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• You may notice that your child’s feet turn in (pigeon toes). Many children have this problem and most outgrow it by the time they are ready to start kindergarten.

• If your child has turning in of his feet, this "toeing in" can come from several places on his body. The turning in can come from his feet. This is called metatarsus varus or adductus. Your child may have turning in from his legs (which in turn makes the feet turn in). This is called internal tibial torsion. A third place the turning in could come from is the hips. Again this causes the feet to appear as though they are turning in. This turning in from the hips is called femoral anteversion.

• Metatarsus varus: You may notice that the bottom of your child's foot is shaped like a "kidney bean". Metatarsus varus is usually caused from the positioning of the baby while inside of the mother. For treatment your physician may have you stretch your baby's foot. He or she will show you how to do the stretching exercises. These exercises could be done at each diaper change. In severe cases, your physician may suggest that casts be put on your child's feet to hold and correct them to the proper position. Occasionally shoes or braces can also be used.

• Internal tibial torsion: This condition of "toeing in" comes from the inward twist of the leg bone. In almost all cases the child will outgrow it by the time he or she starts school.

• Femoral anteversion: This condition of "toeing in" comes from the hips. It is extremely common to find this in normal children between the ages of 2-6 years old. Most children will improve with growth. Bracing has never been shown to work for this condition. Fortunately, it is extremely rare for this to cause functional problems in children.

• In summary, the majority of causes of "in-toeing" are normal developmental stages in your child's growth. It is extremely common for children to "in-toe" and most improve with growth. Occasionally, mild residual "in-toeing" will remain after school age but this has never been shown to interfere with the child's performance. Only in exceptional cases is treatment recommended.