Is your baby's feet turned inward? (Pigeon Toes/Intoeing) Let's talk about this!

When your little one starts walking, you might look at their little feet and think, "Wow, their feet are turned inward, aren't they?" Sometimes you might notice that your baby falls a little more than other babies when they walk or run. This is what we commonly call "pigeon feet," and doctors also call it ``intoeing .'' This is something that many parents worry about. But is it really something to be worried about? Let's talk about it in more detail, shall we?

What are these pigeon toes?

Simply put, pigeon feet are when your child's toes are turned inwards, instead of facing straight ahead. Think of it this way, when we walk, we keep our feet straight ahead. But in this case, it's a little different. The main reason for this is that some of the bones or joints in the child's legs are not oriented in the right direction. That is, there is a slight ``misalignment`` . This is often first noticed when the child starts walking.

The important thing is, as a mother or father, it's normal for us to worry about our children. Especially when they're young, because they can't tell if something is hurting them. But pigeon feet usually don't cause any pain. Most of the time, the condition gets better on its own over time, without any major problems.

How common is this condition?

In fact, pigeon feet are a very common condition that occurs in the first few years of a child's life. As children gradually learn to walk, this condition decreases to a great extent. Therefore, pigeon feet are less common as children grow older and reach adolescence. However, very rarely, this condition can persist in some adults.

How will clubfoot affect my baby?

You may notice that your child's feet are turning inward, whether they are just standing or walking. This may seem a little strange to you, but as mentioned earlier, it is very common. The important thing is that pigeon feet usually do not cause pain to the child. And as the child grows older, this condition should gradually improve.

Why do crow's feet occur? What are the causes?

When the bones in your child's foot, ankle (below the knee), or thigh (above the knee) don't line up properly, your doctor may use the term "pigeon foot" or "intoeing." There are three main reasons for this:

1. Bones in the foot:

The bones that connect our toes to the ankle joint are called `(Metatarsals)` . Sometimes, at birth, `(congenital)` these `(Metatarsals)` bones, especially the middle of the foot, can be tilted inward. This condition is called `(Metatarsus adductus)` . Then the foot looks like the letter "C". This is a very common cause of `(Intoeing)` in babies under 12 months. Some factors increase the risk of this `(Metatarsus adductus)` condition. For example:

• If the baby was in the breech position while in the womb.
• If the amount of amniotic fluid in the womb decreases (Oligohydramnios) .
• If someone in the family has had this condition before `(family history)` .

2. Shin bone (Tibia):

The most common cause of pigeon feet in children between the ages of 1 and 3 is a condition where the shin bone, or ``Tibia'', is turned inward, toward the center of the body. This is called ``Inward tibial torsion'' . If your child's ``Tibia'' is turned inward like this, their legs may appear slightly bow-legged . This condition usually improves on its own by the time the child is about 5 years old.

3. Thigh bone - Femur:

If your child's knee appears to be turned inward relative to the hip joint, it is called ``Femoral anteversion'' . This is because the thigh bone ``Femur'' is rotated inward. This condition can sometimes be passed down from parent to child. ``Femoral anteversion'' can also be caused by the position the baby was in while in the womb, or by ``crowding'' in the womb. Doctors usually recognize this between the ages of 3 and 6, and then the condition gradually decreases.

Other rare associated problems

Very rarely, there are other health problems that can be associated with the condition of pigeon feet. These include:

• `(Cerebral palsy)` (a problem with the nervous system, such as cerebral palsy)
• `(Clubfoot - Talipes equinovarus)` (A severe deformity of the foot present at birth)
• Developmental abnormalities of the hip joint
• Skewfoot and other rare malformations of the foot

These are very rare conditions, so don't panic. If you have any doubts, it's best to talk to a doctor.

Does this condition also occur in adults?

Usually, the condition of pigeon feet improves on its own as you get older. However, some conditions can cause it to persist into adulthood. Two main cases are:

• The previously mentioned `(Metatarsus adductus)` condition (the toes are turned inward, making the foot look like a "C" shape) persists.
• Persistence of ``Femoral anteversion`` (rotation of the thigh bone inward near the hip).

What are the symptoms of pigeon feet?

