Polydactyly (Extra Fingers or Toes) in Babies
The short answer
Polydactyly (having extra fingers or toes) is one of the most common congenital hand and foot differences, occurring in about 1 in every 500-1000 births. It can range from a small, soft nub of tissue to a fully formed extra digit with bones and joints. In many cases, it is an isolated finding with no other health concerns and runs in families. Treatment depends on the complexity of the extra digit and is usually straightforward.
By Age
What to expect by age
Extra digits are typically noticed at birth. The most common type is postaxial polydactyly (an extra small digit on the pinky side of the hand or the little toe side of the foot), which is very common in certain populations and is usually a simple, isolated finding. Preaxial polydactyly (on the thumb or big toe side) is less common and may warrant additional evaluation. Your pediatrician will assess whether the extra digit has bones, blood supply, and nerve connections.
If the extra digit is a small, soft nub without bone (called a rudimentary or vestigial digit), it may be removed in the nursery or at a pediatric visit with a simple procedure. If the extra digit contains bones, tendons, or joints, your baby will likely be referred to a pediatric hand surgeon or orthopedic specialist to plan a more involved procedure, usually performed between 6 months and 2 years of age.
Surgical removal of a more complex extra digit is typically done during this window, before the child develops fine motor skills that depend on hand function. The surgery is usually outpatient and recovery is straightforward. For extra toes, surgery may be done later or sometimes not at all if the toe does not cause problems with shoe fitting or walking. Long-term outcomes are excellent.
What Should You Do?
When to take action
- A small, soft extra digit on the pinky side of the hand, especially if it runs in the family
- An extra toe that does not interfere with shoe fitting or walking
- The extra digit having no bones (a soft tissue tag) that can be addressed with a simple procedure
- Family history of polydactyly, as it is often inherited
- Your baby has an extra finger or toe and you want to discuss treatment options and timing
- The extra digit appears to have bone, joint movement, or a nail
- You notice any other differences in your baby's hands, feet, or other body parts
- You want a referral to a pediatric hand or orthopedic specialist
- The extra digit changes color (turns blue, white, or dark), which could indicate blood flow problems
- There is a thread, hair, or string wrapped around the base of the digit causing swelling
- The extra digit bleeds, becomes infected, or has an open wound
- Your baby has multiple extra digits or other unusual physical findings alongside polydactyly, which may warrant genetic evaluation
Sources
Related Resources
Related Physical Concerns
Baby Hip Dysplasia (Hip Click)
Developmental dysplasia of the hip (DDH) is a condition where the hip joint does not form properly, ranging from mild looseness to complete dislocation. It occurs in about 1 in 1,000 births and is more common in firstborns, girls, breech babies, and those with a family history. When caught early, treatment with a soft brace (Pavlik harness) is highly effective.
My Baby Was Born with Clubfoot
Clubfoot (talipes equinovarus) is a condition where one or both feet are turned inward and downward at birth. It affects about 1 in 1,000 babies and is very treatable. The Ponseti method, which uses gentle casting and bracing, corrects clubfoot in over 95% of cases without major surgery. Treatment typically starts within the first few weeks of life for best results.
Baby Birthmarks
Birthmarks are extremely common -- more than 80% of babies have at least one. Most birthmarks are completely harmless and many fade or disappear on their own over time. The type, location, and any changes over time help your pediatrician determine whether any follow-up is needed.
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.
Baby or Toddler Body Odor - When Is It Normal?
Babies and toddlers can develop body odor from several benign causes: sour milk caught in skin folds, sweating, diaper area odor, strong-smelling foods in the diet, and certain medications or vitamins. True body odor (like adult BO from apocrine glands) should not occur before puberty. If your baby or young toddler has a persistent unusual body odor that is not explained by skin folds, diaper, or diet, it could indicate a metabolic condition, infection, or foreign body (especially in the nose or vaginal area). Unusual persistent odor warrants a doctor visit.
Baby Born with Teeth - Natal Teeth
Natal teeth (teeth present at birth) occur in about 1 in 2,000-3,000 births. In most cases, these are actual primary (baby) teeth that erupted early, not extra teeth. Most natal teeth are the lower front incisors. While natal teeth can sometimes cause breastfeeding difficulties or have a risk of becoming loose and being a choking hazard, many can be left in place and monitored. The decision to keep or remove a natal tooth depends on how firmly it is attached and whether it is causing problems.