Almost all babies are born with some degree of bowleggedness because of the cramped quarters in the womb, says Charles Shubin, MD, director of pediatrics at Mercy FamilyCare, in Baltimore. Since there isn't enough room in there for a baby to stretch his legs out, the leg bones (which are still somewhat soft) become a little curved. As children walk and bear more weight on their legs, the bones naturally straighten. New walkers tend to look particularly bowlegged because they bend their knees to help them balance and support their body weight. Don't stress about bowlegs unless your baby's legs are extremely or unequally curved, or the condition gets worse.
If a child's shinbones or thighbones are slightly twisted, his feet will point slightly inward instead of straight ahead. Less commonly, pigeon toes (or intoeing) develop when the bones in the feet curve in. Both are the result of your baby's position in the womb, says Dr. Shubin. "The legs and feet fit most efficiently in that limited space when the feet are turned in." Pigeon toes that are caused by curved foot bones usually straighten out during infancy or toddlerhood, but it can take until age 6 or 8 for twisted shinbones or thighbones to resolve on their own. Children who have pigeon toes may trip occasionally when they first start walking, but they're no more clumsy than other kids.
Once the gap between your child's knees closes up, she may develop the opposite problem around age 2. Kids' knees can start getting closer together for a variety of reasons -- sometimes the bones overcorrect a little after they've stopped bowing, explains Sara Rizvi, MD, a pediatrician at Texas Children's Hospital, in Houston. Although knock-knees look painful, they usually aren't. In the vast majority of cases there is no need for concern, and your child will be able to run and play normally. Her legs should line up better by the time she's 5 to 7.
If your toddler constantly tiptoes, you might think she's got a future as a ballerina, but this walking style is another leftover from life in utero: Babies' feet are usually pressed up against their buttocks with their toes pointed downward, which shortens the Achilles tendons. This may make it hard for a young child to put her heels down, and it can take a few months of walking and standing to stretch out her Achilles tendons and calf muscles. If your child never puts her whole foot down or her toes seem stuck pointing down, talk to your pediatrician -- these may be signs of cerebral palsy. Also consult your doctor if your child frequently tiptoes after age 2. Although some children with autism do walk on their tiptoes, tiptoe walking alone isn't a red flag for autism in toddlers who are otherwise developing normally, says Dr. Rizvi.
Is It Time for Shoes?
Although it's tempting to buy your baby cute Mary Janes or sneakers, it'll be easier for her to learn to walk inside when she's barefoot. Once she starts toddling, she'll need flexible-soled shoes for walking on pavement.
When to Worry
Kids usually grow out of quirky walking styles, but contact your doctor right away if your child has any of these symptoms.
- Asymmetry (bowing in only one leg, one toe turning in, dragging one leg)
- Redness or swelling in the legs or feet
- Pain when walking
- Legs turning outward
- Constant tripping and falling
Originally published in Parents magazine.