My Baby Stands Only on Tiptoes
The short answer
Some toe standing is normal when babies first start pulling up and bearing weight. Many babies stand on their toes for a few weeks before learning to put their feet flat. However, if your baby exclusively stands on tiptoes and cannot put their feet flat, it may indicate tight calf muscles or increased muscle tone that should be evaluated.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
When babies first start pulling to stand, many go up on their toes. This is often normal as they figure out foot positioning and weight distribution. If your baby can also put feet flat sometimes, this is likely just part of learning. Barefoot time on different surfaces can help them learn to feel the ground with their whole foot.
Your baby should be spending more time flat-footed when standing by now. Some toe standing is still normal, especially when excited. If your baby exclusively stands on tiptoes and never seems to get their heels down, mention it to your pediatrician at the next visit.
If your baby or toddler still only stands on tiptoes, evaluation is recommended. Your pediatrician can check ankle range of motion and muscle tone. Persistent toe standing may indicate tight Achilles tendons or hypertonia that can be addressed with stretching or physical therapy.
Exclusive toe standing at this age warrants a thorough evaluation. While some children have idiopathic toe standing that resolves, it is important to rule out underlying causes. Early physical therapy is very effective for most cases.
What Should You Do?
When to take action
- Your baby is newly pulling to stand and stands on toes some of the time.
- Your baby can and does put their feet flat when standing at a surface.
- Toe standing happens mainly when excited or on new surfaces.
- Your baby is under 12 months and toe standing is decreasing over time.
- Your baby exclusively stands on tiptoes and never puts heels down.
- You cannot gently flex your baby's foot to a flat position.
- Your baby's legs seem stiff when standing.
- Toe standing persists beyond 12 months.
- Your baby has developed toe standing along with increasing leg stiffness.
- Your baby has other new neurological symptoms alongside toe standing.
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Physical Concerns
My Baby Is Walking on Their Toes
Toe walking is extremely common when babies are first learning to walk and is usually nothing to worry about. Up to 5% of children toe walk at some point, and most outgrow it by age 2-3. It only becomes a concern if it persists past age 2 or if your child seems unable (rather than unwilling) to put their feet flat.
My Baby Seems Too Stiff (Hypertonia)
Hypertonia means your baby's muscles feel unusually tight or stiff, making it hard to bend or move their limbs. While some stiffness can be normal during certain movements (like when a baby is startled or upset), persistent stiffness at rest warrants evaluation. Early identification and physical therapy can make a significant difference.
My Baby's Legs Are Stiff When Held Standing
While some babies stiffen their legs momentarily when excited about standing, persistently stiff legs that resist bending may indicate increased muscle tone (hypertonia). It is important to distinguish between a baby happily stiffening their legs to bear weight (normal) and legs that are rigid and difficult to bend (warrants evaluation).
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.
My Baby Only Army Crawls
Army crawling (also called commando crawling) is a completely valid and normal way for babies to move. Many babies army crawl for weeks or even months before transitioning to hands-and-knees crawling, and some skip hands-and-knees crawling entirely. What matters is that your baby is independently mobile and exploring their environment.
One Side of My Baby's Body Moves Differently
Babies should generally use both sides of their body equally. If one side consistently moves differently, is weaker, stiffer, or less coordinated, this warrants evaluation. Asymmetric movement can indicate hemiplegia (cerebral palsy affecting one side), brachial plexus injury, or other neurological conditions that benefit from early therapy.