• Deana Rosaia

Does my baby have flat feet? Baby Standing Alignment

Updated: Nov 15, 2020

The Facts about Early Walking & Alignment

When will they walk? Your little will most likely walk 4-6 months after learning to pulling to stand. It takes that much practice! For some kids, they are on the earlier side and some kids later. Typical motor development shows that toddlers begin walking at 12-18 months of age.

When looking at some general bench marks to dictate walking, your baby should be crawling, transitioning in and out of sitting independently and transitioning in & out of standing independently by 1 year.

Will my baby transition from crawling to walking immediately? Maybe, but most likely not. Babies play with 1-10 steps for up to a few weeks before they decide walking is the best option. Don't be surprised if your little still drops to crawl if they want to get going quickly. You can confidently say your child is "walking" when they can take up to 10 steps consistently

What does early walking look like? Frankenstein - legs spread wide, high guard (hands raised in the air), flat feet, some time a bit of in-toeing and a bit bowlegged.

Let's talk about foot alignment for a hot second. Honestly this will be an entire separate post at some point, but for now, here are the basics

Feet: all babies are born with flat feet! our adult arches do not fully form until 5-8 years of age. But, our babies feet CAN be "too flat" Here is what to look for

The heel! Seriously, draw a line down the back of your babies heel (see pics below). It should go straight up and down and not TILT IN (fancy name: calcaneal valgus.) If the heel tilts in, this will cause extra flatness or pronation at the middle of their foot and make stability/balance very hard.

While we are talking feet, look at the outside boarder of your kiddos feet. It should be on the ground! If the heel tilt is significant enough, the lateral boarders of your child's feet will start to lift up off the ground.

Left: heel straight and lateral boarder of foot on the floor

Center: lateral boarder of the foot lifting & knees drifting in

Right: Heel tilting in at an angle & lifting of the lateral boarder of the foot

The results up the chain?

Knees will collapse in

Children will lean forward into support surfaces while standing

Walking may be delayed

Muscle balance can develop incorrectly

Higher level skills such as stairs and jumping can be effected or delayed

Poor alignment as a child ages can lead to pain/dysfunction down the road

Notice any of these things? Message me or seek advice from your pediatrician

Bow legged & In-Toeing: that is going to have to be a whole separate post. Drop a comment below if you have questions.

Is Tippy Toe walking normal? It can be, intermittently, for the first 2-4 months of walking & it should never be more then 50% of the time. If it persists, set up an evaluation to rule out other neurologic causes and to avoid long term complications.

So often I hear "I was told they would grow out of it!" Fast forward, the kid is five, STILL toe walking and now headed to an orthopedic surgeon for a surgical consult. Or, they are now on my schedule to work on aggressive stretching for their tight Achillies tendons, bracing ect.

Here is the 10 second explanation about toe walking (again, there needs to be a WHOLE other post about it!)

Some toe walking early on is yes, typical. HOWEVER, I expect it to be fully resolved by the age of 2 years. Do some kids "grow out of it" beyond 2? Yes. But here is the trick. WE HAVE NO IDEA WHO WILL OR WONT "GROW OUT OF IT!" So, by the time we deem they are not going to "grow out of it" we are left with serious musculoskeletal problems.

Rule to live by: They are worth repeating. Toe walking should never be more than 50% of the time and should be always trending down as your child approaches 2 years of age.

Also: Toe walking + speech delay CAN be an early sign of autism (one of many, mind you) so, be aware, be proactive, and have it checked out.

What can we do to practice early walking? Walk along a variety of surfaces such as grass, tan bark, sand, rocks. When able, practice softer surfaces such as sand & grass while barefoot!

Surface variety will challenge your child's balance, develop sensory integration, and strengthen the tiny little muscles in their feet which will eventually support their arch development.

How do we support early walking? Supportive shoes when outdoors. Inside? Barefoot all the way. Think of each day as a day at Disney land for your little. Check out the blog post at the end of the email for the key 3 factors when choosing a pair of shoes for your new walker.

Top 3 most important things when picking shoes for your kid

  1. Stiff heel counter: The portion of the shoe that wraps around the heel, it should be very stiff!

  2. Arch support - yes, even in baby tennis shoes

  3. Flexible forefoot: the front 1/3 of the shoe should bend if you are trying to bend the shoe in half. IT SHOULD NOT BEND IN HALF!

Common questions:

Is the brand important? No. There are several brands that offer products with the qualifications I mentioned above.

Do I have a favorite brand? Yes. Wobbly Waddlers. Am I an affiliate? No - they are just great shoes (and owned by a female entrepreneur!)

Drop comments below with questions - seriously, so many blog topics condensed into one today!

What comes next? 3-4 months of straight balance walking practice before looking to progress to new skills such as navigating uneven surfaces, quick walk, beginning to run, stairs & jumping.

When should I be concerned?

  • Persistent Toe walking beyond 4 months after walking or when greater than 50% of the time.

  • Tripping and falling that does not diminish significantly after the first 2-3 months of practice

  • In-toeing to the point of causing tripping and falling. While I mentioned above some in toeing is typical, it should not cause your little to trip & fall.

  • Flat feet that cause the back of the heel to tilt "in." This mal alignment will typically cause kids to walk later (> 15 months) and can make high level motor skills very challenging until corrected.

  • "W" sitting - usually indicative poor core strength and excessive hip rotation. Should always be evaluated by a health care professional.

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