Thursday, July 11, 2013

Delayed Walking

Can Flat Feet Delay Walking?

Just about every baby has flat feet at birth. It takes time for the foot's natural arch to develop. Flat feet rarely cause any problem with walking and often disappear by the age of 2 or 3. Extremely flat feet can make your baby's ankles appear to bend inward as he or she walks. This happens if the arches don't fully develop to realign the foot and ankle. Treatment is rarely needed except in the most severe cases, and is not generally considered until a child grows past the early infant years. A tendency to flat feet can run in families.

How Serious Is Hip Dysplasia in a Baby?

During the first year of life, a condition called developmental hip dysplasia may appear. This condition causes a baby's hips to dislocate because of overly relaxed ligaments and joints. Hip dysplasia can lead to delayed walking or other walking problems. That's because a dislocated hip can cause pain that's made worse during weight-bearing. Developmental hip dysplasia is a general term for any number of problems with a baby's hips. This can be found in about five of every thousand newborns. Only about one in 1,000, though, actually has a hip dislocation. At birth the hips and ligaments may be initially unstable on examination but most quickly resolve in the first weeks.

For unknown reasons, hip dysplasia is more common in first-born baby girls and on the left rather than the right. Your baby's doctor will check for hip dysplasia at birth and during later regular checkups.

If there are any signs of hip dysplasia at an exam this will be followed up closely. Signs include one leg looking shorter than the other, unequal creases in your baby's thighs or buttocks compared to the other side, and overly stiff hips. The doctor will examine the hips to feel whether the hip dislocates or pops back into the joint. Don't worry as the exam is done gently and at worst may be a little uncomfortable. Hip dysplasia requires treatment, usually by a pediatric orthopedic specialist who will usually first assess the hips with X-rays and/or an ultrasound. Depending on the findings, treatment may range from continued observation to special hip braces/splints, manipulation of the hips under anesthesia, or surgery. Treatments also vary depending on the age of the baby.

Developmental Milestones for Walking

By 6 to 10 months:

Most babies will pull themselves up to stand

Between 7 and 13 months:

Most babies will be happily 'cruising' around the furniture (as mentioned before).

Babies will be able to walk a little with support from a parent (but note early walking should not be forced)

Between 11 and 14 months:

Babies will start to walk alone -- by 14 months most babies will walk alone to some degree

When to See a Doctor About Delayed Walking

Your baby's legs, feet, and motor skills will be checked as part of the normal well baby visit. But see your baby's doctor if you're concerned about delayed walking. Use the above milestones and the following guidelines to help you recognize any major delay in your baby's development.

See your baby's doctor if:

your baby isn't walking by 18 months

your baby only walks on his or her toes

you have any other concerns about your baby's feet and legs

Any differences between the movements of one side of the body compared with the other, or favoring of one leg, especially if they seem to be getting worse, should prompt a visit to the doctor.

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