Many parents are asking, “Is there anything wrong with my baby’s toe walk?” “I noticed in the past two days that my baby is standing on his toes and not on his feet, will it affect his walking?” “I checked on the internet, children with pointy feet may develop cerebral palsy in the future, what should I do?” Nowadays, most parents are learning parents, and when they encounter something they don’t understand or something they think is abnormal in the process of raising a child, they often go online to “Baidu”. Since many of the answers on Baidu are not given by professionals, they are often surprised by the answers they find. So is it a problem for your child to have pointy feet? Will it affect the child’s motor development? Is pointy feet an early feature of cerebral palsy? Today, we would like to share with parents what is the situation of pointy feet in babies? Why do normal babies have pointy feet? Normal pointy feet Many babies will stand on the ground with their heels up when their parents support them, which is often referred to as pointy feet. This is mostly early child lower extremity weight-bearing is not good, the child’s lower extremity strength is still relatively weak, coupled with adults to support the armpit will give an upward force, the baby in this force driven by the situation will appear pointed feet. This is generally easier to appear in the younger the child. Secondly, when the child starts to stand on its own holding the edge of the table, sofa, bed edge around 10 months, the child can also appear this situation of pointed feet, especially when these edges are high or when the child wants to take high objects. This is mostly normal. We often find clinically that when holding the armpit, adults put their hands down a little and give a slight downward force; or when the child stands on his own holding objects, give a little adjustment to the height, the child can put his feet flat by himself. If the child still has a pointed foot after adjustment, it does not necessarily mean that there is a problem. You can check whether the dorsiflexion angle is normal and observe the overall development of the child and the perinatal clinical situation. We have done an outpatient study where about 20% of children without any risk factors or developmental problems also develop pointy feet, and the child is followed up to 2 years of age, and by the time the child is able to walk, run, or jump, there is no problem with the child’s development. Abnormal pointy feet Most children with abnormal pointy feet have high risk factors or a history of brain injury, but of course there are a few children who have abnormal pointy feet for which no cause can be found. Most of these pointy feet are due to high ankle muscle tone. Moreover, pointed feet are often not an independent symptom, but are mostly accompanied by other abnormal postures or developmental disorders, such as delayed gross motor development, poor gravity-resistant activity of the lower limbs, and scissor gait. There are also abnormal angles when doing dorsiflexion angle examination of the foot. When a child has any of these conditions, it is recommended to seek medical treatment so that the doctor can distinguish whether the child is normal or not. How to distinguish whether pointed foot landing is normal or abnormal? How can parents distinguish between normal and abnormal when they find a child with pointed feet? First of all, it is also important to look at the child’s perinatal and developmental history to see if there are any high-risk conditions or history of injury. Secondly, we need to see if the child’s motor development is similar to that of children of the same age, if there is any obvious motor lag, and if there are any abnormalities in the child’s motor posture (this often requires a professional doctor’s judgment). In addition, we can check the child’s foot dorsiflexion angle, check the following methods: First of all, we need to know an angle, foot dorsiflexion angle (the angle presented by the red line in the figure below). Check method: baby lying on his back, holding the baby’s leg straight, so that the dorsal foot flexion to the calf, with the palm of the hand to press the bottom of the foot, the angle formed by the dorsal foot and the front side of the calf is the dorsiflexion angle. Left and right to do the check, operation first with a slow medium pressure to form the smallest foot dorsiflexion angle, called “slow angle”, and then fast sudden dorsiflexion to form a “fast angle”. Result observation Normal: slow angle, fast angle are <70 ° Abnormal: slow angle, fast angle are greater than 70 °; the difference between the two angles (fast / slow) > 10 °; left and right asymmetry. When doing the foot dorsiflexion angle check, parents should not be too eager to do a bad job for the first time, plus the baby will have resistance, so they mistakenly think that the baby is abnormal, they can check again when the baby is not paying attention. In addition, parents can also observe if the baby usually has flattened feet. Is landing on the tips of the feet cerebral palsy? Cerebral palsy occurs in children with brain injury. Normal babies and most premature babies do not have brain injury and generally do not have cerebral palsy, so there is no need to be nervous about landing on your toes. If a small preterm baby born at less than 32 weeks or a baby with other brain injury is suspected to have toe landing, be cautious and go to the hospital to see a pediatric neurologist. To conclude, if you suspect that your baby has toe landing, you can determine normal and abnormal by checking the dorsiflexion angle of the foot. When doing so is unsuccessful, it is recommended to go to the pediatrician for professional examination.