The human foot is a complex structure made up of 26 bones, 33 joints and over a hundred muscles, tendons and ligaments. These architectural wonders provide us with the ability to stand upright, bear weight and negotiate locomotion and balance – intricate actions that most of us take for granted.

Unfortunately, most of us also abuse our feet one way or another throughout our lives, generally by spending time in ill-fitting shoes that restrict healthy movement. I personally can attest to years of stuffing my feet into poorly fitting high heels in my 20s for fashion. (Disclaimer: I still wear heels a few times a year when the occasion warrants it, but I got rid of all heels that hurt.) This can contribute to a variety of problems of the foot, including bunions, plantar fasciitis, and corns and callouses, as well as serious alignment and wear-and-tear issues with the ankle, knee and hip joints. Often, this damage only becomes apparent as we age. Mobility, stability and flexibility in our feet are crucial for our overall physical heath and baby feet, which are very different from adult feet, require special care.

How are baby feet different?

An infant's foot looks very different from an adults.

An infant’s foot looks very different from an adults.

When a baby is born the foot bones are cartilage, soft and pliable. Baby feet are a triangular shape, wide in the forefoot and narrow at the heel, as opposed to the generally rectangular shape of the adult foot. Baby fleet are flat, and the toes often are curled. The feet gradually develop, becoming mostly bony by around eight years old and fully developed around 18 years old. I regularly marvel at the expressiveness and articulation of young feet, as well as how they are used to explore their world.

Early foot care for babies and small children can be summed up thusly: optimal foot development occurs in a barefoot environment. The American Academy of Pediatrics recommends not putting children into shoes before their environment necessitates it, and even in the early stages of walking shoes are unnecessary. The more time your baby/toddler/child can spend time barefoot, the better. The primary role of shoes is not fashion but to prevent injury and infection. Luckily there are cute kids’ shoes out there that offer both form and function! (When your child is barefoot, obviously make sure there is nothing around that could injure their feet.)

Guidelines for healthy baby/toddler/small child feet:

Check foot size regularly. Continually monitor the fitting of your child’s shoes, socks and any clothing that covers the feet, like footie pajamas. If they start to look even slightly restrictive, change them up for the next size. Socks tend to shrink in the wash, so don’t assume that the size of the sock, which usually is sized by age, is right for your child. One of my kids has big feet and wore three-year-old socks at age two.

Child's foot at 9 months of age.

Child’s foot at 9 months of age.

It is a good idea to officially check your child’s feet for sizing every 6-8 weeks. For those of us who do a lot of our shopping online, it is very easy to do at home.

To measure your child’s foot:

  1. Have your child step on a piece of paper. (Make sure they are standing, as the foot naturally spreads when standing.)
  2. Make a mark behind the heel and at the furthest point of the toes.
  3. Measure the distance in between.

There are many charts online that show the shoe size based upon the length of the foot. However, it is best to check the shoe manufacturer’s website for their size chart, as sizing can differ among brands.Online reviews about shoes can give you an idea about whether they run small or large, or if anyone has had any issues with the bindings, velcro, etc.

Shoes should have wide toe boxes to accommodate the width of your baby’s forefoot. Many kids’ shoes are simply scaled down versions of adult shoes. This is not good for a child’s feet, as cute as they may be. Toes need to wiggle freely and have the space to grip.

The best shoes for babies and kids are lightweight and flexible, allowing the foot to bend and move as if it were barefoot.

No heels. Heel elevation = not good for your child’s biomechanics.

Shoes made of leather or mesh are ideal and allow your child’s feet to breathe comfortably. Keep in mind that leather shoes take on the shape of the foot, so it is best not to hand them down to another child.

Ideally, children should have more than one pair of shoes and rotate between them. For more mobile kids, shoes with flat, non-slip soles are best.

A child's foot at 18 months of age.

A child’s foot at 18 months of age.

Infant flat feet are normal, and arches may not fully form until around age 10. Your baby/small child’s foot does not need arch support. However, if his foot still is flat at 4-5-years old, let your doctor know.

Some shoes I’ve loved for my little ones are Robeez, Pediped and Soft Star. They’ve also worn Keens and See Kai Run, but some of the latter have slight heels, so watch out for that. Stride Rite also has great shoes for kids.

A special mention to that childhood favorite: Crocs. Personally, I’ve always found them to be…unattractive, but my two-and-a half-year-old twins recently came across a pair of their cousin’s, and it was like they’d seen the Holy Grail. The jury is divided on their health benefits. Crocs have wide toe boxes and flexible but sturdy soles, which is good. But there also have been a lot of injuries due to their instability when kids are running. I recently broke down and bought them each a pair, and I try to limit them to short walks, forays in the back yard, and trips to the beach or store. Clearly, you can’t keep a two-year-old from running when the mood strikes her (or crying when those are the shoes she wants to wear but they’re not appropriate for where you’re going). And we’ve had some falls while running, which makes me nervous. They also collect dirt and mulch, so we regularly have to stop to clean them out. I thought I’d give them a try, and I don’t believe I will be replacing them when their feet grow. Ideally, kids need more stable and protective shoes for places like the playground, or (if you’re in a safe area) bare feet and the ability to grip freely and run, run, run.

Two-year old toes are gripping and connecting.

Two-year old toes are gripping and connecting.

Aside from the aforementioned brands, you can search the Internet for barefoot or minimal shoes for your little ones, as new companies regularly are responding to the call for a lifetime of healthy feet.

Come back Friday for a self-care video to help restore the flexibility of your feet to be more childlike!

 

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