Two weeks ago, my wife and I had baby number 10 born into our home. A child always brings with it excitement, a great amount of joy, less sleep and new stresses. Most babies are cute and fun to hold. Most bring a different feeling into a home. But they also bring a greater responsibility and some worries. One concern that often comes to a new mom is the question: “Are there 10 fingers and toes?” To alleviate this worry, I have created a list of the 5 things to check on a newborn’s feet.
1. Most Babies Are Flat Footed. Approximately 97% of newborn feet are visually flat. This is due to the fat pad in the arch area from birth. Over time, this fat resorbs and the muscles and tendons produce the development of an arch. A flat footed baby should not be a concern. Just enjoy those cute, fat feet.
2. Flexible Feet. A newborn foot is and should be very flexible as bones are only partially developed and muscle, tendons and ligaments are still developing. A foot that is poorly positioned on the leg (tilted out or tilted in), not flexible (tight against the front of the leg) or even contorted (clubfoot) is a warning sign and should be evaluated by a foot and ankle specialist. Remember, thought, that sine the feet are soft and flexible, shoes should be purchased with the same features for a newborn foot (or even better allow them to be barefoot).
3. Baby Shape. The newborn foot shape is characteristically triangular in shape, consisting of a narrow heel and wide forefoot. The foot should be easily held between the thumb and forefinger in a “V” shape. This evaluation allows for evaluation of a foot that is “C” shaped, as the toes and forefoot area tilt in or out, instead of remaining straight. Due to the flexible nature of the infant foot, any abnormalities in shape may be modified by stretching and splinting if caught early.
4. Reflexes. In an infant, the common reflex tested is the Babinski sign. This is elicited by running a blunt instrument or finger from the bottom outside of the heel in a curve towards the big toe. The adult response is curving of toes down and turning the foot outward. In an infant, the response is spreading of the toes and elevation of the great toe. No response would be the only concerning finding at this time.
5. 10 Toes. This is commonly the first thing evaluated on the feet. Abnormalities may include toes that are abnormally large compared to other toes, too many toes, too few toes, or even absence of toes. Webbing of the toes may also be seen at this time. Treatment for many of these conditions is possible but may not always be necessary. Evaluation should be done through a specialized foot and ankle physician.
The foot is a very complex arrangement of bones, tendons, ligaments and vascular/nervous tissues. It will carry the new infant throughout life and should be protected. A key to the development of each foot is the ability to develop unimpeded by constricting clothes or shoes, as the foot with move quite regularly as muscle and tendons mature. Enjoy your babies feet, as they are part of the cuteness that is your baby.
Copyright (c) 2009 Mountain West Foot & Ankle Institute
Brandt R. Gibson, DPM, MS is a foot and ankle specialist and father of 10 children. He has a special interest in children’s feet and seeks to keep them active and healthy. He is located in American Fork, Utah at Mountain West Foot & Ankle Institute. For further educational information, visit his blog at http://mychildsfoot.blogspot.com/ or visit his website at http://www.UtahFootDoc.com .
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