Reference — Pediatrics
Pavlik Harness Care Reference
The Pavlik harness holds an infant’s hips flexed and abducted so the femoral head molds a deeper socket. Worn faithfully under about 6 months of age, it corrects most DDH without surgery — and the two nursing jobs are protecting the skin and protecting the wear schedule.
Educational use only. Strap positions are set by the orthopedic provider and adjusted only by them. Wear schedules and any permitted removal times come from the treating team — confirm the specific orders. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
How It Works
The harness keeps the hips in the position that seats the femoral head into the acetabulum, so the socket deepens as the baby grows. It works best under ~6 months and depends on near-continuous wear. It is not painful, and babies adapt within days.
Do
- ✓Keep the harness ON as prescribed (often 23–24 h/day) — only the orthopedic team removes or adjusts straps
- ✓Dress the baby in a snug cotton undershirt under the chest straps and knee-high socks under the leg straps
- ✓Put the diaper UNDERNEATH the straps; change frequently to keep the harness dry
- ✓Check skin under all straps at every diaper change — especially behind the knees, the groin, and shoulders
- ✓Sponge-bathe while the harness stays on (or per the exact provider instructions for brief removal, if any)
- ✓Position the legs in the harness's flexed-and-abducted set; support with the harness, not against it
Don’t
- ✕Don't remove or loosen/tighten the straps — the strap marks are set by the provider
- ✕Don't apply lotions, oils, or powders under the straps (they macerate skin)
- ✕Don't force the legs together or use devices/swaddles that straighten the hips
- ✕Don't ignore decreased spontaneous leg kicking or knee extension (possible femoral nerve issue)
Report to the Provider
- !Redness that doesn't fade, blisters, or skin breakdown under straps
- !Decreased leg movement, kicking, or knee straightening
- !Cold, dusky, or poorly perfused feet; swelling
- !Foul odor or drainage; the harness no longer fitting (rapid growth)
NCLEX Pearls
- ✦Parents do NOT adjust or remove the straps — only the orthopedic team does.
- ✦Undershirt under chest straps, knee socks under leg straps; no lotions/powders.
- ✦Diaper goes UNDER the straps; keep the harness dry, sponge-bathe with it on.
- ✦Check skin under straps at every diaper change; report redness that doesn't fade.
- ✦Decreased kicking or knee extension can signal femoral nerve compromise — report it.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American Academy of Pediatrics (AAP) · CDC / ACIP (immunization schedule). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →