Double diapering facilitates hip maturation in newborns

Background: Double diapering may help to maintain a baby's hips in flexion and abduction posture, but the efficacy in facilitating hip maturation has never been verified. We investigated whether double diapering results in greater improvement of the alpha angle in newborn babies. Methods: This...

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Main Authors: Wei Chun Lee, Hsuan Kai Kao, Mei Chun Chen, Wen E Yang, Shih Ming Chu, Chia Hsieh Chang
Format: Article
Language:English
Published: Elsevier 2022-03-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957221002217
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author Wei Chun Lee
Hsuan Kai Kao
Mei Chun Chen
Wen E Yang
Shih Ming Chu
Chia Hsieh Chang
author_facet Wei Chun Lee
Hsuan Kai Kao
Mei Chun Chen
Wen E Yang
Shih Ming Chu
Chia Hsieh Chang
author_sort Wei Chun Lee
collection DOAJ
description Background: Double diapering may help to maintain a baby's hips in flexion and abduction posture, but the efficacy in facilitating hip maturation has never been verified. We investigated whether double diapering results in greater improvement of the alpha angle in newborn babies. Methods: This prospective study enrolled newborns with Graf type IIa immature hips and assigned them to the double-diaper or single-diaper group by the day of birth in a week. Parents were instructed on proper hip positioning, except for diapering. Change in the alpha angle from newborn to 1 month after birth, rate of improvement to bilateral Graf type I hips in 1 month, and number of ultrasound examinations and orthopaedic clinic visits in the first year were compared between the two groups. Results: Seventy newborns with 102 type IIa hips were included from January to December 2017. They were allocated to the double-diaper group (n = 33) and single-diaper group (n = 37). With a comparable sex ratio, gestational age, and newborn alpha angle, the double-diaper group had a greater increase of alpha angles in 1 month than the single-diaper group (+7.9° vs. +5.2°, t-test, p = 0.011). Twenty-eight babies in the double-diaper group (84.8%) and 20 babies in the single-diaper group (54.1%) improved to having bilateral Graf type I hips (chi-square test, p = 0.006). Under the same clinical management pathway, subsequent clinical visits and hip ultrasounds before 1 year were significantly reduced in the double-diaper group. Conclusion: Double diapering enhances hip maturation and reduces clinical costs in newborns with physiological immature hips, but the therapeutic role for hip dysplasia requires further study.
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spelling doaj-art-5f4ca1f5e0a048b49577f1dfd0cae5f52025-08-20T03:06:16ZengElsevierPediatrics and Neonatology1875-95722022-03-0163215916410.1016/j.pedneo.2021.06.021Double diapering facilitates hip maturation in newbornsWei Chun Lee0Hsuan Kai Kao1Mei Chun Chen2Wen E Yang3Shih Ming Chu4Chia Hsieh Chang5Department of Pediatric Orthopedics, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, TaiwanDepartment of Pediatric Orthopedics, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, TaiwanDepartment of Pediatric Orthopedics, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, TaiwanDepartment of Pediatric Orthopedics, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, TaiwanDepartment of Paediatrics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, TaiwanDepartment of Pediatric Orthopedics, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan; Corresponding author. Department of Pediatric Orthopedics, Chang Gung Memorial Hospital, 5 Fushing Street, Kueishan Area, Taoyuan, 333, Taiwan.Background: Double diapering may help to maintain a baby's hips in flexion and abduction posture, but the efficacy in facilitating hip maturation has never been verified. We investigated whether double diapering results in greater improvement of the alpha angle in newborn babies. Methods: This prospective study enrolled newborns with Graf type IIa immature hips and assigned them to the double-diaper or single-diaper group by the day of birth in a week. Parents were instructed on proper hip positioning, except for diapering. Change in the alpha angle from newborn to 1 month after birth, rate of improvement to bilateral Graf type I hips in 1 month, and number of ultrasound examinations and orthopaedic clinic visits in the first year were compared between the two groups. Results: Seventy newborns with 102 type IIa hips were included from January to December 2017. They were allocated to the double-diaper group (n = 33) and single-diaper group (n = 37). With a comparable sex ratio, gestational age, and newborn alpha angle, the double-diaper group had a greater increase of alpha angles in 1 month than the single-diaper group (+7.9° vs. +5.2°, t-test, p = 0.011). Twenty-eight babies in the double-diaper group (84.8%) and 20 babies in the single-diaper group (54.1%) improved to having bilateral Graf type I hips (chi-square test, p = 0.006). Under the same clinical management pathway, subsequent clinical visits and hip ultrasounds before 1 year were significantly reduced in the double-diaper group. Conclusion: Double diapering enhances hip maturation and reduces clinical costs in newborns with physiological immature hips, but the therapeutic role for hip dysplasia requires further study.http://www.sciencedirect.com/science/article/pii/S1875957221002217double diapergraf IIa immature hipultrasound
spellingShingle Wei Chun Lee
Hsuan Kai Kao
Mei Chun Chen
Wen E Yang
Shih Ming Chu
Chia Hsieh Chang
Double diapering facilitates hip maturation in newborns
Pediatrics and Neonatology
double diaper
graf IIa immature hip
ultrasound
title Double diapering facilitates hip maturation in newborns
title_full Double diapering facilitates hip maturation in newborns
title_fullStr Double diapering facilitates hip maturation in newborns
title_full_unstemmed Double diapering facilitates hip maturation in newborns
title_short Double diapering facilitates hip maturation in newborns
title_sort double diapering facilitates hip maturation in newborns
topic double diaper
graf IIa immature hip
ultrasound
url http://www.sciencedirect.com/science/article/pii/S1875957221002217
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