My child has flat feet, what will I do?

Oftentimes, I hear this from parents and, I understand their concern that their babies' or kids' foot looks different.

What are flat feet?

Flat feet are also called pes planus. Below is a picture of a flat foot wherein the medial arch or inner border disappears during weight bearing.

An 8 month old with flat foot but arch is starting to develop.

A kid 10 years old with very low arch or the inner border of foot touching the floor when standing or when the foot is loaded.

Having flat feet is normal in babies until they are about two years old. More often than not, as parents we confused a child's fat feet with flat feet.

What causes flat foot?


Flat foot can be caused by genetic predisposition or inherited, muscle weakness and ligamentous laxity.

However, in kids who are delayed in walking, they could also have flat feet as the arches are still weak and have not fully developed.


The pictures below correspond to the same feet as above but no weight is put on it and you can visibly observe the arch.

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This is called a flexible flatfoot. If the child doesn't complain of pain, it is ok but if pain develops or there is discomfort during any activities, it is  highly recommended that you see a doctor and would most likely recommend you to a physical therapist. Flat foot can also be congenital or rigid which is rare.

So,what can you do with your kid or baby with flat foot with no other conditions such as cerebral palsy,pain...

BAREFOOT....being barefoot allows our kids to develop the arches naturally. The foot is constantly challenged especially when walking  in the sand or uneven surfaces. It may not be practical most of the time but when there is an opportunity, go for it.

Tip-toeing while walking and skipping rope also helps form a natural arch for older kids, if they are already physically able to do so.

What about insoles for my kids? 


Insoles are commonly worn to help support the arches. My opinion is they are great if there is pain,discomfort that intervenes with activities but if no other concern, its not necessary. An insole supports the arch but doesn't develop it, so wearing one just weakens the arch more. And lastly, it is always good to consult a physical therapist for an evaluation.

Why do OT 's and PT's discourage "W" sitting?

 I had a client earlier today and saw him in this position.

"W" sitting is a position when children sit with both knees bent and legs turned out forming a letter W on the floor. It is very common among children that parents think its just normal to sit in that position.

In my experience, I usually see it happening before a baby starts crawling especially during transitions from any position to sitting. It gets more frequent when a baby starts to crawl.  Using it to transition or move from one position to the other is ok but the problem lies when staying in or prolonging that position.

W sitting front view

W sitting view from behind

So why a baby or child prefers it?

When  a baby is on W position, he is stable. It widens the base of support due to legs are out.W sitting is very common among babies who are generally has decreased tone, has loose joints and those with poor balance.

Long term effects?


 When babies and children are on this position, they would no longer engage or use their trunk muscles due to added stability of a wide support. Thus,leading to disuse and further weakness. Another observation I had is, babies tend not to use the arms to cross the midline as trunk rotation is limited and also they can't weight shift on the buttocks. Shortening of the following muscles is also very common especially on the hamstrings,gastrocs and heel cords. Later in life, this causes low back pain and knee and foot problems.

 What can we do as parents,caregivers?

The moment we see our kids do this, we need to correct them right away meaning instructing them to sit cross legged,side sit,sit with legs out straight or bent. Early correction is a must so that it doesn't become a habit. And if you think your kids are not growing typically in comparison to other kids their age,consult with your pediatrician and bring your concerns to them.

Baby Jaela Cooing!

Cooing is vowel like sounds.Check out my baby Jaela cooing.

Open mouth vowel sounds such as "aah" are usually the first to be produced because no rounding of the lips is needed.When producing open vowel sounds, the tongue is near  to the bottom teeth.Closed vowel sounds typically follow and these sounds are  "ee" and "oo" and in close vowel sounds, tongue position is near the roof of the mouth. It is encouraged when babies coo,we should repeat the sounds they make and give them time to respond thru facial expression or they repeat the sound you make.


On the other hand, I learned from our speech therapist this month,May, is Better Hearing and Speech Month.  As Early Intervention is becoming more transdiciplinary, it would always be our advantage to know what other disciplines are doing and incorporate in our own management so that a true transdisciplinary approach is accomplished...Till then..Have a great weekend.