Many people regard footwear as purely shoes but it relates to any covering for the foot and may include:

Babygrows and sleep suits

Care should be taken that the foot part is long enough and does not cram the toes.

Pram shoes

These should only be worn for special occasions. They are difficult to size and are best avoided. The best way to insulate the foot is with bootees that do not constrict the ankles or cram the toes.

Tights and socks

Tights and socks – particularly if regularly tumble dried – may shrink and the fit at the heel and length at the toes should be checked regularly, particularly if new shoes have been required because of growth.

Knitted bootees

Knitted bootees are ideal to keep the feet insulated but great care should be taken with their size and, if they are open weave, care must be taken to avoid fibres wrapping around the toe and cutting off the circulation.

Shoes for toddlers and early walkers

These should be fitted by a trained shoe fitter and allow the foot to function normally. Remember that a young child’s foot is a different shape from that of an adult or teenager whose foot tends to have a rectangular shape when looking at the sole. The shape of a young child’s foot is triangular with a narrow heel and a broad front with the inner side of the foot angled inwards. Reputable manufacturers are aware of this and design their shoes accordingly. Ignoring this feature may lead to deformity of the big toe.

School shoes

It is always difficult to describe the ideal shoe, but a “school shoe” is normally visualised as being an ideal shoe. This means that the feet have been measured for width and length. The toe area is foot-shaped and of sufficient depth to allow the toes to move freely. The heel height is no greater than 4cm with a broad base of shock-absorbing material. It also fits snugly around the heel area. It is held on the foot with laces, Velcro or a strap and is made of leather.

Plimsolls

In order to reduce noise levels and keep floor coverings clean, many schools insist on children wearing plimsolls in school with their school shoes only being worn to and from school. Often the plimsolls are kept in a shoe bag at school overnight. As children’s feet are very sweaty, it is unlikely that they will dry out overnight. Plimsolls are excellent for the purpose they were designed for but are an unsuitable environment for a growing foot. It is virtually impossible to have the feet measured for plimsolls. They do not come in half sizes and the rubber soling material encourages sweating and while shoes are often changed regularly, plimsolls are overlooked, so the child can end up with plimsolls that are too small. Children who cannot tie their shoe laces are often encouraged to wear slip-on plimsolls which may further encourage toe deformity.

Trainers

Trainers are generally foot friendly as long as the feet are measured. They usually conform to the school shoe ‘model’ (see ‘School shoe’, previous page). Beware of some trainers which, although leather, may have extensive synthetic linings which can encourage excessive sweating. Children are usually very keen to have a particular brand name. Trainers could be worn in school in place of plimsolls.

Stilettos

Children should not wear stiletto shoes. Apart from the obvious damage they may do to a developing foot, they also alter the way a child walks and their general posture, and may cause lasting damage. There is evidence that children as young as eight years of age are wearing high-heeled, pointed stilettos.

Platforms

The same applies as for stiletto shoes – they alter walking style and posture – but with the added risk of falls and ankle injuries.

Flat shoes

Many children are wearing very flat slip-on ‘dolly shoes’ that can cause stress to the structures on the sole of the foot and back of leg resulting in pain and inflammation. They also tend to have very thin soles and give little protection from injury. Many slip-on shoes are deliberately worn approximately two sizes too small in order that they do not fall off.

Fashion shoes

There should be an element of common sense where fashion shoes are concerned particularly with older children. They can be worn for short periods for special occasions but are potentially damaging to the foot and general posture as they are rarely accurately measured, they tend to be pointed and have a narrow high heel. They are often made of synthetic materials with a thin sole offering little protection.

Baby walkers

Children will walk independently in their own time and when nature intended. Baby walkers encourage joints to take load earlier than intended and the foot and lower limb to move in an unnatural walking pattern. Research has shown the use of baby walkers is associated with a delay in normal walking and activities such as standing and crawling. Their use is best avoided. Baby walkers are banned in Canada.