If you have pigeon feet, you may notice that your child's feet are facing each other and turned inward. This may look like this:

• Just at rest
• While standing `(Standing)`
• While walking `(Walking)`
• When running `(Running)`

Children with pigeon feet may stumble and fall a little more when they walk or run than other children their age.

Importantly, although pigeon foot does not directly cause arthritis, if the condition persists into adulthood, it may slightly increase the risk of stress fractures and arthritis.

How does a doctor recognize this?

Most often, doctors diagnose clubfoot when you take your child for a routine well-child check-up. They will do a physical exam and ask about your child's medical history. If your child is starting to walk, the doctor will carefully observe the way your child walks. They will pay particular attention to the angles of their feet, ankles, knees, and hips. Older children may also be asked to run.

What tests are being done?

The doctor will diagnose pigeon feet mainly through angle and flexibility tests . These are part of the physical examination. X-rays are usually not needed unless the condition does not improve as the child gets older or there are other symptoms.

What is the treatment for this?

The good news is that most cases of pigeon feet get better on their own without any treatment. Depending on the cause of the pigeon feet, your doctor may recommend a "watch and wait" approach. Or, they may recommend exercises or physical therapy to help correct the pigeon feet.

However, very rarely, other treatments may need to be considered. These include:

• Serial casting:

If the condition (Metatarsus adductus) is severe or does not improve on its own, the doctor may recommend a series of casts to stretch and lengthen the muscles of the foot. As you can imagine, it is important and difficult to keep a baby's cast clean and dry. Sometimes these casts can be itchy and smell bad. If you have any questions about applying these casts, talk to your doctor.

• Surgery - Osteotomy:

If the tibia is severe and the child continues to have functional problems as they get older and get closer to adolescence, your doctor may refer you to a pediatric orthopedic surgeon to discuss the possibility of surgery. Surgery is not usually recommended for femoral anteversion. However, surgery may be considered for children over 11 years of age with severe symptoms. This surgery is called an osteotomy .

Can this be prevented?

When we talk about preventing a disease, we look at the risk factors that contribute to it. Some of them we can change, some we can't. The causes of pigeon feet are not really things we can control. These include:

• Having a twin or multiple pregnancy, such as twins or triplets.
• Decreased amount of amniotic fluid in the womb (Oligohydramnios) .
• Large fetus .
• The baby is in the breech position .
• This is a normal variant of normal development .

But the good news is that pigeon feet rarely cause pain and the condition often gets better on its own.

What is the outlook for children with pigeon feet?

The outlook for children with clubfoot is very good. As children get older and their balance and coordination improve, the condition of the clubfoot will usually improve. If the condition persists into school, the child may become a little embarrassed or self-conscious about it. Very rarely, the doctor may discuss the pros and cons of casting or surgery with you.

When should I see a doctor about pigeon feet?

If you have concerns about these things, talk to your pediatrician:

• About the appearance of your child's feet or legs , especially if they appear to be bow-legged.
• If the child falls frequently .
• If you notice anything unusual about your child running .

What questions should you ask the doctor?

When you go to see a doctor, you can ask questions like these:

• What causes my child to have pigeon feet?
• Will pigeon feet get better without treatment ?
• Are there any exercises we can do at home that will help correct pigeon feet?

Can this be fixed? Is this a disability? A birth defect?

These are some of the questions that many parents have.

• Clubfoot rarely persists into adulthood. Usually, as children grow older, their muscles become stronger, and their balance improves, the condition improves on its own without any treatment. Your doctor will monitor your child's clubfoot closely. In rare cases, a cast or surgery may be considered as an option.
• You may not like the way your feet look, but they are not a disability. People with them do not have any problems walking, running, or performing daily activities.
• A birth defect is an abnormality in a newborn baby's body. Because clubfoot is so common in many babies and young children, it is not considered a birth defect.

Finally, things to remember (Take-Home Message)

The term “claw feet” can be a bit of a worry for parents. However, the good news is that it is not painful. Also, while you may be concerned about how your child looks when they walk, most of the time, claw feet will get better on their own without any treatment and will not cause any permanent damage. If you have any concerns about the appearance of your child’s legs or feet, don’t be afraid to talk to your doctor about it. It will give you a lot of peace of mind.

` Pigeon feet, Intoeing, Child health, Inward-turned feet, Foot deformities, Bone development, Children's walking