What Causes Frog Legs in Babies?

Frog leg position in babies is characterized by flexed hips and outward-spread legs, resembling a frog. This natural posture is common in newborns and young infants. It typically occurs during early development and resolves on its own as the baby grows, requiring no medical intervention in most cases.

While the frog leg position is normal, medical providers must be particular about more extreme postures. Severe or asymmetrical frog-like positions might be a sign of underlying hip issues, such as hip dysplasia. Through early diagnosis and treatment, long-term impairments from such underlying conditions may be mitigated or avoided altogether.

Doctors have the duty to protect the well-being of both mother and child. Failure to address risk factors; failure to diagnose the condition early; and lapses during the delivery process are medical negligence that may exacerbate frog legs/hip dysplasia, and other birth injuries. Families that are affected by such negligence may seek compensation through medical malpractice claims.

Key Takeaways

• The "frog-leg" position (knees bent and legs splayed outward) is very common in newborns and is often just a normal result of fetal positioning in the womb; it usually resolves as the baby grows and gains muscle strength.
• Persistent frog-leg posture beyond the newborn period, especially if it's stiff, asymmetric, or accompanied by limited movement, may signal an underlying problem such as hip dysplasia, low muscle tone (hypotonia), or a birth injury.
• Developmental dysplasia of the hip (DDH) is one of the most important medical causes of frog-leg positioning; early diagnosis and treatment (often with a harness or brace) can prevent long-term disability and the need for surgery.
• In some cases, frog-leg posture can be linked to birth injuries like oxygen deprivation (hypoxia), improper use of forceps or vacuum, or nerve damage, which may give rise to a medical malpractice or birth injury claim.
• Parents should seek prompt pediatric evaluation if frog-leg positioning is rigid, one leg is shorter, there's a hip "click," or the baby is not meeting motor milestones, as delays in diagnosing hip dysplasia or neurological issues can worsen outcomes.

What is Frog-Leg Baby Syndrome?

"Frog-leg baby syndrome" is not a formal medical diagnosis, but a descriptive term for when a baby consistently holds their legs in a frog-like posture: knees bent and thighs spread wide apart, resembling a frog's hind legs.

In healthy newborns, this posture is usually normal and reflects how the baby was curled up in the womb; it typically improves as the baby gains strength and starts to bear weight on their legs.

Medically, a persistent frog-leg posture can be a sign of:

• Developmental dysplasia of the hip (DDH), where the hip joint is unstable or dislocated
• Low muscle tone (hypotonia), often due to neurological or genetic conditions
• High muscle tone (hypertonia), as seen in cerebral palsy or other brain injuries
• Spinal cord or nerve problems (e.g., spina bifida, caudal regression syndrome)

Because this posture can be associated with serious conditions, any persistent, stiff, or asymmetric frog-leg positioning should be evaluated by a pediatrician or pediatric orthopedist.

Common Causes of Hip Dysplasia in Babies

Hip dysplasia is a developmental disorder characterized by abnormal formation of the hip joint. It involves insufficient coverage of the femoral head by the acetabulum, leading to joint instability. Severity ranges from mild subluxation to complete dislocation, potentially causing long-term functional impairment if left untreated.

Developmental dysplasia of the hip (DDH) is thought to result from a combination of genetic and environmental factors. Several maternal, infant, or genetic risk factors have been associated with this condition. These risk factors are:

Family history - Babies with a close relative (parent or sibling) who had DDH are at higher risk, suggesting a genetic or connective-tissue component.

Breech position - Babies born feet-first (breech) are at increased risk because the hips are under abnormal stress in utero; the left hip is more commonly affected due to fetal positioning. Infant in breech position (baby's bottom is presented first) increases the likelihood of developing this condition.

Being a first-time mother - First-born infants are more likely to have DDH, possibly because the uterus is tighter and there is less room for the baby to move, affecting hip development.

Having a female child - Girls are more commonly affected than boys, especially if they also have a family history or were in a breech position.

Large birth weight - Larger babies may experience increased pressure on the hip joint during development and delivery.

Other orthopedic conditions - DDH is more common in babies with clubfoot, metatarsus adductus, or certain syndromes (e.g., arthrogryposis, spina bifida).

Tight swaddling with legs straight - Swaddling that keeps the hips extended and pressed together (rather than allowing them to be flexed and spread apart) can increase the risk of hip dysplasia.

Birth injuries - In some cases, DDH or abnormal hip positioning may be linked to birth trauma, such as excessive force during delivery (e.g., improper use of forceps or vacuum), shoulder dystocia or difficult vaginal delivery, or oxygen deprivation (hypoxia) leading to cerebral palsy or neuromuscular problems.

