Parents frequently have worries about their child’s feet. This month we take a look at children’s feet starting with the structure and development of the foot through to the most common worries and tips for the care of children’s feet.

The structure of the foot is highly complex and contains:

• Twenty six bones which allow the foot to adapt to uneven walking surfaces and act as a shock absorber. These bones are not fully hardened until the child is eighteen years old.
• A large number of ligaments which keep the bones together and help the joints to move freely.
• About nineteen muscles and many tendons which run from the muscles to the lower leg to help the foot work as part of the leg to facilitate proper walking
• A large network of blood vessels and nerves

This complex structure has to adapt to the changes in foot posture as the child grows and develops. In the newborn baby the foot composition is mainly cartilage which is soft and flexible and then gradually converts to bone with age.

The fact that the child’s foot is constantly growing means that the child can be at risk from certain foot and lower limb problems at different stages of the development. One of the main causes of foot problems are poorly fitting shoes or in the case of a baby any covering for the foot.

Babies do not need shoes and should be allowed to be barefoot for long periods of time. However the majority of babies have cold feet due to their poor underdeveloped circulation. They can loose heat quickly because of the exposure of the large surface area of their feet and insulation by using socks and bootees are the ideal choice in order to prevent this. Care must be taken when covering your baby’s feet and the following are some suggestions to help you to do that

• When using baby-grows and sleep suits make sure that there is enough room in the foot part of the garment for the foot so that the toes are not crammed at the top.
• Care should also be taken with socks and tights and regular checks made to make sure that the toes are not restricted
• There are many lovely soft flexible baby shoes and bootees on the market and these are safe to use provided that they fit properly, do not constrict the ankles or cram the toes
• The size is also important when using knitted bootees but if the weave is open take care that the circulation is not cut off by the fibres wrapping around the toes.

Children will walk independently when they are ready. It is best to avoid baby walkers because research has shown that their use delays normal walking, standing and crawling and encourage the joints to take load earlier than intended. Once your baby is walking it is important to get shoes to protect his/her feet especially when outside. Shoes for toddlers should be fitted by a trained shoe fitter who will measure the feet correctly for width and length.

Frances Byatt-Smith RN RHV BA Psychology

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