Hip Clicks During Diaper Changes
The short answer
Soft clicking sounds from your baby's hips during diaper changes or leg movements are very common and usually harmless. These clicks are typically caused by ligaments and tendons snapping over the joint and are different from a true hip "clunk," which may indicate hip instability. Your pediatrician checks the hips at every well-child visit.
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By Age
What to expect by age
Soft clicking or popping sounds from the hips are very common in newborns as their joints are still loose and flexible. These benign clicks are caused by ligaments and tendons moving over the joint and are not the same as the "clunk" that pediatricians look for during hip exams (Ortolani and Barlow tests). A clunk feels like a joint moving in or out of position and is a sign of hip instability that needs further evaluation. If your pediatrician finds the hips to be stable on examination, clicking sounds alone are not concerning.
Clicking may continue and remains common. Your pediatrician will continue to check the hips at routine visits. If there are risk factors for hip dysplasia (breech presentation, family history, firstborn girl), a hip ultrasound may be ordered around 6 weeks of age regardless of examination findings. Simple clicking without instability does not typically require imaging.
Hip clicking from ligaments usually decreases as your baby's joints stabilize. If clicking persists or you notice asymmetric leg folds, limited hip movement, or one leg appearing shorter, mention these to your pediatrician.
Joint clicking may occur occasionally from normal joint movement and remains common in active babies. If there are concerns about hip development, X-rays replace ultrasound as the preferred imaging after about 4-6 months of age.
What Should You Do?
When to take action
- Soft, painless clicking sounds during diaper changes or leg movements
- The clicks are not associated with any visible movement of the hip joint in or out of position
- Your pediatrician has examined the hips and found them stable
- Baby moves both legs freely and equally
- You notice a louder, deeper "clunk" rather than a soft click
- One leg seems less flexible or cannot be spread as wide as the other during diaper changes
- The thigh skin folds appear markedly uneven
- Your baby suddenly stops moving one leg, seems to be in pain with hip movement, or one leg appears significantly shorter than the other
- Your pediatrician detects a hip clunk on examination and recommends urgent imaging or referral
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Physical Concerns
Baby Hip Dysplasia (Hip Click)
Developmental dysplasia of the hip (DDH) is a condition where the hip joint does not form properly, ranging from mild looseness to complete dislocation. It occurs in about 1 in 1,000 births and is more common in firstborns, girls, breech babies, and those with a family history. When caught early, treatment with a soft brace (Pavlik harness) is highly effective.
Hip Screening Ultrasound Follow-Up
A hip ultrasound may be recommended for your baby based on risk factors for developmental dysplasia of the hip (DDH), including breech presentation, family history of DDH, or findings on physical exam. The ultrasound is painless and helps ensure the hips are developing normally. Early detection and treatment of DDH leads to excellent outcomes.
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