Flat Feet
All babies appear to have flat feet. The reason for this is that a baby’s foot initially has a large fat pad on the inside arch which slowly decreases as they grow. The ligaments that hold together the bones of the arch of the foot are also lax and flexible. This wad of fat causes them to have a waddling gait when they first start walking and the high inside arch seen on most adults' feet doesn't start to develop until around two years old and will not be fully developed until around six years old. Children usually start to take adult-like heel-toe steps around three to four years old.

Games e.g. tickling your baby’s toes, feet and legs can help to stimulate your baby's muscles. However it is advisable not to over do this activity because too much tickling may cause stress to your baby because they are unable to ask you to stop. It is also a good idea to let your baby kick around a lot.

Intoeing
Parents are very aware of their child’s gait and intoeing is by far the commonest worry presented by parents to health visitors. Intoeing is seen when the toddler walks with the feet turning inwards (commonly called "pigeon-toed"), but most cases correct themselves as the child becomes a more confident walker. Intoeing is caused before the baby is born, when the feet are pressed into this position inside the uterus. Intoeing usually doesn't cause serious problems, even if it doesn't go away by itself and it does not cause arthritis or clumsiness Talk to your health visitor or GP if the problem persists beyond toddlerhood or worsens, especially if it only seems to affect one foot, as there could be an underlying developmental problem that needs checking out.

Bow Legs
Bowing is part of the normal development of the child and will improve as the child grows without treatment. Babies are born with bow legs and some children correct their bowing early, for example, in some babies by about eighteen months of age the leg will have corrected itself by straightening out. In other children a knock-kneed alignment will still be present by the age three to four years old and will not be corrected to the normal adult alignment until the age of five or six. Occasionally the bowing will never fully correct and that is why some adults have bowed legs. Bowing does not require treatment and as you can see there is a wide range of normal. However if you are worried about any aspect of your child’s development talk to your Health Visitor or GP

Frances Byatt-Smith RN RHV BA Psychology

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