Don't Panic, it's Just Club Foot

Three months before my due date smack dab in the middle of my amniocentesis, my doctor revealed the ultrasound showed that my daughter had two club feet. I didn’t know how to react. I had no idea what club feet were. Were her feet missing? Deformed? Fin-like structures? I had no clue. When I got home, I cried. Then I pulled out my laptop and started searching.

The truth was both of her feet were turned in and upside down. Need a better mental picture? Okay, stretch out both your arms in front of you, then point your hands toward the ceiling like you are looking at your fingernails. Now point your fingertips at each other, then move your fingertips away from you slightly. That's a pretty good representation of what mild club feet look like. More severe club feet would be similar to adding one more step which would be twisting your hands, so your palms are facing toward you. That’s Chronic Club Foot. That’s what my daughter had.

If you just found out you’re expecting a child with one or two club feet, your emotions are running rampant. First, there’s shock - no, not my baby, he/she is supposed to be perfect and healthy. Next, comes denial - maybe the next check-up will show they were wrong. Then, of course, guilt - what did I do to cause this? Lastly, fear what else could be wrong? What will life be like for this precious one and for us? Can we handle this?

First of all, take a few deep breaths and calm down. This is not your fault, you did nothing to cause this, and more importantly, it's not going away. As a matter of fact, no one is really certain how club foot happens. Theories suggest it’s a bit of a genetic issue plus possible environmental concerns, but no one knows for sure. Blaming yourself, your partner or your environment will serve no purpose so put those thoughts to rest. Secondly, and most importantly, of all the birth defects your child could have this is the BEST option. Why? Because, it's treatable, it's CURABLE. Your child WILL move past this and live a healthy life. Thirdly, clear the air with your doctor. Be blunt. Ask about any other concerns or complications. Most of the time, there aren’t.

Here are some statistics, 1 in 1000 births are club foot, in 50% of the cases both feet are affected. If one foot is affected, that leg may have a smaller calf muscle, and that foot may be smaller than the unaffected foot. Many cases require a minor surgery in which the Achilles tendon is severed once casting and repositioning of the foot are complete. This is done as an outpatient procedure at approximately 4 months old. In more severe cases bone reconstruction and/or a tendon transplant is necessary and may require hospitalization overnight, but that is usually when the child is much older.

The first thing you should to do is call your pediatrician and get a referral to a Pediatric Orthopedist, don't wait until the child is born. Get the doctors name and phone number, call them for a consult if you are nervous or concerned. However, the hospital will contact the Orthopedist when the baby is born, and they should visit you before you check-out to update you on the baby’s condition.

Trust your doctor, BUT check with your insurance and see if contacting a local Shriner’s Hospital would be in your best interest. Shriner’s does take insurance, and they are a research hospital so your child would be in excellent hands, and your contribution will aid in improving treatment for future children. Shriner’s usually cover’s your deductibles AND anything your insurance won't pay if you are struggling with the costs.

Many insurance companies have huge deductibles or won’t pay at all for Orthodontics, so be prepared. Contact the Orthopedist and ask them about the different types of casting they offer for club feet. There are a couple of different types, some are easier to deal with than others. The standard treatment is to place the baby in casts for approximately the first 3-4 months of their life, changing the casts weekly as the feet/foot are adjusted back into the correct position. This does not hurt the baby, their bones, tendons, and ligaments are flexible at this age, but it can be uncomfortable and frustrating for everyone involved.

My advice, take the baby home from the hospital and cuddle it without the casts for a week or two. It’s not going to hurt anything, and you’ll get some bonding time before the process begins. Enjoy the soft cuddly closeness and love that little bundle with all your heart. Then begin the casting process. Why? Casts are hard and heavy, and it's a bit awkward handling the baby with them. My parents wouldn't even hold my daughter because they were afraid they would drop her.

Keep infant Motrin on hand. Check the dose with your Pediatrician, give it to your child in the doctor's office or just before arrival to help with any discomfort they may experience while adjusting to the casts. An encouraging note: children usually develop strong leg and stomach muscles from lifting the casts and kicking with them. Believe me, after a while they can hurl those things. If you're not careful, you could get a black eye while trying to give them a kiss on the tummy! My daughter loved to slam her casts down on the changing table, just to hear the banging noise.

After the casting is over the child will be fitted with braces (custom fitted boot-like shoes with a bar in between the feet that allows for a bit of movement). They will wear this brace 24 hours a day for a short while. Then progress to wearing them only at night and nap time. Normally the children wear the braces until they are 3-4 years old. Don’t slack on this or your child could backslide and end up needing more casting and surgery. Use these braces every night, no exceptions, no excuses.

When the casts are changed, expect tears, it's not painful, but it's scary for the baby due to the noise of the machine they use to cut off the casts. Don’t be surprised if your child doesn't want anyone messing with their feet at this point. My daughter was extremely protective of her feet. Ask your doctor if you can use the casts that can be removed by the parents the night before the recasting appointment. That's an excellent cuddle time, and it's an easier transition for the baby than having the casts cut off once a week. Be prepared for a lot of sponge baths if you can’t get this type of casts.

If those are available, once they are off, give the child a bath and moisturize their legs and feet BUT wash them off before the doctor appointment to avoid sanitary issues and cast slippage. If you can't get that type of cast, bring lotion with you to the doctor’s office, and once the casts are removed, you will be allowed to wash her legs. Use the lotion ONLY if his/her skin is dry and flaking and again, wash his/her legs after a few minutes to remove the lotion before they put on her new casts.

More advice; don't be embarrassed by the casts in public. No one is going to think you are bad parents who injured their child. When a stranger asks what's wrong, smile and say, "It's club feet, and he/she's doing fine." You’ll be surprised by the number of people who will volunteer a club foot story about someone in their family, and it usually ends with how well that child is doing now. One more thing, restaurant high chairs and club feet don't mix, be prepared, bring in your infant’s car seat in with you.

People with club foot

·            Football players Troy Aikman, Charles Woodson, Pat Summerall and Miguel Riffo

·            Olympic Soccer Player Medalist Mia Hamm

·            Professional Figure Skater Kristi Yamaguchi

·            Baseball players Jim Mecir and Freddy Sanchez

·            Roman Emperor Claudius

·            Lord Byron, Sir Walter Scott

Lastly, know that you’re not alone. Check with your local parents as teachers association and see what they have to offer. They may know of programs in the area or state that can benefit you or your child. They’ll also come to your home and check on your child's physical and mental development and help you determine how they’re doing and where they should be in their natural development. Your baby should crawl and walk pretty close to schedule, but if they’re a bit behind don't worry, they’ll catch up.

And yes, you’ll feel cheated, you’ll feel denied of your cuddling opportunities with your soft little baby. That's when you need to remind yourself of how lucky you are to have this sweet child in your life and how lucky you are that this birth defect was only club foot, it could have been much worse.

Remember to be brave, remember to be proud. Realize that your baby is watching you. He/she is taking note of your emotions and reaction to everything that is going on. So be positive for them. You can do it. It's not going to be easy, but you’ll get through it, and everything is going to be alright. Hang in there!

Kimbra Townsend