Babies with Clubfoot: A Practical Guide for Parents

When I found out by unborn baby had clubfoot, I initially panicked. Mostly because I didn’t know what that was. To make matters worse, there is virtually nothing helpful about it in the blogosphere. It was mostly filled with other panicking pregnant women feeding into each other’s anxieties (and companies trying to take advantage of that anxiety).

My method of coping became to pretend it didn’t exist until it did.

Then she was born and, of course, her foot was clubbed.

And the world didn’t end.

The only thing different about her was that she had some extra doctor appointments.

So if you’ve been told your baby has clubfoot and you want reassurance, there it is. Everything is going to be fine and your baby will be as normal as any other baby. Clubfoot is an easy thing to fix these days.

For practical advice on what happens next, let’s continue.

Babies with Clubfoot: A Practical Guide for Parents

The short of it is that clubfoot means the baby’s foot is turned in and up. If your baby has bilateral clubfoot, then it means both of them are clubbed instead of just one. Left as is, it is a crippling disability.

But we live in the magical world of modern medicine. Just over the last 15 years, huge leaps have been made in how clubfoot is treated.

Here is what our daughter’s clubfoot looked like:

How IS clubfoot treated?

I’m not a doctor and I can’t really give advice on how clubfoot should be treated. All I can tell you is that, for my daughter’s, she was treated with the Ponsetti method and then a surgery (an Achilles tenotomy) to loosen the tendon so her toes could stretch properly. It was a simple incision and you can’t even tell where it is because it blends so seamlessly with the wrinkles between her ankle and heel.

Here are some pictures of her cast:

After that, she was moved into the boot and bar. She wore it 23 hours a day for a few weeks and then transitioned to only wearing it at night. She will continue wearing it until she is 4.

Here is her foot after the casting and surgery:

It looks exactly the same as the other foot.

Here’s a picture of her boots:

She loves playing with the straps.

The boots basically act as a retainer (like after you’ve had braces). They keep the foot from reverting back to its original position as the baby grows. So it’s a very important part of the process, hence why it lasts so long.

When should I contact an orthopedic doctor?

If you want a consultation, you can get a referral from your OBGYN at any time.

We didn’t do this, though. We had a name of a doctor we wanted to see, but we waited until after the birth to meet her.

The biggest reason we didn’t make an appointment before the birth was because it wasn’t going to accomplish anything. Without seeing the baby in the flesh, there is nothing an orthopedic doctor can tell you (aside from the details of typical treatment) that any other doctor could. The clubfoot could be any variation of severity, which will change how the orthopedist wants to proceed with treatment.

The other reason is that sometimes ultrasounds are wrong. Maybe the baby looks like it has a clubfoot, but it’s just the position in the uterus making it look that way. Our specialist had a hard time actually confirming the clubfoot for the longest time because our daughter kept sitting on her feet during the ultrasound. It took about 2 months to confirm that the clubfoot was not bilateral, as initially thought.

I don’t want that to give you false hope, though. If your ultrasound is showing clubfoot, you should be emotionally prepared for that to be true.

My point is: if knowing a worst-case scenario would give you peace of mind, then by all means, schedule a consultation. But you don’t have to make an appointment until after the baby is born.

Will my baby be in any pain?

The clubfoot itself isn’t painful, despite how it looks. Of course, it would be if baby tried to walk on it. Good thing they’re immobile for the first few months of their lives.

During the first few weeks, we did some stretches with her that a physical therapist recommended (she was in the NICU for 2 weeks, which proved to be beneficial, as they called in their own physical therapist who had experience with newborns and clubfoot). Our baby found them uncomfortable after a while (the way stretching muscles can be) and would give off obvious signals when she was ready for you to stop. Otherwise, it didn’t really hurt her.

When our orthopedic doctor first started casting our daughter’s leg, she was clearly annoyed by the cast and was JOYOUS anytime it was removed to have a new one put on. But she didn’t ever appear to be in pain. And believe me, she would have let us know.

That said, if your baby is uncomfortable, you can help relieve that through baby-wearing (I LOVED the Boppy ComfyFit Hybrid Carrier. My husband’s boss gifted it to me and I LIVED in that thing for the first few months of our daughter’s life). When they’re laying down, our ortho recommended putting a rolled up burping cloth or towel under her leg to keep her comfortable and keep her hips aligned. But she HATED this, so we skipped it.

Will my baby be able to walk?

If you are vigilant with the treatment, then most likely. My (limited) understanding is that babies whose clubfoot is treated early and not allowed to relapse (by not following through with treatment) have no trouble walking.

The funny thing about her diagnosis was that the most unexpected people in my life turned out to also have experiences with clubfoot. My best friend’s brother had clubfoot and played basketball in high school. My 70-year-old neighbor had clubfoot (and was treated back when the surgery was pretty hit-or-miss, but he walks just fine). My neighbor’s nephew also had clubfoot and was a linebacker for his college football team.

