From the Guidelines
Parents should follow up with a healthcare provider if their infant's feet turn outward while walking and the condition persists beyond age 2-3, worsens over time, causes pain, affects only one foot, or is accompanied by other developmental concerns. This recommendation is based on the understanding that outward-turning feet can be a common and often self-resolving condition in early walkers, but persistent cases may indicate underlying issues that require evaluation and possible intervention 1.
Key Considerations
- The natural development of a child's feet and legs, including the soft cartilage and layer of fat tissue, can mask abnormal development, emphasizing the need for careful observation and follow-up if concerns arise 1.
- Allowing children to walk barefoot or in socks indoors can help feet grow normally and develop muscular joint strength, but this must be balanced against the risk of damage to unprotected skin, particularly in conditions like epidermolysis bullosa (EB) 1.
- Protective dressings and appropriate footwear are crucial for children with severe types of EB to prevent damage and promote mobility and independence, despite potential cost implications and limitations in availability 1.
Assessment and Intervention
During assessment, a healthcare provider will examine the child's gait, leg alignment, and joint flexibility, possibly ordering imaging studies if structural issues are suspected. Most cases of outward-turning feet resolve without intervention as children grow, but some may benefit from physical therapy exercises, orthotic devices, or rarely, surgical correction for severe cases that persist into later childhood. The decision to intervene should be based on the severity of the condition, its impact on the child's quality of life, and the potential for natural resolution with growth and development.
From the Research
Feet Turning Out While Walking in Infants
- The development of an infant's gait is a complex process that involves the interaction between the infant's maturation and the environment 2.
- As infants begin to walk, their feet may turn out due to various factors, including developmental dysplasia of the hip (DDH) or other musculoskeletal issues.
- Studies have shown that infants with DDH may exhibit unique developmental trajectories, and early intervention can improve gait acquisition 2, 3.
Monitoring and Follow-up
- It is essential to monitor an infant's gait development and follow up with a healthcare professional if concerns arise about their walking pattern, including feet turning out.
- A healthcare professional may recommend regular check-ups to assess the infant's gait development and identify any potential issues early on.
- Early detection and treatment of DDH or other musculoskeletal issues can help prevent long-term complications, such as early coxarthrosis 4, 3.
Treatment and Management
- Treatment for DDH or other musculoskeletal issues that may cause feet to turn out while walking in infants depends on the underlying cause and severity of the condition.
- Pelvic osteotomy may be required in cases of persistent acetabular dysplasia, and recent research has suggested various treatment options for managing residual dysplasia 5, 3.
- A healthcare professional can provide guidance on the best course of treatment and management for an infant with feet turning out while walking.