In a nutshell: It’s relatively common for a newborn to have feet that turn inwards. This is due to a condition called talipes or ‘club foot’. There are 2 key kinds of talipes: positional and structural. Positional talipes generally happens because your baby’s feet are squashed in the womb and usually corrects itself over time. With structural talipes, the foot is immobile and will need to be put in a cast to be corrected.
What does talipes / club foot look like?
“Club foot, also known as talipes,” says our expert family GP Dr Philippa Kaye, “is a relatively common condition for children to be born with, affecting about 1 in 1,000 babies in the UK. It can occurs in 1 or both feet, with approximately half of cases affecting both feet.
The image above shows, on the right, the position of normally presenting newborn feet and, on the left, an example of bilateral talipes, where both feet point downwards and inwards
Can talipes / club foot be diagnosed before birth?
Yes, but not always, so you may not discover it until after your baby is born.
“Club foot can be diagnosed at your 20-week scan,” says Dr Philippa, “although it is more often diagnosed after the baby is born – either at the 1st medical check after birth or at the 6 to 8-week check. If you are concerned about your baby’s feet and ankles and your doctor or health visitor hasn’t mentioned anything, then please take your baby back to the doctor.”
What’s is positional talipes or club foot? And what’s the treatment?
If your baby’s feet are pointing downwards and inwards but are otherwise mobile, then your baby’s likely to have positional talipes: the medical term for a newborn’s feet that aren’t structurally affected but are ‘stuck’ in an abnormal position because of the way they were positioned in the womb.
“For some babies, the talipes is positional and the feet are mobile,” says Dr Philipppa. “This is generally because they have been a bit squashed in the womb.”
“In this case, the feet tend to correct by 3 months, but some sessions of physiotherapy may also be required.”
What is structural talipes or club foot? And what’s the treatment?
If your baby’s feet are pointing downwards and inwards and their feet and ankles aren’t mobile, then your baby’s likely to have structural talipes.
“This occurs because your baby’s foot bones are not growing in the correct direction,” says Dr Philippa. “And it will need treatment – from when your baby’s about 2 weeks old – to correct.
“The treatment is called the Ponseti method. It involves very gently manipulating your baby’s foot or feet very gradually into a better position and then setting this position by putting a plaster cast around the foot and ankle.
“This process is repeated every 6 to 8 weeks in order to gradually move your baby’s foot and ankle into the correct position.
“Sometimes a minor procedure to loosen the Achilles tendon at the back of the ankle is also needed, generally under a local anaesthetic, to help the foot positioning.
‘My baby has talipes’: a mum’s story
“My little boy was born with unilateral (left-foot) talipes. This wasn’t picked up at any scans while I was pregnant.
“We were told first that it was positional and a bit of manipulation would fix it.
“Unfortunately it turned out to be more severe than that and, at 12 days, he had his first cast on.
“These worked so well. We only had 4 casts before going into full-time boots.
“We’re now 4 weeks away from them, hopefully, coming off in the daytime.”
“After the last cast, your baby will wear boots, constantly for 3 months, to stop the club foot reverting back. And then only when they are asleep – up to about the age of 4. (And yes, your child gets new boots as they grow!)”
Will my child be able to walk properly?
Yes, nearly all children treated with the Ponseti method end up with pain-free, normal-looking feet. “Treatment for structural talipes is generally successful,” says Dr Philippa, “and children learn to walk at the same time as their peers and can manage physical activity.
“Sometimes, if only 1 foot is affected, that leg may be slightly shorter than the other leg which can lead to them getting more tired during physical games and sport.”
If I have more than one baby, are they all likely to be born with talipes?
It depends on the type of talipes your baby has. “Structural talipes is more likely to have a genetic factor than positional talipes, as it tends to run in families,” says Dr Philippa.
As a rule:
- if you have 1 child with structural talipes, then the likelihood of another child also being affected is 1 in 35
- if either you or your partner had structural talipes, then the likelihood of having a child affected is 1 in 30
- if both you and your partner had structural talipes, then the likelihood of a child being affected is 1 in 3.
Where can I get help if my baby has talipes or club foot?
STEPS is a charity that helps people affected by childhood lower limb conditions, including talipes or club foot. You can call their helpline on 01925 750271 (open Monday to Friday, 9.30m to 4pm)
About our expert GP Philippa Kaye
Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.