Intoeing: When your baby's feet point inward

Some of you may remember being in funny shoes or braces when you were a baby to correct intoeing. Intoeing is a condition seen frequently in babies and toddlers. As the baby learns to walk his feet point inward.

There are three common causes for intoeing. One in metatarsus adductus, where the feet alone turn in. Another is femoral anteversion, where the whole leg, from the hip on down, turns in. The third cause is tibial torsion, where the lower leg and foot turns in. All three of these conditions are benign conditions that usually correct themselves. Usually, the turning-in is from how the baby was positioning in the womb, but there may be a genetic component as well. There is nothing to do to prevent in-toeing, which is usually present at birth but may not be  obvious until child starts to walk.

Years ago metatarsus adductus was corrected by having the child wear shoes known as "reverse last shoes." These shoes pointed in the opposite direction – that is, instead of pointing inward, they pointed out. The hope was that by wearing these shoes, the tendency to turn in would be corrected.

Tibial torsion and femoral anteversion were often corrected by night braces. These braces turned the legs out at night in hopes of correcting the tendency to turn in.

Once they compared children who were treated with these devices with children who were not, they found that the outcomes were similar. That is, the devices (which children did not love) were probably not necessary. In most cases, Mother Nature self-corrects and the children gradually turn in less and less as they get older.

One orthopedist I know likes to point out to worried parents that some of the best runners are pigeon- toed. So, if the feet turn in a little, so what?

There are some children who have more severe or structural problems such as a clubfoot, a structural defect of the bones of the foot that may cause the foot to turn in, out, or point downward. These children may need surgical intervention or braces. They also may be put in a cast. So, if you are worried about intoeing, check with your child's doctor, but don't worry too much. Most likely, the condition will gradually improve on its own.

Does your child walk with his feet turned in? What did your doctor tell you about the condition?

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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