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First steps, first problems

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C. A. V. Nogueira, M.D. ▼ | May 30, 2014
First steps, first problemsIf you ever saw a little child walking, you know they are walking in a funny way like a little ducks leaning left and right, with the main goal no to fall down on their back. They are funny because their legs are not well-developed yet and one of the first things you will notice is bowed legs.


Bowed legs in small children are very common. While it may seem that's because of those huge diapers between their legs, the main reason is that their bones are not straight yet. When a child with bowed legs stands with feet put together, there is a space between the lower legs and knees. One or two legs may be curving outward and that's perfectly normal and it's called genu varum.

Genu varum, bowed legs in Latin, is a normal condition if your child is under two years old. That condition starts to improve at 18 months of age, usually, and when your child is three of four years old, the legs are straight and the small person is happily running around, of course faster than you.

Keep in mind that any extra weight, read: overweight child, put additional stress on the legs and that complicate things for those small bones. Keep your child weight in reasonable range.

Here we must say that parents have some expectations and they are not always right. If you think that your kid should stand on its feet on the first birthday, because some beliefs are saying so, forget it.

Keep in mind that your kid is not a "small person," its body has its own rules, strengths and weaknesses, and it decide it won't walk with 12 months, than it won't. Period. The kid will walk when the kid decide it's time to walk.

While at that, you may also forget "you must crawl to be able to walk". There are children that never crawl, they just happen to come to the table and take that cake. We are not sure is the power of cake so strong to bring the kid across the room, but again: The kid will walk when the kid decide it's time to walk.

Now, we said that bowed legs are a normal condition but if you see that the condition doesn’t start to improve after the second birthday, it’s time to see the doctor because your kid may have Blount's disease. Sound scary but it isn't.

Blount's disease is a condition that occurs in toddlers but also in adolescents. It happens when there is an abnormality of the growth plate in the upper part of the shinbone (or tibia). Growth plates are determining the length and shape of the adult bone. It's hard to say is it about Blount's disease if your kid is under the age of two years, but if the legs are bowed and the third birthday is near, you should do some x-rays.

Blount's disease must be treated to prevent its progressive nature. If the condition is left untreated, the child's knees will suffer from a great stress and there can be pain because bones in unnatural position can't carry the body weight.

If the doctor spots it early, this problem can be solved with braces that help bones to form as they should. In cases where braces are of no help, a surgery will step in, somewhere around the age of four years. It may stop the condition to progress and, of course, it may prevent permanent damage to the bones.

So far so good, nothing terrifying on kid way, but there's another condition you should know about: rickets. Well, this is a disease. It occurs when the kid doesn't get enough vitamin D, calcium or phosphorus. Without those substances there's no happy life for bones, so they are very important for a healthy child.

The absence of those ingredients causes bowed legs but also other deformities. As you may imagine, rickets are more likely to develop in poorer countries when people just don't have enough of different foods to eat. In developed countries the milk you are buying in the store every day has all minerals, vitamins and stuff, so no worries here.

Well, in fact there is one worry: A genetic defect when the body doesn't know what to do with vitamin D can cause many problems. If the doctor suspects it's about rickets, a simple blood test will confirm or deny that.

Fortunately, rickets can often be controlled with drugs and of course change in eating habit. If the condition is persistent, the surgery will step in again to solve deformities.

One thing we must emphasize here: Although it may seem terrible the first time you see deformities in your kid's bones, the situation is not tragic. Young bones are still growing and have a great chance to be corrected and to continue to grow as they should.

So, don't be surprised if you learn that neighbour’s kid, the king of speed, had his legs in braces not so long ago, looking very sad, but now thinking what football club he will be joining.

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