These risk factors must be addressed effectively by medical providers to avoid hip dysplasia after birth. In cases where there is apparent maternal or fetal distress, medical teams must respond promptly - otherwise, they could be held liable for any birth injuries they might cause.

The incidence of developmental hip dysplasia in the US is approximately 10 per 1000 live births; and at birth, 1 in 1000 cases have dislocated hips. In Native Americans, the reported incidence is found to be 10+ times higher. In African individuals, developmental dysplasia of the hip is rarely identified.

Warning Signs and Symptoms of Hip Dysplasia

Hip dysplasia in babies is usually painless, so parents and caregivers often don't realize there's a problem until a pediatrician notices it during a well-child exam.

Parents should watch for these warning signs and seek prompt evaluation if any are present:

Uneven leg length - One leg appears shorter than the other, especially when the baby is lying on their back.

Limited hip movement - One hip or leg doesn't move as freely as the other; for example, it's harder to spread that leg outward during diaper changes.

Hip "click" or "clunk" - A popping, clicking, or clunking sensation or sound in the hip when moving the baby's legs, especially during diaper changes or when spreading the legs.

Asymmetric skin folds - The skin folds under the buttocks or on the thighs don't line up; one side has more or deeper folds than the other.

Persistent frog-leg posture - The baby consistently holds their legs in a frog-like position, especially if it's stiff, asymmetric, or doesn't improve with age.

Delayed motor milestones - The baby is slow to roll, sit, crawl, or walk, or has an abnormal gait (e.g., limping or waddling) when they start walking.

Refusal to bear weight - The baby avoids putting weight on one leg or seems to favor one side when trying to stand or cruise.

If any of these signs are noticed, parents should contact their pediatrician immediately and request a hip screening, which may include ultrasound (for infants under 6 months) or X-ray.

Preventing Hip Dysplasia from Developing

Hip dysplasia in babies can lead to several potential long-term effects if not addressed properly. Several measures - before and after birth - may be taken to lessen the possibility of hip dysplasia in newborns. These measures include:

Use hip-healthy swaddling - Swaddle with the baby's hips and legs able to bend up and out (frog-leg position), not tightly straight and pressed together; avoid tight swaddling that forces the legs into extension.

Use baby carriers and seats that support hips - Choose carriers, strollers, and car seats that allow the baby's hips to be flexed and spread apart (M-position), not dangling straight down.

Avoid prolonged time in restrictive devices - Limit time in car seats, bouncers, and swings when not traveling; give the baby plenty of tummy time and floor time to move freely.

Regular check-up and screening during pregnancy - Attend all well-child visits and make sure the pediatrician checks the hips at every checkup; early screening can catch DDH before it causes permanent damage.

Genetic counseling - For families with history of hip dysplasia, inform the pediatrician so they can monitor the hips more closely.

Doing exercises that encourage hip development - Gentle exercises and activities that promote healthy hip movement and development.

Avoiding prolonged baby walkers or jumpers - These devices can place unnecessary stress on developing hips.

Apart from early diagnosis and proper treatment, doctors must also properly educate their patients on child care, especially first-time parents. Doctors must also conduct regular evaluations of the newborn to ensure that they are healthy and well.

Early diagnosis also effectively prevents the development of this condition. It allows affected children to receive all necessary treatments before their condition worsens. In order to catch the condition early, medical providers may perform the following:

Physical Examinations

• Ortolani test, where the hip is gently abducted and lifted to feel for clunking
• Barlow test, where a downward pressure is applied on the thigh to check for instability
• Galeazzi sign, where leg lengths are compared for asymmetry

Imaging Tests

• Ultrasound, which is the primary tool used for infants under 6 months (typically under 4-6 months)
• X-rays, typically used for older infants and children (after about 6 months of age)
• MRI or CT (if needed) for complex cases to get detailed 3D images of the hip bones and soft tissues

Observation Of:

• Limited hip abduction
• Asymmetric skin folds on thighs
• Apparent leg length discrepancy

Routine Screenings

• Performed during regular pediatric check-ups

Diagnosis and Treatment Options

Early diagnosis and treatment of hip dysplasia are critical to prevent long-term complications like arthritis, chronic pain, and the need for hip replacement later in life.

Diagnosis

Clinical exam - The pediatrician or pediatric orthopedist checks for hip stability, range of motion, leg length, and skin folds; maneuvers like the Ortolani and Barlow tests are used to detect hip instability.

Ultrasound (sonography) - For infants under about 4-6 months, hip ultrasound is the preferred imaging test because the hip joint is still mostly cartilage; it shows whether the hip is properly seated in the socket.

X-ray - After about 6 months of age, X-ray becomes the standard imaging test to evaluate the bony structure of the hip joint and monitor treatment progress.

