From birth, every parent is concerned about their child’s feet. There is a sigh of relief when it’s noted the baby has all 10 fingers and toes. It is important to understand the “normal” developmental stages for growth of children’s feet, especially in the first few years; these are the feet that will carry the child throughout their life, so it is ideal to take good care of them right from the start.
Right from the beginning you will note that the baby’s foot shape is different from that of an adult – it has a narrow heel and a wide broad forefoot and will probably remain that way until the age of four.
A newborn’s feet have no fully-formed bones, but very pliable soft bone similar to cartilage covered with protective “puppy fat”. This layer of subcutaneous tissue/fat covers the whole foot making it hard to fit in the shoes. it is this fatty layer that fills in the arch area of the foot that gives a flat foot appearance. This will slowly start to wear off when the child starts to crawl and later walk. So don’t panic! It is ideal to let the feet of the new-born be as free as possible as not to damage the pliable soft cartilage. Try avoiding constricting footwear, “baby grows” and socks. The main use of shoes & socks at this stage is to keep the feet warm.
As cute as small shoes may seem, wait until the appropriate time arrives. The child starts to crawl between the third and sixth month, the bones of the feet are starting to ossify slowly and the foot is still covered with the fatty tissue. This is usually the first time you will be going to attempt shopping for shoes. Trained personnel at specialised children’s shoe shops such as Scholl will measure your child’s feet, so it will be ideal and easier that the child is relaxed and calm for this first experience.
The ideal pre-walker shoe at this stage will have a flexible non slip outer sole and have a breathable leather upper that will keep the perspiring child’s feet fresh. The shoe may also have a protective toe cover that will protect those little toes and give the child a better grip to assist in crawling. Arch supports are not necessary as these may only cause an uneven surface that may cause blisters to the young feet. Measurements taken by trained personnel usually include “growing “space that is required to give enough space for the foot to grow. This is usually hard to assess or fit at this stage, so the gauge used will assist in giving an ideal starting point. The growing space is important so that the shoe is not too tight and harms the soft bones.
The pre-walker can still be used during the cruising stage even when the child starts to stand upright and is attempting to take the few steps aided. Always keep checking the fit since the foot is continuously changing size. When the shoes are removed check the child’s feet regularly and if you note any slight changes such as redness or blistering on the toes, that might indicate an incorrect fit and need for a larger size.
At the cruising stage between the sixth and ninth month the bones start to ossify which is encouraged by the more active movements and soft impact done by taking those few steps. However, there are still gaps in those young bones, so the foot is still prone to injury and being bent out of place so the correct fit is essential. There is no need for harder shoes for these short episodes of heroic adventures, we need to wait until the child is more confident and starts to take the first few steps without any help.
Unaided walking usually starts at any time between nine and eighteen months. The foot will be growing at a faster rate up to sixteen millimeters (two sizes) every year, so keep checking the fit. There are nearly 25 bones forming in the child’s foot at this walking stage, but they still have some gaps that are filled with the fatty tissue especially on the upper instep making it hard to fit in shoes like a slip-on. Also the child’s weight is increasing and joints are still very flexible, this is mainly due to the fact that the ligaments and tendons that keep the bones together have not yet formed or tightened. As a result this pressure and flexibility might make the foot roll inwards making the lower limb unstable. So the shoe selected at this stage should assist in keeping the foot supported. This is achieved by selecting a shoe having the correct width at the heel as well as the forefoot allowing no gaping on either side. The outer sole should be semi-rigid and be flexible mainly were the toes bend at the widest part of the foot. The shoe should have a fastening that will allow a snug fit at the instep and not allow any slippage from the heel. The upper made of breathable protective material ideally leather that has stiffeners at the heel for support. At this age the child be tempted by certain shoes that are either too big or hard to bend, so it’s important the parent chooses the right shoe.
Not all children start walking at the same time but if you have any concerns do speak to your podiatrist or pediatrician who has monitored your child since birth.
The foot will start taking on a more adult shape between two and four years, all the fat will start to disappear. The foot will have more bones in it at this stage than at any other time ever. It is interesting to note that the adult foot usually has 26 fully-formed bones but at this age forty-five separate bone centers will grow together over the next 15 years. No arch would have formed during the initial walking phase, but this is perfectly natural. Arch supports should be avoided unless prescribed by your podiatrist or foot specialist.
At age four and upwards secondary bone centers that have developed will start fusing, the arch or foot type will be more evident. The foot will still grow at a slower rate, as the feet carry on developing until the child is in their late teens. Running/Training shoes are best suited for the active child. Breathable uppers that have stiffeners especially around the heel counter area to keep the foot stable, outer soles that are flexible in the widest area and velcro or lace fastening to keep the foot secured in the heel area.
Any hereditary foot types such as flat feet or high arches are more evident after age four. Gait changes or walking patterns will be noticeably different and this is the ideal time to have your child feet first check up with your podiatrist.
The podiatrist will be able to give you advice selection of appropriate footwear based on the specific foot type and if needed can also suggest treatment. Foot pain is not normal so if any ailment is present before age four do not hesitate to consult with a foot specialist.