Q: Hi Doctor, I am planning to buy a baby carrier and I have read recently that ‘baby carrier X’ is not good for the babies’ hip. Is this true? How do I decide which carrier is good for my baby as there are a few brands in the market. (Sharifah) A: Dear Sharifah, Baby carriers or baby wearing have been around for centuries and as of late, baby carriers have become controversial.  At the end of the day, as with any issues concerning babies, good safety practices and informed choices by the parents are important.  Whichever carrier you choose, research it well and learn to use it properly. Before I go on further it is important to understand that hip dysplasia is known to develop around the time of birth or after birth hence that is why hip dysplasia is often referred to as developmental dysplasia of the hip (DDH).   It is thought that genetics plays a role but until today the exact cause of DDH is still unknown and there are no evidence based research or studies which has correlated baby carrier with hip dysplasia. What is Developmental Dysplasia of the Hip (DDH)? The hip is a “ball-and-socket” joint. DDH is a condition where the hip is unstable and is dislocated i.e the ball (upper end of the thighbone) is out of the socket. The dislocation may be partial or complete and may affect one or both hip. The condition runs in families. How to recognize DDH in babies? The signs include reduced flexibility of one leg, different lengths of the legs and uneven skinfold on the thigh. The child may be limping or have a duck-like walk.  However it is important to remember that some babies may not show any sign. Although babies’ hip are checked after birth before discharged home, not all DDH can be picked up as some may not be present at birth and may develop after. That is why choosing the right carrier is important. The Medical Advisory Board of the International Hip Dysplasia Institute  (IHDI) recommends that when one wants to choose a carrier, the principal is that the carrier should allow the hips to spread apart. The hips should bent and the thigh needs to be separated. This is ‘healthy hip positioning’ and would promote natural hip development . When the hips and knees are straight and the legs are brought together, this unhealthy position may pose risk to the baby, especially if maintained for a long time. The following are recommended positions by Medical Advisory Board of the International Hip Dysplasia Institute :- 1) CAR SEATS 2) BABY HARNESS   Not recommended : Thigh NOT supported to the knee joint. The resulting forces on the hip joint may contribute to hip dysplasia.  Recommended : Thigh is supported to the knee joint. The forces on the hip joint are minimal because the legs are spread, supported, and the hip is in a more stable position. 3) BABY SLING  Baby carriers may be used from birth and it is imperative that both mother and the baby should be comfortable with it. It’s an individual choice and I agree that there are many in the market and therefore it may be difficult to decide. But imagine carrying your child naturally, your carrier should also give the same ‘natural’ comfort  feeling. Safety Guidelines for Learning New Carrier 1. Use a teddy and practice first. Understand how to use the carrier well , preferably in front of the mirror so you can have a good look on how the baby ‘s limb looks like when in it. 2. Pick a good day to try the carrier. Both mother and baby should be well rested before trying out the new device. 3. Get a spotter to help you. The spotter must be able to catch the baby at any instant if he or she should start to fall. 4. Start with the carrier while you’re sitting on the floor then move up. Next try lifting the child onto your body from a chair. This should be done gradually as you feel comfortable with how it works. ( answered by Dr Charlotte Jane Joseph ) References: 1.http://hipdysplasia.org/developmental-dysplasia-of-the-hip/prevention/baby-carriers-seats-and-other-equipment/#sthash.BTyJZr3k.dpuf 2. http://www.which.co.uk/baby-and-child/baby-transport/guides/choosing-a-sling-or-baby-carrier/ 3. http://babywearinginternational.org/pages/safety.php