About Your Baby's Arms and Legs

Why do his feet and legs curve in?

Curved Feet

Sometimes parents and grandparents are worried about how their baby's legs and feet look. The shins and feet of most newborns curve inward, and they look quite pigeon-toed.

When the baby is tucked up in mom's uterus, his feet and legs curve to fit in the tight space. After he is born, he still holds his feet in the same tucked position.

Shin bone straightening doesn't start until he starts walking. When he walks the leg muscles pull on the rapidly growing bones, and they will eventually straighten. This process happens naturally over several years with no help needed from doctors or parents.

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Collarbone Fracture (Clavicle Fracture)

collarbone fracture

When the baby is born, the oval shaped head must fit through mom's pelvis first. Then the shoulders must fit through. Sometimes they just won't fit, and the stress of the delivery on a collarbone can snap it. So much is going on when the baby first come out, that collarbone fractures often aren't noticed right away.

In babies, because their bones are so flexible, they splinter like a thin green stick (called "green-stick fractures"). They are more like bone cracks than actual fractures. The bruising, swelling and pain of a fracture comes from the living membrane that wraps around the bone (the periosteum).

When I check a newborn baby, I check the collarbones on each side. If there is a fracture, the side with the fracture feels different than the side without the fracture, sort of like crinkly paper under the skin (called crepitus). Usually the two shoulders look the same, but sometimes they don't. Sometimes the baby moves the arm on the injured side less than the normal side.

Baby with arm pinned

The good news about a collarbone fracture in a baby is that they always heal up just fine. Within three weeks, in a newborn, the bone is well healed and doesn't hurt. No special care is needed, other than to pin the shirt on the injured side so the baby moves that arm less. It also helps to remind us adults to be gentler when lifting and dressing the baby.

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Why are her hands and feet blue? (Acrocyanosis)

Acrocyanosis

For a few weeks new babies don't regulate their circulation very well. So, off and on you will see blue hands and feet on your baby. It doesn't mean she is cold, or that anything is wrong. It is because her nervous system contracted the blood vessels to her arms and legs for no good reason.

You don't have to do anything about it. It will go away in about twenty minutes. Make sure her gums and tongue are bright pink. Sometimes the skin around her lips may look blue, this is normal and is because of the rich blood supply to the face and mouth. But her gums and tongue should always be bright pink. If her tongue turns blue, call 911.

If your gramma's legs turn blue, that is NOT OK, and she should get checked right away.

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How do I cut his fingernails?

Fingernails

Chances are your new baby has scratched his face with his fingernails. He didn't even know he was doing it. It's OK, those scratches heal up within a couple of days in new babies.

However, he won't stop scratching himself for a couple of months, so you will want to keep his fingernails short. The nurses will not cut your baby's fingernails for you. You are going to have to do it. (I have never been in a hospital where the hospital staff will cut a baby's fingernails. Maybe sometime, a long time ago, someone got sued for it.)

The best time to mess with your baby's fingernails is when he is sound asleep. You can use tiny scissors or clippers. You might miss and draw a little blood, but just hold the finger and it will stop bleeding in a minute. Most moms just bite the fingernails off of their babies. Your lips and tongue are very sensitive and you can be very delicate and safe doing this.

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Extra Digits

Extra Digit

Sometimes babies are born with extra digits on their hands and feet. This tends to run in families.

Most of the time the extra digit is soft skin and easy to remove. The nursery doctor can numb it up and tie it off. The skin dries up and falls of in a week or so, like a scab. If the extra digit has bone in it, it will need to be checked and managed by a hand surgeon.

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Thanks to Janelle Aby MD, Stanford School Of Medicine, Newborn Nursery, and Lucille Packard Children's Hospital for the use of occasional photographs.