Parenthood is a regular exercise in learning things you didn’t know, and a hilarious new viral TikTok post perfectly captures that.
The video, which was shared by @shelbanddyl , features dad Dylan Reese as he’s informed that his baby doesn’t have kneecaps. “Wait, do you mean to tell me…this baby doesn’t have kneecaps?” he asks. Dylan’s partner, Shelby, informs him that kneecaps develop later in childhood, with the father looking incredulous. “This little nugget is kneecap-less until they’re like 2 to 6 years old? That’s wild!”
The comments were packed with people who said that they, like Dylan, had no idea that babies didn't have kneecaps. But doctors say that the truth about babies and kneecaps is a little more complicated than what the video suggests.
“Babies actually have kneecaps, but they’re different from adult kneecaps,” says Tracy Zaslow, M.D. , a pediatrician and pediatric sports medicine specialist in Los Angeles. “This is just how babies develop.” So what does that mean exactly? Our experts explain.
Do babies have kneecaps when they're born?
Yes and no. “N ewborns and young infants do not have bony kneecaps yet,” says Krupa Playforth, M.D. , a pediatrician in Virginia. “They do, however, have immature kneecaps that are made of cartilage.” ( Cartilage , in case you’re not familiar with it, is strong, flexible tissue that lines joints and creates structure in the nose, ears, and other parts of the body.)
The kneecap, or patella, is a structure that changes over time as a baby's skeleton matures, explains Elizabeth Donner, M.D. , pediatrician and member of the BabyCenter Advisory Board. When babies are born, they have a “precursor” to the kneecap, she says, adding, “This may be informally referred to as a ‘cartilage patella.”
Technically, there’s a kneecap in place when babies are born – it’s just not the same as what a kneecap looks like in adults.
These kneecap precursors usually “harden or ossify into bone in the first few years…” says Chandani DeZure, M.D ., pediatrician and a member of the BabyCenter Medical Advisory Board.
And there's a reason for this: Having soft cartilage kneecaps is helpful during the birthing process . “It is easier [for your baby] to exit the birth canal with softer tissue – and it's more flexible and thus less prone to injury,” says Dr. DeZure.
So when do kneecaps actually form then? The cartilage in the kneecap [starts to] turn to bone between the time your child is 2 and 6 years old, says Dr. Donner. As your child gets older, this process of cartilage becoming bone (ossification) continues until they are about 10 or 12, when the kneecap has usually fully developed into a strong bone, says Daniel Ganjian, M.D ., in Santa Monica, California. “In the meantime, the cartilage kneecap provides enough support for a young child's needs as they learn to crawl , walk , and run,” he says.
This isn’t a phenomena specific to kneecaps, either. “Babies are born with more bones than adults and as with the patella, some of these are made of cartilage,” Dr. Playforth says. With time, those bones and cartilage can come together and change to create the bones that we recognize in adults, she says.
Are babies more prone to injuries because of their underdeveloped bones?
Yes and no. Adult bones help protect organs because they’ve fully ossified, which means babies’ organs are a little more vulnerable (although risk of injury to them is still relatively rare).
At the same time, the fact that babies have so much more cartilage than bone has its advantages. “The presence of cartilage throughout a baby's body actually protects them from skeletal injuries such as broken bones, which is important when learning to crawl and walk,” says Dr. Donner. “Babies in general… are more flexible and can tolerate more variety of positions comfortably without causing injury,” says Dr. DeZure.
As long as you’re following basic safety practices – like putting safety gates up at the bottom and top of stairs, supervising young children closely, and trying to keep them from jumping off of higher structures – your baby should be fine.
Dr. DeZure says it's also important to ensure that your baby is getting the right nutrients: “Make sure your infant is getting the appropriate amount of calcium and vitamin D to promote strong bone formation." (Children under the age of 4 need anywhere from 200 to 700 milligrams of calcium, while kids under age 13 need anywhere from 10 to 15 micrograms of vitamin D, according to the National Institutes of Health).
Talk to your child's pediatrician about whether they get enough calcium through milk and food, or whether they need a supplement to help.
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