Caring for children’s feet
Parents worry about their children’s teeth, eyes, and other body parts. They painstakingly teach them how to wash, brush, and groom themselves – but do nothing to care for their little feet.
Children’s feet are different from adult’s feet because they are not yet fully developed. At birth, and in early childhood, the feet are fat, round and floppy, and will eventually grow and change into the shape we recognize as normal feet. At six months of age a child’s foot is still mostly cartilage and the final bones do not start to form from cartilage until three years. A child’s foot will double in size by the age of one and is approximately half their adult length by 18 months. By age 18 years most bones in the feet and body are fully formed.
During this period of development, a child’s foot is flexible and at risk for injury and deformity due to abnormal pressures from ill-fitting footwear. Care should be taken when choosing and fitting shoes for children.
Nearly all children appear to have flat feet when they first start walking – this is partly due to posture and is associated with fatty deposits in the foot. When toddlers walk, they have to balance a relatively large head and torso so they walk with the knees bent, legs wide apart and their feet turned outwards. Parents are often anxious about when their child will walk. The average age to begin walking is 10 to 15 months.
When your child first begins to walk, shoes are not necessary for indoors, however when walking outside or on rough surfaces, the baby’s feet should be protected in lightweight, flexible footwear made of natural materials. On average, children’s feet grow two sizes per year in the first four years of life and one size per year thereafter until growth is complete around age 14. This is not written in stone however, and sometimes a child’s feet may not grow for a considerable period of time and then may grow several sizes in a short period.
Many of the problems found on the children’s feet are associated with growth, overuse, weight gain and posture. Genetics also play a crucial role in the development of your child’s feet. Some children walk with their toes pointing inwards (in-toeing) and some outwards (out-toeing), and others walk on their toes (toe-walking). It is estimated that 10 to 20 percent of children have flat feet. Most children grow out of in-toeing, out-toeing and toe-walking by 24 months of age. If the child’s feet are causing pain, discomfort or affecting mobility this is not normal. It is recommended that all children with foot pain and any persistent foot complaint should be seen by a podiatrist.
Outside of foot deformity, the main cause of foot problems and possible deformities is ill-fitting footwear. If you notice any of the following problems with your children’s feet they should be seen by a podiatrist. Foot problems may include foot, leg, or heel pain; swelling, limping, flat feet, foot deformities, skin rashes, hard skin, lumps, bumps on the feet, nail complaints, tripping or stumbling; or the child not wanting to walk and asking to be carried instead. It is best to make an appointment to see the podiatrist if you have any of these concerns or questions about your child’s feet. The podiatrist can help your child by providing a comprehensive examination, diagnosis of any foot problems and then, either managing the condition or referring to an appropriate consultant.
Treatment will vary based on the complaint or concern but may take the form of footwear prescription or advice, assessing how the foot is functioning, custom orthoses (special insoles) to be worn in shoes, casting, etc. Researchers have found that giving correctional foot support to children with insoles or orthotics between the ages of two and five years of age can significantly improve mature foot development. After age five, correctional support can help but there can be no more changes to the basic foot structure.
Parents can help care for their children’s feet by following these tips:
• Always have your child’s feet measured for length and width before buying shoes.
• Always fit shoes with the child standing, because the foot spreads on weight-bearing.
• Check the size of their socks and shoes regularly for fit, condition and wear.
• Check shoe sizes every one to three months up to age three, every four months to age five, every six months from five years onwards.
• If possible, do not allow your child to wear the same shoe every day. Alternate the child’s shoes to allow them to dry out, especially if the feet are sweaty.
• Be especially careful and observe the feet after wearing new shoes, they can cause blisters and sores if they don’t fit properly.
• Inspect feet regularly for inflamed nails, red pressure areas on the foot, top of the toes, around the ankle and at the back of the heel.
• Good foot hygiene is vital. Wash their feet daily with simple soap and water and dry well, particularly between the toes. After drying, a small amount of talcum powder or moisturizers can be used. Children have naturally sweaty feet, but smelly feet may be an indication of poor hygiene or an infection.
• The toenails should be inspected regularly and trimmed as required. Cut the nails straight across and never cut down into the corners or cut them too short.
For more information or to see a podiatrist visit Bahamas Foot Centre Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820 or email [email protected] or visit www.apma.org.