Key takeaways: Many newborn foot positions are flexible and improve on their own. Clubfoot is a stiff, inward-turned foot that doesn’t correct with gentle movement. It’s treated very successfully with the Ponseti method: gentle casting, often a minor heel cord procedure, and bracing.
Babies spend months curled up in the womb, and their feet often show it. Most foot positions are flexible and improve on their own. Clubfoot is different and needs treatment.
Common, Flexible Foot Positions
Metatarsus adductus: the front of the foot turns inward, making the foot look like a bean. The heel is normal. Most cases are flexible and improve on their own over months. Sometimes stretching or casting is recommended.
Calcaneovalgus foot: the foot is bent up toward the shin. It usually improves on its own in the first weeks to months.
These feet can be gently moved into a normal position.
Clubfoot (Talipes Equinovarus)
Clubfoot affects about 1 in 1,000 babies. The foot:
- Points down and turns inward.
- Is stiff and can’t be moved into a normal position.
- May have a deep crease on the sole.
- The calf may be smaller.
It can affect one or both feet. It’s sometimes seen on prenatal ultrasound. Most cases occur on their own, but sometimes clubfoot is associated with other conditions.
The Ponseti Method
The Ponseti method is the standard treatment and is very effective:
- Casting: gentle stretching and a series of casts, changed weekly, usually starting in the first weeks of life.
- Achilles tenotomy: most babies need a small procedure to lengthen the heel cord, often done with local anesthesia.
- Bracing: a brace with shoes attached to a bar is worn full-time for a few months, then at night and naps for several years, to prevent the clubfoot from coming back.
Following the bracing schedule is key to success.
Outlook
With treatment, most children with clubfoot walk, run, and play normally.
Talk to your baby’s doctor if: your baby’s foot is stiff and can’t be gently moved into a normal position, or a foot position isn’t improving over the first months.
The Bottom Line
Many newborn feet look unusual at first and improve on their own. Clubfoot is stiff and needs treatment, which is highly successful with the Ponseti method.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Sources
- Ponseti International Association. About clubfoot and the Ponseti method. https://www.ponseti.info
- American Academy of Orthopaedic Surgeons. Clubfoot; metatarsus adductus. OrthoInfo. https://orthoinfo.aaos.org
- Dobbs MB, Gurnett CA. Update on clubfoot: etiology and treatment. Clin Orthop Relat Res. 2009;467(5):1146-1153.
- Lewis ML. A comprehensive newborn exam: part II. Skin, trunk, extremities, neurologic. Am Fam Physician. 2014;90(5):297-302.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