Everything we have read indicates that the biggest reason clubfoot relapses is because parents become complacent by the fact that, after a while, the foot looks normal. So my advice would be to do exactly what the doctor says. Don’t fall into the trap of, “My baby fell asleep in my arms and I don’t want to wake her, so I’ll skip the boots tonight.” If you justify skipping it once, it’ll become easier to do it again and again.

Your baby will fall back to sleeps, so just put the boots on them.

The walking will likely come later than other babies, though. Our daughter is 11-months-old and has been working on standing for a month. This is totally normal, because the boots and bar kept her from learning to put weight on her feet as early as some babies do. But now that she’s figured it out, it’s all she wants in the world. It probably won’t be long before she takes her first step.

How much harder is my life going to be?

I mean, look. When we find out our babies are going to have any kind of disability or deformity, it crosses our mind. Maybe it shouldn’t, maybe it’s selfish, but here we are and feeling guilty about it isn’t useful.

The good news is that this isn’t going to change much of anything for you. You’ll have to go to a few extra doctor’s appointments. It will start as every few weeks, then every few months, and then quickly turn into once a year.

Obviously if you live in America and your insurance is terrible, you may experience additional financial strains. But we’re not here to talk finances.

The biggest difficulty we faced was during her surgery.

Because of COVID, only one of us was allowed at the hospital. We chose my husband, because of his medical background. Our daughter didn’t enjoy coming out of anesthesia, so she cried a lot. She was also hungry, because she had to fast few a couple hours before the surgery. Because she was hooked up to monitors and IVs, my husband wasn’t able to comfort her in the way she preferred (walking with her).

It was a long day.

But it was only a day and then it was over. Now the biggest issue is wrestling her into her boots at night (and her diaper, and her pajamas). That’s all due to her wanting to crawl and play, though. Once the boots are on, she thinks they’re the best toy (she loves to roll her other toys under the bar).

The nice thing is that the ritual has become a sleep cue for her. And changing her diaper while she’s wearing them is so much easier (just grab the bar to hold her legs still).

What do I do if my baby has a blow out in the cast?

This is pretty common. All you can do is clean it up and hope for the best. Our ortho was pretty reassuring about the fact that excrement on the cast was par for the course.

We did run into one issue where she had pooped into her cast without us knowing. When the cast was removed, she had a large rash all down her thigh. It looked painful, but it didn’t seem to bother her.

Here’s a picture of what that looked like:

Honestly, it looked a lot worse than it actually was. (And all those white and yellow pieces are remnants of the cast, not infected skin. Those came off after a nice soak in the bathtub.)

We just kept it clean and dry and it went away pretty quickly. Obviously you want to follow whatever advice your doctor gives on treating this.

Will my baby’s feet blister?

Blistering is likely to happen at some point. If it happens a lot, you will want to see your baby’s ortho.

Some ways you can help prevent blistering:

Use socks with grippy rubber on the bottom
Don’t moisturize your baby’s feet or ankles
Make sure you’re pulling the straps all the way to the line indicated by your doctor
Make sure the tongue/flap isn’t puckering and scrunching up under the straps (if this happens and you can’t seem to get it to flatten out, show it to your doctor and ask if they can trim it for you)
After putting the boots on, give the cuffs and toes of the socks a tug to make sure they didn’t bunch up under the boots

If blistering still happens, see if your babies toes are sticking out of the boots. If so, it may be time to call the ortho and get her fitted for a larger pair.

My baby has eczema and we do have to occasionally put Aveeno Eczema Therapy Nighttime Balm between her toes to help with scaling and itching. Using a q-tip to do this keeps it from getting on the rest of her feet, though.

Will my baby’s feet smell?

Yep.

But kids are smelly sometimes. Just pay special attention to their feet while giving baths.

Welcome to parenthood!

What clothes should I buy for babies with a clubfoot?

Here’s where I’m going to disappoint you: you’re going to want to skip the adorable footie pajamas for a while (sorry). Our daughter wore them for a couple weeks before her casting (and, yes, I cried when she couldn’t wear the Winnie the Pooh feeties anymore).

Now that she’s only wearing the boots to sleep in, she can wear footie pajamas during the day. Sometimes we will risk her wearing footie pajamas to bed (since she’s in overnights and doesn’t need changed at night). But I just know we’re going to regret that one night when she has a massive blow-out in her sleep, requiring us to completely remove the boots in order to change her pajamas.

During the few months of casting and 23-hour-a-day boot-wearing, though, forget it.

As for the rest of your baby’s wardrobe:

If your baby is being cast in the summer, congrats! Dressing your baby will be a little easier. Think onesies. Lots and lots of onesies.

If your baby is being cast during colder months, it will be a little more difficult because getting pants over that cast is difficult if you don’t get the right ones.

The basic rule we follow for buying clothes that will work with her casting and boot-wearing is this: buttons up the legs and crotch.

Here are the items we found essential for getting through the initial treatment period:

1. Halo sleep sack

Swaddling was necessary for our daughter. Sometimes it was the only thing that calmed her down when she was upset. But a lot of swaddles and wearable blankets are too narrow in the legs for the cast and bar. (I LOVED the Swaddle Me sacks, but they had this problem.)

