Caring for Your Baby's Feet

Newborn Feet

Your baby's new feet may be blue, wrinkled, and peeling like much of the rest of his body after nine months in a cocoon of protective fluid. Be assured, however, that his feet will pinken up and fill out as soon as he gets warm.

Baby's feet normally appear flat because children are born with a pad of fat in the arch area. Also, their foot and leg muscles aren't developed enough to support their arches when they first begin to stand. In fact, the arch doesn't usually become apparent until about age 2 1/2.

At the time of delivery, your ob-gyn, and then later your pediatrician, will look for obvious abnormalities of your baby's feet and legs. She will check his hips to make sure they are not dislocated, tickle the bottom of his foot to check for the appropriate neurological response (the toes should fan out), and will actually count to make sure there are ten toes. Occasionally, an infant is born with an 11th (or even 12th) toe, called polydactyly.

Though alarming to parents, this condition simply requires surgical removal of the additional toe to avoid problems with wearing shoes and walking, as well as for cosmetic reasons. The procedure is usually done before your child begins to walk, but can be performed at almost any time from infancy. Once the toe is removed, your child's foot will develop normally, and he will run, jump, and play just like every other kid his age.

Webbed toes are much more common than multiple toes but often go unnoticed by parents because webbing can occur to varying degrees. Webbed toes result because the skin failed to separate between two toes during fetal development, making the area look webbed, similar to a duck's foot. The toes can be surgically separated for cosmetic appearances or if the webbing interferes with the normal toe movement essential for walking.

Genetics, uterine positioning, and prolonged breech positioning can contribute to various congenital foot deformities. Clubfoot, a common disorder, leaves the foot slightly smaller than a normal foot, with the toes pointing toward one another and down. The APMA says clubfoot occurs in 1 of every 1,000 live births and may be present in both feet. If you've already had a child with clubfoot, there's a 10 percent chance that a subsequent child will be born with it, too.

Foot x-rays confirm that a child has the condition, and additional x-rays of the limbs and spine are typically taken to rule out any other associated bone problems. Treatment can begin at birth -- the earlier the better -- while the foot and legs are still pliable. The skeleton of an infant is still very flexible as it hasn't yet solidified into the hard bones of older children and adults. Because of this flexibility, the abnormal position of the foot can be corrected with plaster casts. It takes several weeks to months, and the casts are typically changed every one to two weeks. Your baby should quickly catch up on achieving motor skills, such as rolling or crawling, once the casts are removed.

Special shoes or braces are usually required after the casting to hold the foot in its new position. Surgery may be needed if the initial treatment wasn't successful.

Metatarsus adductus is another foot problem present at birth. It is just as common as clubfoot but sometimes overlooked. The foot is often shaped like the letter "C" with the big toe pointing in and facing the other foot. To treat it, a podiatrist will stretch the foot and reshape it with plaster casts as well.