Clicking Hips (Developmental Dysplasia of the Hip) in Babies
Content reviewed against published AAP, NHS, NIH guidelines
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Hip clicking, clunking, or instability in babies can be a sign of developmental dysplasia of the hip (DDH), where the hip joint does not develop properly and the ball does not sit securely in the socket. Soft clicks from ligaments/tendons are common and benign, but a distinct "clunk" (the feeling of a joint moving in or out) needs urgent evaluation. DDH affects approximately 1-3% of newborns and is best treated early — ideally in the first 6 weeks of life with a Pavlik harness.
Key takeaways
- Hip clicking, clunking, or instability in babies can be a sign of developmental dysplasia of the hip (DDH), where the hip joint does not develop properly and the ball does not sit securely in the socket.
- Most common cause: Benign soft tissue clicks (ligaments, tendons — normal)
- Emergency: Hip dislocation after trauma (severe pain, inability to move leg, deformity)
- Home care: Important: hip clicking needs professional assessment — this is not a "wait and see" situation
Possible Causes
When to Seek Help
Emergency — Call 911 or go to ER:
- Hip dislocation after trauma (severe pain, inability to move leg, deformity)
Urgent — See doctor today:
- Distinct hip "clunk" detected in newborn (needs ultrasound within 2 weeks)
- Newborn with risk factors and clinical signs of DDH (limited abduction, leg length difference)
- Failed or missed newborn hip screening with current concerns
Same-day appointment:
- Asymmetric thigh folds or apparent leg length difference noticed by parent
- Limited hip abduction (cannot spread legs equally)
- Hip click or clunk persisting beyond the newborn period
- Walking with a limp or waddle at onset of walking
Monitor at home:
- Soft clicks without limitation of movement or asymmetry (common and benign)
- Known DDH under treatment with Pavlik harness — routine monitoring
- Mild laxity detected at birth with planned follow-up ultrasound
- Normal hip examination with family history of DDH (screening ultrasound at 4-6 weeks)
By Age
0-2 months
Normal: Soft "clicks" from ligaments and tendons are extremely common and usually benign. Mild hip laxity from maternal hormones is common and typically self-resolves. Hips checked at birth and 6-8 week check.
Worry if: Distinct "clunk" felt during hip examination (Ortolani or Barlow positive). Asymmetric thigh skin folds. Apparent leg length discrepancy. Limited abduction (cannot spread legs equally for diaper change). Risk factors: breech presentation, family history of DDH, first-born female.
2-6 months
Normal: Mild hip clicks from ligaments are still common and usually benign. Hip laxity should be improving as maternal hormones clear.
Worry if: Limited hip abduction (one or both sides). Asymmetric thigh creases. One leg appearing shorter. Clicking becoming more pronounced rather than resolving. Difficulty with diaper changes due to tight hips.
6-12 months
Normal: Hips should be stable. Clicking sounds from normal movement joints are common.
Worry if: Late presentation of DDH: limping when starting to walk, leg length discrepancy, waddling gait. Limited range of hip movement. One side consistently less mobile.
1-3 years
Normal: Occasional joint sounds during normal play and movement. Toddler joints are flexible and may pop.
Worry if: Limping or waddling gait. Leg length discrepancy. Pain with hip movement. Walking on toes on one side (compensating for short leg). Late walking combined with hip stiffness.
Home Care
- Important: hip clicking needs professional assessment — this is not a "wait and see" situation
- Avoid tight swaddling of the legs — hips should be free to flex and abduct (spread apart)
- Use "hip-healthy" swaddling: snug around arms/chest but loose around hips and legs
- When carrying baby, encourage legs in "M" position (knees above hips, spread apart)
- Use baby carriers that support hips in flexed, spread position (avoid narrow-based carriers that hold legs together)
- If Pavlik harness is prescribed: wear it as directed (usually 23 hours/day), keep skin clean and dry underneath
- Double diapering is NOT a treatment for DDH despite past recommendations
- Attend all follow-up ultrasound and orthopedic appointments — early treatment prevents surgery
- Risk factors to share with doctor: breech presentation, family history, first-born, female sex, oligohydramnios
Frequently asked questions
What causes clicking hips (developmental dysplasia of the hip)?
When is this an emergency?
What can I do at home?
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Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Symptoms
Bottom line
Most cases of clicking hips (developmental dysplasia of the hip) in babies are not emergencies. However, seek immediate care if hip dislocation after trauma (severe pain, inability to move leg, deformity).
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.