Newborn Feet Turning In: What's Normal?

It is relatively common for a newborn to have one or both feet turning inwards, a condition known as talipes or clubfoot. This occurs due to the position of the baby in the womb or genetic factors, and it can often be corrected with gentle exercises, stretching, or casting. In some cases, the condition may self-correct over time without any treatment. However, if you are concerned about your baby's feet, it is important to consult a doctor or health professional for advice and guidance.

Positional talipes, or talipes equinovarus (TEV), is a common condition in newborns that may affect one or both feet

Positional talipes is usually diagnosed after birth during routine examinations of the baby's feet. It is important to distinguish it from structural talipes, as the latter requires more intensive treatment. In most cases, positional talipes can be treated with simple exercises that stretch the foot and ankle in an upwards and outwards direction. These exercises are gentle and painless for the baby, and they can be demonstrated by a maternity hospital physiotherapist. Additionally, ensuring that the baby's clothing is not too tight around the feet and massaging the foot and ankle with oils or lotions can aid in treatment.

In most cases, positional talipes improves within a few months without any treatment. However, if there is concern about stiffness or a lack of improvement, it is recommended to consult a doctor. In rare cases, more severe positional talipes may require a cast and orthotics. Nonetheless, positional talipes will not affect a baby's ability to crawl or walk.

It is important to note that babies with positional talipes on one or both feet should also undergo a hip examination. This is because there is an increased risk of associated conditions such as torticollis, hip dysplasia, and scoliosis. A hip screening ultrasound is recommended at 8 weeks of age for babies with positional talipes.

Clubfoot, or structural talipes, is one of the most common birth defects, affecting the tendons connecting the lower leg muscles to the inside of the foot

It is relatively common for a newborn to have a foot – or both feet – that turn inwards. This condition is called talipes, and it affects about 1 in 1,000 babies born in the UK. Talipes can be further categorised into two types: positional talipes and structural talipes. While the former is often caused by the position of the baby in the mother's uterus during pregnancy, the latter is a more severe condition known as clubfoot.

Clubfoot is characterised by one or both feet being rotated inward and downward. The affected foot and leg may appear smaller than the other, and the condition can cause walking difficulties and pain as the child gets older. It is important to distinguish clubfoot from positional talipes, as the former cannot be gently moved back into place.

The most common initial treatment for clubfoot is the Ponseti method, which involves correcting the foot position and then applying casts at repeated weekly intervals. If the clubfoot deformity does not improve, an Achilles tendon tenotomy can be performed, followed by the use of an orthopedic brace until the age of five. With early treatment, children with clubfoot can experience good results and lead a normal life.

Metatarsus adductus, a C-shaped foot, can cause pigeon-toeing and difficulty fitting into shoes

It is relatively common for a newborn to have a foot – or both feet – that turn inwards, a condition known as talipes. In most cases, this is something that will self-correct over time. However, if the foot is very curved or immobile, it may require treatment.

Talipes, also known as pigeon toe or intoeing, is further categorised into positional talipes and structural talipes. Positional talipes is when the foot is fully flexible or correctable and can be easily moved into a normal position. Structural talipes, on the other hand, is when the foot and ankle are immobile, indicating that the baby's foot bones are not growing in the correct direction.

Metatarsus adductus, a curved foot or C-shaped foot, is a common cause of pigeon toe in babies younger than 12 months old. It is a congenital malformation where the front portion of the foot turns inward, resulting in a C-shaped appearance. This condition can lead to pigeon-toeing and difficulty fitting into shoes as the child grows older.

Metatarsus adductus is caused by tight tendons or muscles pulling the bones into an abnormal position. Flexible cases may resolve with gentle stretching and manipulation, while inflexible cases may require serial casting or surgery in rare instances. Treatment for metatarsus adductus aims to gradually reposition and stretch the foot into the correct alignment.

In summary, metatarsus adductus, a C-shaped foot, is a congenital condition that can cause pigeon-toeing and shoe-fitting difficulties in children. Treatment options range from gentle exercises and stretches to serial casting and, in rare cases, surgery.

In-toeing, or pigeon-toeing, is a natural turning in of the legs that may persist as children get older

In-toeing, or pigeon-toeing, is a condition where a child's feet point inward instead of straight. It is a common condition in young children and infants, affecting approximately 1 in 5,000 births. It is usually painless and often resolves on its own without treatment. In most cases, children will outgrow the condition as they develop muscle strength and coordination.

There are three main causes of in-toeing:

• Femoral Anteversion: This is caused by a torsional pull from the hips, resulting in the child's knees and feet turning inward. It typically becomes noticeable when the child reaches school age and usually corrects itself by the age of 9 or 10.
• Tibial Torsion: This is caused by a torsional pull from the lower legs (shinbone), causing the child's legs and feet to turn inward. It typically improves gradually, with normal alignment occurring by the time the child starts school.
• Metatarsus Adductus: This originates from the feet, specifically the forefoot, and is a common foot deformity typically visible at birth. The foot bends inward from the midpoint to the toes, giving it a "C" shape. This condition usually corrects itself by the time the child reaches 6 months, but in severe cases, casting and special shoes may be required.

While most cases of in-toeing are mild and do not require treatment, early intervention is recommended if the condition is identified in infancy and does not show noticeable improvement over time. Treatment options may include physical therapy, stretching exercises, bracing, or casting. In rare cases, surgery may be considered for severe deformities or gait issues that persist beyond the age of 8.

It is important to monitor the condition and seek medical advice if there is no improvement or if the child experiences frequent tripping and falling. However, parents can be reassured that in-toeing is generally not a cause for concern and does not typically cause pain or long-term issues.

Treatment options for talipes include gentle exercises, stretching, manipulation, and casting

It is relatively common for a newborn's feet to turn inwards, a condition known as talipes. In most cases, this is something that will self-correct over time. However, if the foot is very curved or immobile, treatment options are available. Treatment options for talipes include gentle exercises, stretching, manipulation, and casting.

Gentle Exercises

Physiotherapy plays a crucial role in treating talipes. Physiotherapists can guide parents on exercises to perform with their baby's feet. These exercises focus on stretching and mobilising the foot and ankle, improving the range of motion and flexibility. The exercises are gentle, painless, and carry no known risks or side effects. They are typically performed when the baby is relaxed, such as during nappy changes.

Stretching and Manipulation

The Ponseti method, a widely used technique, involves gentle manipulation and stretching of the foot to relax the surrounding tissues. This technique gradually moves the foot into a better position. The physiotherapist stretches the foot, and after applying a plaster cast, the foot is held in this position.

Casting

After the foot has been manipulated and stretched, a plaster cast is applied to hold the foot in the corrected position. This cast is typically left in place for about a week, after which the process is repeated. Over time, the muscles and ligaments stretch, allowing for a better foot position. This gradual process may require multiple casts over several weeks to achieve the desired outcome.

Frequently asked questions