By: Shanna McGinnis, MD
Ask any parent and no matter the age of their children, they can probably recall their babies’ first steps. Walking is one of the most pivotal and memorable milestones in a child’s life. It generally occurs around the first birthday and allows for greater mobility and thus, more exploration of the surrounding environment. In my office, I get lots of questions from parents regarding walking so I thought I would address some of them in this issue’s article.
One of the main questions parents ask is “When should my baby walk?” The answer, as I alluded to previously, is around the first birthday, but the accepted range is between 9 months and 15 months. This range can vary with prematurity and certain medical conditions. Many parents assume, as the old adage states, that a baby must crawl before they walk. However, some infants never crawl prior to walking. Some scoot on their bottoms or find another means of mobility. Lack of crawling is generally not a sign of developmental delay. A more consistent milestone is cruising. Most infants will pull up on furniture, like sofas or coffee tables, and “cruise” or walk around the furniture while holding on. So when a parent asks whether their baby should be walking, I generally consider their age and whether they are cruising since it is the precursor to walking. If you ever have concerns about whether your baby is meeting a developmental milestone, check with your pediatrician.
Another hot topic surrounding walking is use of infant walkers. Many parents (and almost all grandparents) are surprised that I discourage walker use. Contrary to popular belief, infant walkers do not assist babies in learning to walk. As a matter of fact, they may do the opposite and delay walking. If you observe a baby in a walker, you will notice that he or she tends to lean forward to propel the device. Try this: stand up and lean forward. Did you notice what happened? You probably went up on your toes as you leaned. This is exactly what happens when babies use walkers. Certain muscle groups are overused while others are neglected and the child is denied opportunities to pull up to cruise. In addition, walkers are not considered safe. They give a false sense of safety since the child seems contained, but infants are able to reach higher and move faster in a walker. Walkers are associated with an increased incidence of fractures and head injuries due to rolling down stairs, pinched fingers and toes, drowning, and burns from pulling hot items off tables or stoves. The American Academy of Pediatrics does not recommend walkers and their sale is forbidden in many countries.
Bowed legs are a common source for concern in new walkers. While there are some medical conditions associated with bowed legs, the most likely cause for your child’s bowed legs is physiologic genu varum. That is a fancy way of saying it is normal for new walkers to have bowed legs. Take a look around the playground or your playgroup and you will notice the same bowing in some of your child’s peers from the onset of walking until about 18 months to 24 months. You may also notice that your child’s toes point in or out. These variants are also generally considered normal. All of the above typically improve with time without any intervention. It is not likely that your child will require bracing or therapy for these issues. As always, any specific concerns should be discussed with your pediatrician so he or she has an opportunity to examine your child and answer your specific questions.
My advice to parents is to put your efforts and resources into childproofing your home rather than expensive devices that likely will not help your baby walk sooner. Encourage cruising by placing toys on the sofa or table. If you have any concerns about your baby’s leg or foot alignment, ask your doctor to check it out. Most importantly, charge your camera or keep your smartphone handy to capture those first steps when they do happen. Enjoy this precious phase of life with your sweet baby who is quickly turning into a toddler.