MRI or CT (if needed) - In complex cases, MRI or CT may be used to get detailed 3D images of the hip bones and soft tissues, especially before or after surgery.

Treatment Options

Treatments for hip dysplasia vary from case to case. Naturally, more severe cases require more complementary approaches. Age also plays a huge factor when designing treatment plans for children. Treatments for said condition may include:

Pavlik Harness - A soft brace for infants (0-6 months), keeps hips in proper position. This soft, dynamic harness gently holds the hips in the correct position while allowing some leg movement; worn full-time for several weeks, then part-time, with regular follow-up and ultrasound to monitor hip position and socket development.

Abduction Brace - Similar to Pavlik, used for older infants or milder cases (e.g., Ilfeld, Rhino, or "bucket" brace). A more rigid brace that keeps the hips flexed and abducted to promote proper joint formation.

Closed Reduction - Non-surgical repositioning, followed by casting. If bracing is not successful, the hip may be manually repositioned under anesthesia (closed reduction) and held in place with a body cast (spica cast) for about 3 months.

Open Reduction Surgery - Surgical hip repositioning for severe cases. If closed reduction fails or the hip is severely dislocated, surgery is performed to open the hip joint and reposition the ball into the socket; followed by a spica cast and often physical therapy.

Pelvic/Femoral Osteotomy - Reshaping bones in older children when more extensive surgical intervention is needed.

Physical Therapy - Strengthens muscles, improves joint mobility. Used alongside bracing or casting to maintain range of motion, strengthen muscles, and support normal motor development.

Hip Spica Cast - Full-body cast used post-surgery or for some reductions to maintain proper hip positioning during healing.

With early detection and appropriate treatment, about 90-95% of babies with DDH can achieve normal hip development and avoid long-term disability.

All medical expenses (past and future) are considered in a medical malpractice claim. In birth injury cases, compensation ensures that an injured child is provided with all the necessary support for their growth and development.

Apart from medical expenses, other economic and non-economic losses are also factored in. Lost income, emotional trauma, and decreased quality of life are some of the more common considerations. For actual compensation figures, please refer to our previous wins.

FAQ

When do baby frog legs go away?

In healthy newborns, the frog-leg posture usually starts to improve within the first few weeks to months as the baby's muscles strengthen and they begin to bear weight on their legs.

Most babies gradually straighten their legs and adopt more typical sitting and lying positions by 3-6 months of age, especially as they gain head control, roll, and start to crawl.

If the frog-leg posture is very stiff, asymmetric, or persists beyond 6 months, or if the baby is not meeting motor milestones, it may indicate an underlying problem like hip dysplasia or a neurological condition and should be evaluated by a pediatrician.

How can I prevent my baby from getting hip dysplasia?

Use hip-healthy swaddling - Swaddle with the baby's hips and legs able to bend up and out (frog-leg position), not tightly straight and pressed together; avoid tight swaddling that forces the legs into extension.

Use baby carriers and seats that support hips - Choose carriers, strollers, and car seats that allow the baby's hips to be flexed and spread apart (M-position), not dangling straight down.

Avoid prolonged time in restrictive devices - Limit time in car seats, bouncers, and swings when not traveling; give the baby plenty of tummy time and floor time to move freely.

Attend all well-child visits - Make sure the pediatrician checks the hips at every checkup; early screening can catch DDH before it causes permanent damage.

Be aware of risk factors - If there is a family history of hip dysplasia, breech birth, or other orthopedic problems, inform the pediatrician so they can monitor the hips more closely.

Can hypertonia in babies be cured?

There is currently no cure for hypertonia (high muscle tone) in babies, but it can be effectively managed with early, intensive therapy.

Treatment focuses on physical therapy to improve range of motion, strength, and motor skills; occupational therapy to support daily activities and fine motor development; medications (e.g., muscle relaxants) or localized injections (e.g., Botox) to reduce spasticity; and in some cases, treating the underlying condition (e.g., cerebral palsy, brain injury) can improve symptoms.

With consistent therapy and support, many children with hypertonia can achieve good function and quality of life, but it is typically a lifelong condition that requires ongoing care.

Is it normal for babies to have frog legs?

Yes, it is very normal for newborns and young infants to spend time in a frog-leg position, especially when lying on their back or during diaper changes.

This posture is a natural result of how the baby was curled up in the womb and usually resolves as the baby grows stronger and starts to move more.

However, if the frog-leg posture is very stiff or rigid (not floppy), noticeably different on one side, accompanied by a hip click, uneven leg length, or delayed milestones, or persistent beyond 6 months or worsening over time, then it may not be normal and should be evaluated by a pediatrician to rule out hip dysplasia, low/high muscle tone, or a birth injury.

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