It may seem like a strange question, but lots of parents search the internet wondering whether babies do actually have kneecaps. It makes sense considering a baby’s kneecaps feel soft and rubbery, and not at all like the hard kneecaps we have as adults.

So… do babies have kneecaps? If so, what are their kneecaps made of? When does a baby’s kneecaps get harder? What do you need to know to protect your child’s kneecaps?

Do babies have kneecaps at birth?

The answer is yes, babies do have kneecaps (or patellae) at birth. However, a baby’s kneecaps are made up of a piece of cartilage, which is softer and more flexible than bone. Cartilage gives structure where it’s needed in the body (such as in our nose, ears, and joints). Over time, the cartilage that forms a baby’s kneecaps will harden into the bony kneecaps that we have as adults.

Why aren’t babies born with bony kneecaps?

Babies have a lot more cartilage in their skeleton than adults do. Having more cartilage than hard bone makes it easier for them to curl up in the uterus and pass through the birth canal. This means less risk of injury to both baby and mum. Also, kneecaps of cartilage are better able to handle the falls and bumps that accompany the early years.

Can my baby’s kneecaps get injured?

While babies’ kneecaps seem more delicate than those of older kids, they are no more prone to injury. A baby’s kneecaps are meant to be flexible and soft, so they can crawl and toddle around without getting hurt.

When does the cartilage in the kneecaps turn into bone?

According to orthopedic sports medicine specialist, Dr Edmonds, a centre of bone starts forming in the cartilage of the kneecaps between two and six years of age. This process of cartilage turning into bone is called ‘ossification’. However, the formation of bone in the kneecap takes many years and is usually not complete until a child is around 10-12 years old.

In some children, the bone may start to develop in several areas of the cartilage in the kneecap at the same time. Usually, these pieces of bone eventually fuse together, but occasionally they don’t fuse properly and the kneecap appears split or doubled. This is called bipartite patella and while it often gets better on its own, some children may need treatment with physiotherapy.

What about injuries in older children?

Injuries to the knee can occur in children, particularly children who are active or play sports. Knee pain can be due to a fracture, dislocation, sprain, or injury to ligaments around the kneecap.

If your child has any of the following signs or symptoms, it’s best to see your doctor:

• Pain and/or swelling around the knee that doesn’t improve in 24 hours
• Stiffness or difficulty when trying to move the leg or bend the knee.

Leanne Vidler has been a Registered Nurse for 35 years, with her experience ranging from acute care in paediatric and paediatric intensive care (in Australia, Saudi Arabia, and the UK); infection prevention and control; education; immunisation; aged care; quality assurance; research; policy; and national guideline development. She now provides support and education to parents and families, helping them navigate and enjoy the crazy and precious early years of parenthood, as The Mama Coach.

Make sure you also check out our article on what you should do if your baby rolls over in their sleep.