My wife gave birth to our first child last night. I’m exhausted and I’m sure she is but we need some information right away. The baby is perfect but he does have a foot deformity on both sides they are calling “clubfoot.” What is the treatment for this problem and how soon should be take him to see a specialist?

Clubfoot is not a rare or new condition. This condition has been described in medical literature since the ancient Egyptians. It is a congenital problem, which means the condition is present at birth and occurred during fetal development. The condition affects both feet in about half of the infants born with clubfoot. Clubfoot affects twice as many males as females.

Clubfoot is a term that describes the position of the foot your baby was born with. The foot is turned under and towards the other foot. The medical term for this problem is equinovarus. When broken down into its parts, equinovarus means that the toes are pointed down (equinus) with the ankle flexed forward (like the position of the foot when a ballet dancer is on her toes). Varus means tilted inward. The ankle is in varus when you try to put the soles of your feet together.

This twisted position of the foot causes problems. The ligaments between the bones are contracted, or shortened. The joints between the tarsal bones do not move as they should. The bones themselves are deformed. This results in a very tight, stiff foot that cannot be placed flat on the ground for walking. To walk, the child must walk on the outside edge of the foot rather than on the sole of the foot.

Fortunately, treatment is quite successful using a method developed by Dr. Ponseti. This type of treatment is started as soon as possible (usually within the first week after birth). The foot is manipulated (moved) to stretch and loosen the tight structures. The foot is then placed in a cast to hold it in a corrected position. This is repeated every one or two weeks until the deformity is corrected.

Your pediatrician will guide you through this process. You will be referred to an orthopedic surgeon immediately — often while the baby is still in the hospital. Treatment may even begin before you take the baby home but if not, then within the first week. If this is not what happens where you are, then seek the services of an orthopedic surgeon who has experience with the Ponseti method. Studies show excellent long-term results with this treatment.