Finally, your baby is walking and you've noticed his/her feet tend to point inward when they walk. Your child is intoeing, and you may be worried. Intoeing means that when a child walks or runs, the feet turn inward instead of pointing straight ahead. It is commonly referred to as being "pigeon-toed".

Intoeing is often first noticed by parents when a baby begins walking, but children at any age may display intoeing. Occasionally, severe intoeing may cause young children to stumble or trip.

Cause
It is believed that intoeing is related to the position the baby was in while in the womb before birth, as the legs/feet turn to try and fit in this confined space. The cause of intoeing depends on where in the lower leg it occurs -- the hips (tension in the ligaments); the thigh bones (femoral torsion); the knees (torsion, arched or knock knee); the legs (tibial torsion) or the feet (metatarsus adductus, in-toeing, hollow feet). These conditions may run in the family or may happen on their own.

What to expect
In most cases, intoeing usually does not cause pain, nor does it lead to arthritis. After birth, as the child grows, the infant's legs and feet should gradually rotate to a straighter position. In most children, especially those younger than eight, intoeing will correct itself because the foot is still flexible and growing even without the use of casts, braces, surgery or any special treatment. But a child whose intoeing is persistent, and who has pain, swelling, or a limp should be seen by a podiatrist.

Signs to watch for
o If the soles of the child's shoes wear unevenly;
o If your child has small lumps or bumps on his feet;
o If your child is experiencing pain in his feet or legs;
o If he falls or stumbles often;
o If she develops skin or nail problems;
o If he complains of tiredness in his legs/feet;
o If she keeps walking with her legs/feet turned inward with no improvement over time.

If the problem persists
In some cases, the problem may persist to later childhood. This is why it's important to pay attention and watch the way your child's feet are growing and how they are walking. This will help you identify any signals that may indicate a visit to the podiatrist is necessary.

What you can do
The majority of the intoeing will straighten by the time a child gets to adulthood, however, there are things you can do to promote healthy development of your child's feet and legs.

o Allow your baby to stretch his legs and kick his feet;
o Encourage your child to engage in simple stretching exercises;
o Do not allow your child to sit in the "reverse tailor" position. Children with this condition often sit with their knees bent under their hips and their feet flared out behind them. Even though they may find this position comfortable, discourage it. This is not good because it encourages both the knees and the feet to point inward while walking;
o Teach your child to have good posture;
o Make sure she wears proper socks and shoes;
o Orthotics may be needed.

If the problem still persists and causes major issues for your child such as pain, falls, tripping and unsightly gait, your podiatrist might prescribe her custom-made orthotics to reduce the daily symptoms. There are several different types of orthotics, and your podiatrist will recommend the most suitable according to your child's condition and needs.

o For more information or to see a podiatrist, visit Bahamas Foot Centre Rosetta Street, telephone 325-2996; Bahamas Surgical Associates, Albury Lane, telephone 394-5820; or email us at foothealth242@gmail.com, or visit www.apma.org.

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