Introduction
The Rhino brace is a device that holds a baby’s hips in place to help them grow normally. It is usually used for older babies.
It is used to treat developmental dysplasia of the hips, or “clicky hips”.
About this device
Babies diagnosed with hip problems, like developmental dysplasia of the hips, will see a specialist health professional called an orthotist. An orthotist makes and fits different equipment like braces and braces and manages their use in treatment.
The Rhino brace is a lined, plastic shell that is worn by your baby and held in place using three Velcro straps.
This brace holds the legs up and apart, also known as a flexed or “frog” position. This is the best position for hip joints, allowing contact between the thigh and hip bones. This position helps strengthen the muscles and ligaments while your baby’s hips develop.
Your baby's orthotist will ensure the brace fits correctly and that you have education about checking and putting it on properly at home.
Generally, the brace is fitted correctly if you can still fit one finger between the brace and your child’s legs.
Care of the device
To wash the brace:
- wipe over the legs and brace with a damp cloth
- dry very well with a towel.
Contact your orthotist if you are concerned about cleaning the brace.
When to seek help
Speak to your child’s treatment team if you need help adjusting the Rhino brace.
Your child’s doctor will tell you how often your child should wear the brace and when it can be removed.
Management
Bathing and skin care
If your child's doctor has said the brace cannot be removed, you will need to give them a sponge bath instead.
If your child can remove the orthosis for bathing, try to keep their hips apart in the flexed position as much as possible during.
Make sure your baby is completely dry before refitting the brace. Pay special attention to skin folds around the thighs where moisture can get trapped.
Try to keep the brace as dry as possible.
Make sure there is always a thin layer of clothing between your baby’s skin and the brace.
Check your child's skin every day for any redness or irritation that may appear from rubbing, trapped sweat or other fluids. Contact your child's treatment team as soon as possible if their skin becomes broken or irritated.
Positioning
The Pavlik harness works best when a baby is on their back. You will need to regularly change your baby’s head position while sleeping to stop their head from being in the same position for too long. This will lower the risk of developing a flat head, or plagiocephaly.
Tummy time is still important for babies who are using the Rhino brace. Speak to your child’s treatment team for support and strategies for tummy time.
There should not be any issues with breast or bottle feeding with the Rhino brace. It may take some time to find a comfortable position that works best.
Keep your baby in the flexed position with the brace when holding them.
Clothing
Babies who are using a Rhino brace can use nappies as normal. When changing your baby’s nappy, lift them from their bottom instead of holding their feet together. This will lower the risk of moving their hips out of the correct position.
Babies can wear loose-fitting closed and sleep sacks that do not pull the knees together. Speak to your child’s treatment team for recommendations on types of clothing if you are unsure.
Carriers
Generally, babies should not be put in a carrier with a Rhino brace while in treatment. This is because carriers can put pressure on their hips.
Some brands are approved for use by Healthy Hips Australia. See them here: Healthy hips - babywearing.
Car seats
Most babies will be able to fit into their regular car seat or capsule with a Rhino brace while they are in treatment. Make sure you can secure the straps and your baby’s legs are not pushing hard against the sides.
Speak to your child’s orthotist if you have any concerns or want to check your baby’s position in their car seat while wearing the Rhino brace.
If you have not yet bought a car seat or capsule, you can speak to your treatment team about recommended brands, models, and attachments.
Strollers
Most babies will be able to fit into their normal pram or stroller with a Rhino brace while they are in treatment. Make sure you can secure the straps and your baby’s legs are not pushing hard against the sides.
Speak to your child’s orthotist if you have concerns or want to check your baby’s position in their pram or stroller while wearing the Rhino brace.
You can speak to your treatment team about recommended brands, models, and attachments if you have not bought a pram or stroller.
Some brands and models are approved for use by Healthy Hips Australia. See them here: Healthy hips – prams.
High chairs
Babies over six months old will start to eat solid foods. Using a highchair with a Rhino brace can be difficult.
Healthy Hips Australia has information about managing highchairs and the Rhino brace: Healthy hips – high chairs.