If you’re good with a swaddling blanket, that will solve your problem. Our daughter broke free of those pretty quickly. (Pediatric nurses are clearly made of magic. There is no other explanation for how they do it so perfectly.) For the rest of us, there is Halo. These swaddles and sleep sacks expand from the hip to the feet, which means the cast and the boots will fit into them flawlessly.

There are less expensive knock-offs these days that are just as nice. We have found a bunch at children’s consignment stores (if you have a Kid to Kid or a Once Upon a Child near you, GO THERE. They’re amazing).

Here are the ones we’ve tried and loved:

For swaddling babies with clubfoot:

Halo Sleepsack Swaddle Cotton
SwaddleMe Arms-Free Convertible Swaddle — My husband and I had very differing opinions about this. He hated the arms because he swore she was getting out of them. When I swaddled her, I didn’t have that problem (we had different methods, I guess). Halo was the clear household favorite, since she wasn’t able to break free at all. But for something cheaper, I (and I alone, apparently) recommend these.

For when your baby learns to roll:

Once baby is rolling over, you’ll need to stop swaddling. But the wearable blankets are still very nice, because it gives them an extra layer of warmth. Here are the ones we used:

Halo Sleepsack 100% Cotton Wearable Blanket — These are a heavier cotton. Great for when the weather is warming up or cooling down. We also use them sometimes in the winter, if our baby’s pajamas are really heavy (keeping in mind that we live in Atlanta).
TILLYOU Large Breathable Cotton Baby Wearable Blanket with 2-way Zipper — These are like the Halo sleepsack, but much thinner. So we use them in the summer.
Halo Sleepsack Microfleece Wearable Blanket — We use these ones probably more than any other. They’re so soft and they’re great with cold weather, obviously. But they’re also good if you hate hot weather and like to keep the air conditioning turned down.
BABYINABAG Baby Sleeping Bag and Sack, Minky Dot, Quilted Winter Model — This is great when it’s REALLY cold because it’s so thick.

For sizing, you’re really going to have to go by your baby. Ours is VERY long (tall like her dad), so she’s been in a size L since she was about 6-9 months.

These are something I recommend getting at consignment stores, if you can. I’ve gotten tons of like-new Halos for $8-$10 at Kid to Kid.

2. Wearable sleeping bags

When it’s cold, these are fantastic. Your baby is warm, their legs fit, changing their diapers is easy.

These can be grouped with the sleep sacks, but until your baby starts crawling, I view them as clothes.

3. One-Piece Button-up Coveralls

These are essential. Make sure they button up the legs and crotch and that the leg cuffs don’t have that annoying thing where the cuff doesn’t unbutton (Burt’s Bees does that sometimes and it makes me crazy).

You’ll want to invest in a lot of these. They come in short sleeve, long sleeve, fleece, cotton. We avoid getting the ones with hoods because daycares in our area have regulations about kids not being allowed to wear hoodies (they’re too dangerous to let them sleep in and they can get caught on things like door handles).

The only issue is that these can be kind of hard to find sometimes, particularly in larger sizes (like 18-months). So when I find them, especially at second-hand stores, I stock up. We use them pretty much constantly.

Because they’re sometimes so difficult to find, here are a few more examples of the ones we have used and liked:

You can see from the list that finding fleece is very difficult. I couldn’t find any (but trust me, they exist).

If you buy in the store, Wal-Mart and Carter’s have the best deals and the biggest selection. Even if their online stores leave a lot to be desired.

4. Knee-High/Thigh-High Socks

Let’s face it, baby socks are adorable, but useless. They never stay on, even the ones that promise they will.

Turns out, though, that knee-highs and thigh-highs exist for babies. And you’re going to need a lot of them.

The biggest thing to keep in mind when buying these socks is to find ones with rubber on the bottom, so they don’t slip around in the boot and cause blisters.

The ones we have tried and liked are:

These have been basically impossible to find in stores, so I’ve pretty much been exclusively buying through Amazon. They have tons of styles and colors and you baby will go through a lot of them. So don’t worry about getting exactly the right set, you’ll have plenty of time to find the ones that work best for you.

5. A bathtub with a sling

I know, maybe you’ve read that babies are more comfortable in those circular tubs. They probably are. But those tubs aren’t going to keep the cast from getting wet.

A bathtub with a sling was ESSENTIAL for us. Our bathroom is tiny, so we put the tub on a towel in the middle of her bedroom, so we would all be comfortable. This is pretty easy to do when they’re tiny and not splashing yet. She laid in the sling, above a couple inches of soapy water. My husband kept her from kicking her cast into the water and I sponged her off.

We loved The First Years Sure Comfort Newborn to Toddler tub. We still use it now that she’s sitting up splashing around and she loves it.

Should I buy bar covers?

Eh. We didn’t. The bar doesn’t bother her. It doesn’t pinch. She doesn’t kick herself with it. So it’s up to you.

Do I need special shoes?

That is a question for your ortho. I will say, keeping shoes on a baby is not worth the trouble or the cost of buying them. Once the baby starts walking, it may be a different story. We haven’t gotten there yet, but I will update this post when we do.