She's 3.7 and been out of the harness for nearly three years!

Trillian don't forget that your HCP's may not be very familiar with BF. I'm Irish and know the abysmal (shameful)BF rates . I have no words of advice except persist and don't be afraid to push people to give you the help/advice with BF that they should be, no matter what your babies needs....

All the best to you and your wee one!

Hi Trillion I've only just seen this or I would have posted sooner. My DD was in a pavlik from 3-6 months. My solution to the bf problem was to use a my brest friend cushion. DD lay flat on her back on the cushion and I turned her head towards me. I really cannot recommend it highly enough. The only problem is that it isn't cheap and I guess you can't be sure it will work for you. I wouldn't worry that your DD will be too heavy for it though. I fed DD on it until she was 9 months old and she's a big girl I will keep my fingers crossed for you. It probably doesn't feel like it at the moment but this is a good thing for your DD as it has a 90% chance of solving the problem without surgery. It's such a shock when it first goes on though isn't it? Your DD will adapt though, and soon it will seem completely normal to you both. Keep posting and let us know how you get on. I don't normally look in breast and bottle feeding these days as my DD is now 18m and suddenly decided at 9 months she wasn't interested in bf anymore but I'll keep an eye on it to see how you're doing.

She fed well yesterday thankfully, and her 3am feed last night coincidentally was on the side that is easier to feed on, so it wasn't too bad.

She's still pretty miserable though - we had 45mins of high octave screaming last night and again this morning, which is very unlike her. We checked that the harness wasn't rubbing anywhere but we could only get her to settle with Calpol. I'm not sure if it's colic/wind as winding her is tricky with the harness - instead of rubbing her back vigorously we have to pat it gently and keep her upright until she eventually burps, which isn't as thorough as we would normally be. She's prone to posseting (spelling?) and even projectile vomiting (we are waiting on an appointment for that too) so used to wind her for ages and ages to be sure that it wasn't a contributory factor. Getting her to sleep is very difficult too.

She keeps kicking her legs, trying to turn onto her side and even achieves positions a yoga master would be proud of to allow her legs to straighten temporarily :(

herethereandeverywhere We used to feed mostly with both of us on our sides lying down - it was the only position we could manage for the first few weeks. I used that when I was hoping she'd go for a nap, and she mostly fell asleep during it. I always thought it funny that it's the position recommended for post Caesarean sections because she seemed to like it as she could kick me in the stomach

DrCosyTiger I got a MyBrestFriend since I posted. They are very expensive, but it might just have been the shop we went to as we didn't have time or inclination to shop around. I tried it with the packaging on first to see if it worked so I could return it if it didn't . It kind of does so I'll keep it, but her neck is stiff looking to the left (related to the hip) so it's a little harder that way but at least my arms aren't aching halfway through a feed. I've been doing that one or a mixture of lying down & dangling - propping myself up on one elbow while she's lying flat on the bed so she doesn't have to turn much. I'm hoping your timescale is similar to mine - your DD was the same age starting in the harness too. DD's hip isn't dislocated, just under developed, but they still refer to it as DDH.

One small thing is clothes - we got some 6-9 month babygros to tide us over until we figured out what to put on her as recommended on the Steps site, but they're too small to fasten fully without putting a little pressure on her legs. What did anyone else do?

Hi again Trillian, glad things are getting a little bit easier on the feeding front. I suspect you've not got a bad deal on the mbf cushion, they were expensive everywhere I looked when I got mine

Yes our timescales are similar - my DD went in at about 13 weeks too. My DD's hip wasn't completely dislocated either. I know things are hard for you at the moment, but hopefully our experience can give you hope that this will all be worthwhile in the end. Although the harness went on a bit 'late' compared to some others, it totally did the trick for us. DD is now 18 months and her hip is absolutely fine.

On clothes, we used enormous babygros at night (two sizes too big!) and in the daytime we used dresses and little socks. However, our time in the harness was over summer so we didn't need to worry too much about keeping DD warm (in fact we had the opposite problem of the harness making her too hot). Hopefully someone with a winter harness baby will come along soon to help on the clothes front [DrCosy calling Robino ...]

