Ask The Baby Expert Question Number #24:
“How do I prevent toe walking?”
It seems like parents questions and conversations around town cluster by topic. Lately, I’ve been hearing this one a lot, “How do I prevent my baby from being a toe walker?”
“My doctor said my preemie is at risk of toe walking and I should avoid using walkers and jumpers. Now I’m worried! What else can I do?!?!”
You are in the right place, dear readers! Especially you PREEMIE PARENTS!
A quick note – toe walking risks factors
Preemies and low birth weight (IUGR) babies are at higher risk of being toe walkers. So are babies with increased muscles tone (hypertonicity) or stiffness in their legs. And for some full-term, healthy babies, even the excessive use of “suspension containers”–like jumperoos, walkers, and exersaucers– can delay motor development and increase a baby’s risk of being a toe walker later on.
If this is new to you, please read this post first to get more background info about toe walking
INFANT AND PREEMIE EXERCISES TO PREVENT TOE WALKING
*These tips and tricks are designed to be done throughout the first year before they begin pulling up to standing or cruising on their own.
ONE- stretch their feet!
This is great to start a few weeks after you bring baby home, especially if they are a preemie or low birth weight baby. Smaller babies aren’t as cramped in the womb as larger, full-term babies in the last few weeks of gestation, so they don’t get the constant pressure on the bottoms of their feet which stretches the heel cords (AKA calves or Achilles’ tendons).
*If your baby’s ankles flex so much that the tops of their feet touch their shins, you don’t need to “stretch” them routinely. Just check their flexibility about once a week to make sure nothing changes. Then move on the next trick – standing with flat feet.
Tip: make sure you contact the full surface of the foot when applying pressure or stretching. If you just press on the toes or the ball of the foot, you will accidentally activate the calf muscles, causing the toes to point or the leg to stiffen.
Check out this video on varies activities you can do with your baby to help stretch their heel cords!
TWO – Help your baby stay flat-footed when bearing weight on their legs
This is where you can really prevent toe walking or (perpetuate it) without even knowing it!
When your baby is standing on your lap or pulls to stand when you are holding on to their hands, you should check their feet frequently. If the feet are not flat or fully in contact with the surface, you need to adjust them.
Tip: Try to avoid holding your baby up with your hands. This means that your “support” should only be for balance and safety, while the full weight of your baby’s body should be on his or her feet.
Why does this matter? I’m glad you asked! Just keep reading…
THREE – Avoid suspension devices like jumperoos and walkers
This one is so hard for parents to buy into because babies LOVE these devices! They really can provide hours of fun for baby and hands-free time for you!
So what’s wrong with them? I’ll keep it simple and to the point of preventing toe walking…
Containers that “suspend” your baby artificially by providing support to other parts of their body (butt, back, belly) in addition to their feet create confusion in the neurological system. The brain is tricked into thinking that the butt or trunk can support the body weight so the feet are free to dance and bounce with wild abandon!
In all seriousness, this is where these devices can really wreak havoc on motor development. The brain is already pre-wired to go through a specific sequence of motor skills and milestones, each one leading to the next. From the time the baby leaves the womb, human baby brains and muscles have to figure out how to coordinate against gravity to ultimately become independent walking and running on only two feet! If a baby spends excessive amounts of time in sitting or suspension devices, the normal progression of development can get off track.
But when a baby is partially supported and only his toes and the balls of his feet touch the floor, this actually sets off a newborn reflex to bounce on the toes. Since we all know that we have better balance and stability and walking skills if we stand on flat feet, you can see how this causes a problem. The more the baby stands or bounces on the toes, the more ingrained the new (but abnormal) motor pattern becomes in the brain. If a baby spends significantly less time on flat feet than tiptoes, they will soon adopt the tiptoe stance as the primary way of standing and walking.
FOUR – Don’t rush their development and please don’t skip tummy time or crawling on all fours!
As mentioned in the previous section, humans development is pre-determined and we don’t need to interfere except when a baby is born with physical differences or starts to fall off the normal path in the first year. Prematurity, back to sleep and baby containers are major risk factors for delays or deviations in normal development.
If you focus on tummy time from day one, limit sitting propped or in containers, and focus on crawling before walking, it will be very unlikely that your baby will be a toe walker or have problems with their physical development after they take their first steps!
FIVE – Prevent sensitivity in the feet
Expose your baby’s feet to lots of different textures, sensations, and pressures. You may have heard that “sensory processing” issues are related to toe walking. A child that is overly sensitive to different textures, sounds, lights or environments may avoid these “inputs”. When an infant or child doesn’t like to wear shoes or put their feet in the sand or grass may have “tactile defensiveness” and may adopt a toe walking strategy to avoid uncomfortable sensations on their feet. A child that has a muted response or a high threshold to stimulus or input from the environment (AKA sensory seeker) may go up on their toes to “feel” their body working and moving better.
*Tip: Start putting shoes on your baby early, so they are accustomed to wearing them long before they have to for walking and foot protection. Alternate shoe wearing with sensory experiences like rubbing lotion with a washcloth or soft brush with firm pressure, or playing in sand or grass. How about some toe painting with pudding? Where do I sign up? 😉
Check out this post on summer sandals with good arch support and protection!
Easy peasy lemon squeezy, right Mommas and Papas?!?!
♥ If your baby is already pulling to stand and won’t put her heels down at least 75% of the time, check out this video of activities you can do to help them bear weight on flat feet.
♥ If your child is already a toe walker, check out this post to determine if a physical therapy evaluation is recommended.
Then read this post from Dinosaur Physical Therapy to learn about some great activities and products you can try at home to help your child get their heels on the ground!
Did this post spark any questions about your baby? Just leave a comment below, or schedule a FREE 30-minute video consult with me today. Send me some video of your baby standing, cruising or walking and I will give you some tips and activities to try specific to your child’s individual needs!