Toeing In/ Pigeon Toed

In the first two years nearly all babies toe in. This is due to two conditions:

• The normal bowing of the legs leftover from the fetal position in the womb.
• Normal flatfeet. Babies seldom develop much of an arch until the age of three years. To compensate, babies turn their feet inward while walking, in effect to make an arch and better distribute their weight. The normal developmental timetable for feet and legs is as follows:
• Bowed legs from birth to three years
• Toeing out, ballerina style, when beginning to walk
• Toeing in from eighteen months to two to three years
• Walking with straight feet after three years
• Knock-kneed from three years to teens

If your toddler runs without tripping, don't worry about turned-in feet. This should self-correct. If, however, your child is tripping over his feet more and more, orthopedic treatment may be necessary, usually beginning between eighteen months and two years. (Treatment usually consists of a brace placed between special shoes to keep the feet turned out; the brace is worn while sleeping.)

Besides curving in of the lower legs, called internal tibial torsion, (twisting of the major lower leg bone), another reason for toeing in is internal femoral torsion (twisting inward of the upper leg bones).

Here's how to tell the difference: Watch your child standing. If the kneecaps are facing straight forward, the toeing in is most likely due to internal tibial torsion. If the kneecaps turn toward each other ("kissing kneecaps"), it's most likely due to internal femoral torsion.

Encouraging correct sleeping and sitting positions can lesson both deformities.

• The saying "As the twig is bent, so grows the tree" certainly applies to baby's legs. Discourage your child from sleeping in the fetal position . If baby persists in sleeping in this position, try sewing the pajama legs together.
• Try to keep your toddler from tucking his feet beneath him while sitting; this aggravates internal tibial torsion.
• To lessen internal femoral torsion, discourage your child from sitting in the W-position but encourage sitting cross-legged or sitting with his feet straight out.