February 1, 2024

Is it okay for a Baby to Waddle with Feet Outward? What is “Toeing Out”?

In my continued effort to expedite information for parents, it is ok for your baby to waddle with their feet outwards up to the age of 2, or until the child has been walking for 4-6 months.

In my continued effort to expedite information for parents, it is ok for your baby to waddle with their feet outwards up to the age of 2, or until the child has been walking for 4-6 months. Toeing out in new walkers is very typical up to the age of about 2, or once they have become proficient walkers.

And here is why toeing out is normal in toddlers who have been walking for 4-6 months…

Babies walk in this pattern for several reasons, primarily because they are trying to maintain their balance by keeping a wide base of support due to their nervous system and their overall architecture.

New walkers are working with immature nervous systems so they need repetitive practice to build the nerve pathways.  In addition, they are learning what to do with the sensory input that they are receiving from their vestibular system (inner ear), as well as the somatosensory proprioception (feeling where their body is in space).  There are motor development theories that say that children walk not when the stepping pattern is mature, but when the balance control system matures.

Structurally, at the time children begin to walk, their center of mass is around the base of their ribs.  As they grow (and the head to body ratio changes) that center of mass lowers to around their belly button.  This high center of mass early on makes it more difficult to balance, leading to the need for an increased base of support to avoid falling.

New walkers often fire a lot of their hip muscles in order to stabilize themselves as they learn to balance on two feet.  EMG (neuromuscular studies) of children with 6 months of walking experience have also shown that they will fire their outer hip muscles (specifically the muscles that outwardly rotate their legs, and that move their legs apart) for stability.  In doing so, the hip outward rotators over-power the inward rotators, which brings their feet and legs out.

The anatomy of the feet of new walkers also facilitates their out-toeing gait pattern.  Newer walkers have large fat pads on the bottom of their feet and do not have the muscle strength or ligament stability to create a stable structure.  This capability of stabilizing at the foot typically comes with practice and age.

Since new walkers have had little weight-bearing through their legs, the shape of the thigh bone promotes a wide stance.  As the child bears weight on their legs, the shape of the bone begins to more closely resemble the mature alignment.

New walkers will often keep their arms at either chest or shoulder height to help with their balance.  This wide balance reinforces toddlers’ wide stance.  Once these children begin to swing their arms when they walk, then each step begins to promote a more narrow foot placement.

If you ever have concerns about how your child is walking, address it with your pediatrician.  If your child has been walking for 6 months or more and they continue to walk with a wide foot placement and arms at shoulder height, you may have legitimate concerns that could be addressed.

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