About one out of every 1,000 babies is born with a foot that’s twisted. It may curl sideways with the toes bent at a funny angle. Or, it might have an odd shape and point in the wrong direction, so that it appears to be crooked, or even nearly upside down. Doctors call this clubfoot.
Most babies who are born with clubfoot are healthy in all other ways; about half of them have it in both feet.
Clubfoot doesn’t cause pain, but if it’s not treated, it can make it hard for a child to walk without a limp. It’s easy to correct in most cases, so most children don’t have long-lasting effects.
Can It Be Prevented?
Clubfoot happens because the tendons (bands of tissue that connect muscles to bones) and muscles in and around the foot are shorter than they should be.
Doctors don’t know what causes it, and there’s no way to ensure that your baby won’t be born with it. But some things make clubfoot more likely. They include:
- Gender. Two-thirds of babies with clubfoot are male.
- Family history. Babies with a parent or sibling who had clubfoot are twice as likely to get it.
- Lifestyle choices. If you smoke or use illegal drugs while you’re pregnant, you raise your baby’s chances of being born with it.
- Other birth defects. In some cases, it’s linked with another condition a baby is born with, such as spina bifida.
- Too little amniotic fluid during pregnancy. This surrounds your baby in the womb. If there’s not enough, your baby’s chances of being born with clubfoot are higher.
Symptoms
It’s easy to notice clubfoot when a baby is born. Here are some signs:
- The foot points downward, and the toes may be curled inward.
- The foot appears to be sideways or sometimes even upside-down.
- The foot may be smaller than a normal foot by up to a half-inch.
- The calf muscles on the affected leg may not be fully developed.
- The foot may have a limited range of motion.
Most doctors can spot clubfoot simply by looking at your baby when they're born. If you have an ultrasound done late in your pregnancy, your doctor may notice it then.
Treatment
Your doctor will begin to correct your baby’s clubfoot shortly after they’re born. Babies don’t use their feet until they learn to stand and walk, so the goal is to fix it early enough to prevent delays. Your doctor will use a cast or surgery.
Casting. A baby’s tendons bend and stretch very easily, so doctors are able to turn the clubfoot in the right direction to help correct the problem. They gently move the foot into a position that’s closer to where it should be. Then, they put on a cast to hold it in place.
About a week later, the doctor removes the cast. They gently stretch the baby’s foot some more, puts it in a new position, and puts on a new cast. They'll continue this pattern for weeks or months. Your doctor may take X-rays to be sure the baby’s bones are slowly moving into their correct positions.
If the series of casts helps to correct your baby’s clubfoot, they’ll need to wear a special brace or shoe to keep it at the right angle until after they've learned to walk. This is because a clubfoot tends to turn back to its original position. Some children may only need to wear the brace or shoe for a short time. Others may need it for a few years to make sure the foot stays at the right angle.
Surgery. If the tendons and other tissues in your baby’s foot are too short, no amount of stretching and casting can do the trick. If this is the case, surgery may work.
Babies who need clubfoot surgery often get it between the ages of 6 months and a year. Unlike the gradual casting process, the doctor fixes everything in one procedure. They may lengthen tendons or take other steps to turn and shape the foot to a more normal position.
After surgery, your baby will need to wear a cast to keep their foot at the correct angle. Then, they’ll need a brace or a special shoe for about a year so the foot doesn’t go back to its original position.