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Why is my child walking with his toes pointing inwards?

Q: My son is 14 months old. He started walking when he was 12 months old. He has good balance in walking and running. While walking, he keeps his toes inwards for both the legs by ~35 degrees. Is it normal and will he keep toes forward in the coming months? Is it a sign of any vitamin deficiency?

A:In-toeing is common in infancy. In children less than 2 years of age, it is due to a condition called internal tibial torsion. This is often the result of normal in utero positioning. The paediatrician must carefully examine the child to rule out rickets (resulting in large soft spot of skull, swollen wrists, delayed walking etc) and metatarsus varus (front half of foot may be less flexible in this), both of which need treatment. If these are not present, the condition resolves by 2 years of age with normal growth and development. X-rays are not needed. Treatment is not indicated before 2 years of age.

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