Look Who's Walking
Before she takes her first step, your baby needs to develop adequate strength in her legs to carry her body weight, as well as the confidence to stand on her own two feet. While many parents look to the first birthday as the target date for this major milestone, the average age when children begin walking is closer to 15 months.
A lot of babies "cruise" -- walk by holding on to furniture -- for many months before taking those first real steps. When children do walk on their own, their feet tend to spread out farther than adults' feet to give them more stability. You may also find that your child walks on his toes. This is normal at the beginning, but persistent toe-walking is not.
If your child is still walking on his toes after a few months, make an appointment with a podiatrist, who will test for a tight Achilles tendon or a contracted muscle. (The APMA Web site, apma.org, can recommend a podiatrist in your area who treats children.) If that's not the problem, your podiatrist may refer you to a neurologist because, in rarer cases, toe-walking can be a symptom of a neurological problem.
Besides toe-walking, many other foot and leg problems that might not have been apparent at birth are often noticed by parents and doctors when a child starts to walk. This is a good time to visit a podiatrist if you have any concerns, especially if there's a family history of foot problems.
One such problem, intoeing or pigeon toes, is when one or both feet point inward. It can be caused by uncorrected metatarsus adductus or an abnormal rotation in the foot, leg, thigh, or hip. Some children outgrow the condition, but unfortunately many do not, especially if foot and leg abnormalities run in the family. These cases may require surgery to correct. It's also a good idea to have children sit with their legs crossed in front of them rather than on their knees or with their legs behind them, which can aggravate intoeing.
Your toddler may also appear to have knock-knees (knees that are turned in) or to be bowlegged (turned out at the knee), but typically as she walks, her legs will straighten out. If you're concerned, your pediatrician can evaluate your child's knees to determine if they are in proper position for your little one's age.
If your baby's feet still appear to be flat by the time he's 2 1/2 to 3, he may truly be flat-footed due to a bone deformity or a tight Achilles tendon. Have a podiatrist evaluate him, particularly if there is a family history of flat feet. The condition can lead to leg cramps, bunions, and hammertoes as early as the teenage years. Flat feet can be treated with shoe inserts once your child begins to walk. In some cases surgery may be recommended.
The earlier foot and leg problems are diagnosed and treated, the better off your baby will be.