Bowlegged Baby: Common Occurrence or a Cause for Concern?

    Updated 14 April 2020 |
    Published 21 June 2019
    Fact Checked
    Reviewed by Kate Shkodzik, MD, Obstetrician and gynecologist
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    Bowlegs in babies shouldn’t always be considered a red flag for parents. In fact, children are naturally bowlegged early in life and the issue usually resolves itself. Below, learn what to do if it doesn’t.

    What are bowlegs?

    Also known as genu varum, bowlegs are an outward curve of the upper half (femurs) and lower half (tibias) of the leg bones. The result is a bow-shaped appearance in your baby’s legs when they’re standing with their feet and ankles together. Their knees do not meet while in this position. Alternatively, when their knees meet, but their ankles do not, they would be diagnosed as knock-kneed rather than bowlegged.

    Note that toddlers who are learning to walk often appear bowlegged as they sway from side to side before gaining enough confidence to move forward. More often than not, the problem spontaneously disappears without treatment by the age of 2.

    What causes bowlegs? 

    Typically, the physiological condition of genu varum is caused by cramped conditions inside the womb. The curled position that a fetus is forced to adopt within the uterus encourages the development of bowlegs, osteomalacia, and/or rickets.

    In certain cases, bowlegs could be the direct result of rickets (defective mineralization of cartilage in the growth plates). Symptoms of rickets include pain and weakness in the bones, delayed growth, and even deformity. Vitamin D and calcium deficiencies are generally to blame.

    Vitamin D is essential to maintaining strong, healthy bones. According to the FDA (Food and Drug Administration), infants should consume a maximum of 400 IU of vitamin D per day. While the human body’s able to produce its own vitamin D with the help of sunlight, it’s also found in eggs and oily fish.

    Aside from rickets, however, there are other possible explanations behind bowlegs.

    • Blount’s disease (or tibia vara), which presents complications like meniscal tears, gait abnormalities, and osteoarthritis (OA). It normally requires orthopedic treatment and monitoring to improve prognosis and quality of life.
    • A vitamin D deficiency due to poor diet and lack of sun exposure, inflammatory bowel disease, or gastrointestinal bypass surgery. Sometimes, a genetic predisposition for vitamin D resistance or a chronic illness (e.g., kidney disease) lies at the root of the problem.
    • Bone dysplasia and improperly-healed fractures have been known to lead to bowlegs, and in rare cases, lead or fluoride poisoning may be the culprit.

    How to fix bowlegs 

    Despite being present during early infancy, the condition tends to clear up after 6 to 12 months of walking. The deformity is naturally corrected when your baby’s legs begin to bear the weight of walking upright.

    If the issue does not resolve itself or appears suddenly around the 2-year-mark, be sure to consult your pediatrician. When left untreated, bowlegs could increase your child’s chances for developing a number of serious problems later in life. These include arthritis of the hips and knees, gait abnormalities, joint instability, osteoarthritis, meniscal tears, and degenerative joint disease.

    Keep in mind that only in severe cases would corrective surgery or casts be recommended to treat infants with bowlegs. Most medical experts actually advise against using braces or corrective shoes as they interfere with physical development.

    When to see a doctor for bowlegs 

    Your baby’s ability to learn how to walk is not delayed or inhibited by bowlegs. However, its presence may create knee problems down the road if it lasts past the age of 2.

    Should you seek professional advice, a detailed history, physical examination, and perhaps blood tests, will be conducted. Your doctor might also refer your case to an orthopedic specialist.

    How to prevent bowlegs

    Under most circumstances, nothing can really be done to prevent this condition. The exception is when bowlegs are produced by rickets. Though rickets rarely occurs in most parts of the world today, there have been signs that it’s regaining prominence.

    Babies with darker complexions have a greater likelihood of developing rickets. This is because darker skin requires more sunlight to produce sufficient amounts of vitamin D for the body. 

    If your child has bowlegs due to rickets, there are several steps you can take. First, ensure that they’re being adequately exposed to natural sunlight each day and their skin’s at least partially uncovered. You can also increase their consumption of oily fish and eggs, or add a vitamin D supplement to their diet to compensate for the shortage.

    History of updates

    Current version (14 April 2020)

    Reviewed by Kate Shkodzik, MD, Obstetrician and gynecologist

    Published (21 June 2019)

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