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First 5 years are critical for foot development

How to Care for Little Feet

I love baby feet, they are so cute and chubby. Sadly, as adults our feet usually aren’t quite as cute, but that is a story for another day. Today, let’s learn about young feet and how to best care for them.

Baby feet are much different than adult feet and deserve some consideration as they become the base on which we stand and walk on. When a baby is born, their feet are made up of cartilage-like tissue which will ossify into bones over time. By 9-18 months, each foot will have about 25 bones, but the navicular bone (top of foot in area of shoe ties) isn’t yet becoming a bone. The navicular bone is the structural link between the midfoot and forefoot doesn’t start ossifying until the 3rd and even the start of the 4th year of life. Thus the first 5 years are critical for foot development.

An infant does not need to wear shoes. Socks for warmth, good hygiene, and mild lotions to prevent dryness should be adequate for baby foot care. In fact, even in toddlers, shoes are only necessary to protect the feet from the environment whether it is cold or there are stickers in the grass. Being barefoot has lots of benefits for our infants and toddlers.

Benefits of walking barefoot include:
1. Feet are free to grow. The bones will not be crowded and the arch will be able to better form. Barefeet tend to grow wider which helps with having a good base of support for standing and walking.
2. Sensory skills such as touch, proprioception and vestibular input are increased when the feet are bare and this helps with balance and body awareness issues.
3. Sensory play with the feet will expand a child’s understanding and tolerance of the world’s textures.
4. The intrinsic foot muscles (tiny muscles in the feet) work best out of shoes as the shoes will block their ability to function fully. Stronger muscles help with better foot control for agility and balance.

Some safe textures for little feet are indoor surfaces such as wood flooring and carpet. Outside textures can include: sand, pebbles, grass, moss, straw and dirt/mud. To keep little feet safe do a quick scan of the outdoor play area for stickers, trash/broken glass, etc. and make sure the temperature of the walking surface is safe. For example, sand and concrete can be too hot and will burn little toes.

So you have determined that your young walker does need shoes for safety. Here are some key components of buying the best shoes for their growing and developing feet.
1. Low soles, little feet don’t need to be on high heels.
2. A larger toe box for movement as toddlers still have wide feet. Also leave about 1 cm of growth room at the toes.
3. Soft leather or breathable fabric for cool, comfortable feet.
4. Lightweight, flexible soles to help aid in walking skills – let those little muscles be active as possible.
5. Padding around the ankles and adjustable fastening for increased comfort.
6. A heel loop can help with putting a shoe on and removable insoles can allow for just a little more growth/width room. Shoe example by Ten Little

Toddler feet should be checked for size at least every two months and at the age of three they should be checked for size every three months. At the age of four most children’s feet start to slow their growth rate and may only grow a size a year. Keep checking for signs of shoes being too small still, as everyone is different.

You should not forget to use cotton or other wicking socks to help with skin care in the shoes. Even after your toddler or preschooler is in shoes, make sure they have plenty of barefoot time each day. Bones are still forming, and the arch does not fully form until the ages of 5-6 years. This means that your infant and toddler will look like they have flat feet. Additionally, your child may have a pigeon-toed or out-toeing gait pattern. This is quite common, and most children outgrow this by age 8-9.

If, however, your child trips over her/his feet or just seems clumsy compared to other children, please feel free to contact your primary service provider with questions. We are here to help!

By Angela Pulaski, Physical Therapist

Baby Feet Photo Courtesy of SJ Nuzum Photography.