My DD took a few days to get used to the harness and was very unsettled in this time(also tried to kick legs) but after a few days she was fine. She actually slept better in it then when she came out of it. (I say this not to show off but only to try and give you a little bit of hope that things will improve.) But it definitely did make winding more difficult and if you're having problems on this front anyway the harness certainly won't improve them. However ... the harness really shouldn't make her so uncomfortable she needs calpol. If you think it is, then maybe worth mentioning at your next hospital appointment (we had weekly check ups, are you getting this?) We were given soft lint strips to put in the bits that might rub and that helped a lot. Or it may be that you need a bigger size or it needs readjusting.

It's hard, I know, we've been there. All I can say is try and hang on in there and each day you get through is a day closer to when it comes off. Keep posting and we will help in any way we can, even if it's just sending waves of moral support!

Robino answering DrCosy.....

Hi Trillian - winter born baby here. Your answer is dresses and these. Then you can add socks if needed but my DD had fewer problems with socks than her compatriots in winter as she couldn't kick them off her harness (assuming your harness has inbuilt toes).

I suspect (and hope) your DD will calm down a bit on the sleeping front when she gets a bit more used to it. The winding I can't help with but it will not be easy so positive thoughts for you.

Last thing - do you have a spare harness for when the inevitable "monster poo" covers the other one?

I don't want to cause confusion but my DD couldn't wear leg warmers as to get them on you'd have to remove the foot part of the harness (which wasn't allowed) or pull them over the harness which pulls in the straps and so compromises the harness. How did you manage it Robino? (Genuine question).

I used to put my DD in a babygro one size too big with the crotch section unbuttoned (so the straps stayed in a triangle shape from shoulders to feet) then put a dress on top of that to disguise the partly dressed look. I described DDs wardrobe at length in the link I posted further up the thread(!) It was important to me for her to look normally/properly dressed - I think it helped me deal with the whole thing.

We also weren't allowed to remove the harness even in the event of a monster poo. We had to clean round it (and put thin gauze between dirty harness and skin) and make an appointment for an asap visit to have another one fitted. Advice about this and bathing in general varies from hospital to hospital it would seem though.

Oh blimey; I think I'm going to stop giving advice on these threads! It seems like our hospital/ consultant were very lax about what you could/ couldn't do with a harness.

We were allowed to take her out for an hour twice a week in order to bathe her. I was also told if it was looking tight because she had grown that we were to adapt it ourselves as long as we kept it at the same angles. Maybe this is why DD was in her harness for so long

Our consultant/physio were very strict on the "do not touch the harness" front alright, so the leg warmers are out for us I'm afraid. They're very cute though :)

I had planned to cut the legs off some leggings she has and use them as diy leg warmers when she was supposed to be in the brace, but was then flummoxed by how to keep her legs warm in the harness. The physio said we should have no problems dressing her, but again had no practical advice - I'm pretty sure she has no experience of handling babies with her lack of her breast feeding advice .

We're dreading the monster poo as we don't have a second harness! She actually had a pretty giant one the day she got the harness, but my husband was home so between us we managed to change the nappy without getting it everywhere. It was a 2 man job though, so hoping she doesn't do it when husband is at work!

I re-read the thread you posted herethereandeverywhere - good advice! I only read the breast-feeding bits at the time as that was my main concern .

Feeding has stalled a little again, but I'm hoping it's just because she's tired after a busy day with visitors.

can you feed in bed/floor, with her lying down and head to the side. use cushions etc to get you into the best position for this?

It is definitely possible to use a sling with one of those harnesses and there's some research out there that indicates it actually helps to reduce the time a baby will need to spend in the harness.

Some info on www.storchenwiege.com/babycarrierresearch.htm will try and dig out my other links.

There are several mums on Natural Mamas www.naturalmamas.co.uk/ who've got babies with (or had) hip dysplasia who would be able to advise you on slings if you wanted to go down that route.

I know of one mum local to me who's on NMs who breastfeeds so she may also have some advice she can lend.

Hope that helps :)