Some parents, grandparents too, have a panic from the time the child is born; to the crawling stage; to the first step; to walking; and straight through the growing stages. The questions range from: “are they going to remain with flat feet”, to “will they stay bow legged”? Truly these answers cannot be given before a certain age, and actually the age tends to vary dependent on the condition. It is critical to remember that kids are not little adults, hence development changes throughout their growth. Generally between age 7 -10 most “problems” should have sorted out. Congenital, or what presents like severe deformities or gait issues, should be assessed earlier. A range of common questions typically asked would be answered.
How often do I need to change my child’s shoes?
It depends on the child and their age. On average, children’s feet grow at two sizes per year in the first four years of life, and one size per year thereafter, until growth is complete. However, a child’s foot may not grow for a considerable period of time, and then grow several sizes in a relatively short period. In general, the main period of accelerated growth in girls is between 8 and 13 years, with the peak rate at approximately 12 years of age. In boys this is slightly later, between 10.5 and 16 years, with the peak rate at approximately 14 years. This corresponds with puberty.
My baby has flat feet, is this normal?
Nearly all babies appear to have flat feet when they first walk. This is partly due to posture, and partly associated with deposits of fat which make the feet look flat. When a baby walks, it has to balance a relatively large and unwieldy head on a short torso. In order to do this, they walk with the knees bent, legs wide apart, and the feet turned outwards. Also, the nervous control of gait is still being learned, and all of these factors combine to give a flat-footed appearance.
Checking if child’s shoes fit properly
Given in Trinidad and Tobago someone measuring your feet at a store isn’t a norm, an easy way to check the length yourself, is by cutting a strip of paper that is the same length as the inside of the shoe. Get the child to stand on it, and measure the distance between the longest toe and the end of the piece of paper. A newly fitted shoe will be approximately 12 – 16 mm longer than the longest toe, to allow for growth and the foot elongating when walking. Shoes that are only 5mm longer should be regarded as too short and replaced.
My child always wears sneakers, is this unhealthy for their feet?
Not once good foot health is practised. The feet should be measured for the shoes which should have sensible features such as: adequate room, depth and width in the toe area; foot shaped in the toe area; laces or Velcro fastening; well-fitting and firm at the heel; and shock absorbing heel and sole.
Fitted sneakers are best, but not always possible. Remember, many sneakers are designed for particular sporting activities, but may not be suitable for regular every day wear. Children often choose sneakers due to peer group pressure, and fashion trends to wear the right label or style.
My teenager insists on wearing high-heeled, pointed shoes, and I am worried about the long-term damage this will do to her feet.
You are right to be concerned about the long-term effects of this, and the practice should be discouraged and reserved for occasional use. These effects are not only to the feet, but also to the posture in general, with the possibility of future knee, hip and back problems. In the short term, the feet will also be damaged with restricted movement at the ankle joint, hard skin on the soles of the feet and tops of the toes, and increased risk of in-growing toe nails.
Warning signs to look for when checking a child’s feet
They can be broken down into four main areas. These are skin, nails, deformities and posture.
-Skin – Look for areas of redness and rashes particularly between the toes, in the arches, and below the ankle bones, indicating athlete’s foot; particularly if they are itchy. Look for red marks and/or blisters at the back of the heel, and on the tops of the small joints of the toes, indicating ill-fitting shoes. Raised and painful hard masses on the soles of the feet may indicate a fish eye.
-Nails – Any inflammation around the nails should be taken seriously, as it may indicate infection. Any discolouration of the toenails should be checked by your podiatrist.
-Deformities – Toes should always be straight, in line with the foot, and not drawn back or curled. The fifth toe may tuck under the fourth slightly, and the fourth under the third toe, but the big toe should also be straight.
-Posture – If the feet appear to be excessively turned in or out, or the arch looks very flat, especially if the child complains of pain, the advice of a podiatrist should be sought.
This is the first of a series on pod-paediatrics, next, we’ll deal with activities and their impact.
Your feet mirror your general health . . . cherish them!