1. Pavlik Sling General Points It is best to allow the child’s knees and thighs to come apart to allow the hips to point toward the center of the child’s body. Try to avoid external forces to bring the child’s legs together, but allow the child to bring his/her knees together. Keep the legs naturally apart in a large “V” shape, but do not force them apart. The Pavlik sling is designed to keep your child’s hip in a specific position. The sling should not be removed at the beginning of the treatment and you should consult your doctor if it can be removed even if it becomes soiled. The position of the sling should be checked weekly or bi-weekly by a doctor or nurse at the beginning of treatment and sometimes needs to be adjusted. This is so that the hip is maintained in the best possible position as the child grows normally. Soft, lightweight clothing (preferably a T-shirt or tank top) can be worn in the sling. Sometimes the shoulder straps of the sling rub against the neck and can be padded with soft padding at the shoulder straps. DAILY: Check for skin abrasions on the knees, groin and both sides of the neck. IMPORTANT: You do not undo the straps (3, 4, 7, 8), these are the straps that maintain hip flexion and abduction. When the hip joint becomes normal (which it does in most cases), your doctor will begin to allow you to remove the sling at specific times. 2. How do I dress while wearing the Pavlik sling? Most babies can wear a onesie under the sling or a baby suit with buttons underneath for easy diaper changes. A onesie with a collar is recommended, but a regular onesie can also be worn if the straps do not rub against the baby’s neck. Clothing should be as loose as possible around the legs. When changing clothes it is important to undo only a part of the sling at a time to keep the hips in the proper position as much as possible. It is advisable to have more than one person help with the first few changes. To change the top: 1. Lay the baby down and first loosen (do not remove) the chest strap with the nylon buckle at the front. 2. 2. Undo the shoulder straps (#1) and take the right upper arm out of the garment. 3: Remove the dress from the baby’s head and refasten the shoulder straps (#1) 4: Undo the shoulder straps (#2) and take off the old dress. 5.Put on the new garment from the left upper arm, over his/her head, and re-tie the shoulder straps (#2) 6.Undo the shoulder straps (#1), the garment over the right upper arm, and re-tie the shoulder straps (#1) 7.Pass under the relaxed chest strap and straighten the garment (Points: Shoulder straps (#1) and (#2) should be fastened on the top of the infant’s blouse). 8. Check that both straps are at the marked points (sometimes the straps need to be readjusted) 9. Retighten the chest strap, loosening it to the point where four fingers can be placed between the baby’s chest and the chest strap. Socks Long socks may be worn under the leg straps of the Pavlik sling, which helps to avoid skin abrasion. To change socks: 1. Undo the two straps (#5) to take one leg out of the sling. 2, Put on the new sock, put the leg back in the garter and fasten the two straps. 3. Do the other leg as above (#6). It is best to wear cotton socks. Diapers Wear diapers in the normal manner but under the spreader straps (#3, 4, 7, 8). If the diaper is worn outside the sling, urine will soak the sling. Urine may corrode the sling and cause it to fail. Do not let him/her stand up during diaper changes. 3. How do I take off the Pavlik sling? 1. Place the baby on his/her back. 2. Remove the leg straps (#5, 6). 3, Remove the chest strap and shoulder straps (#1, 2). 4.How to put on the Pavlik sling? 1.Spread the sling on a flat area. 2: Lay your child on his/her back so that his/her back is at the back of the chest strap; 3: Fasten the front chest strap and shoulder straps according to the markings (#1, 2). 4, Finally fasten the foot straps (#5, 6). 5, When your child is not wearing the Pavlik sling Encourage your child to kick when he/she is not wearing the sling. The ideal time is during the baby shower. If your child is allowed to take off the sling, swimming is excellent practice. Your doctor will advise which activities are allowed at the clinic. When your child is not in a sling, they should be allowed to move freely. Treat them just like a normal child. All activities are allowed, but you should avoid adults pushing or pulling on your child’s hips. When your child can remove the sling for 4 or more hours a day, wash the sling by hand in warm water or in the washing machine. Use a non-irritating soap. If washing in the washing machine, wrap the sling in a pillowcase to prevent the buckles from damaging other clothing. If you dry the sling in a tumble dryer, the sling can also be wrapped in a pillowcase or placed on a towel in a radiator. Of course, the best thing is sunlight. 6. When the treatment is over Because your child has been wearing the sling for some time, his/her development may be relatively delayed compared to other children. However, this is only temporary and he/she will soon be able to catch up. As a precautionary measure, the use of baby walkers or baby trampolines is not recommended for 4 to 6 months after the end of treatment for hip dysplasia, as this is detrimental to hip development.