How often do I need to change my child’s shoes?

How often you need to change your child’s shoes 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. To ensure that shoes still fit properly for length and width, a trained shoe fitter should check them every eight weeks. You may do this more frequently if you are aware that they are actively growing in height. In general, the main period of accelerated growth in girls is between eight 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.

When should I buy my baby her first pair of shoes?

Ideally a child should not require shoes until they are walking competently out of doors. In order for the foot to develop normally and naturally, the child should be barefoot for as long as possible and within the realms of safety to avoid injury. The age at which a child begins to first walk unaided is very variable. On average, for a girl it is 12 months, and for a boy, 15 months, but it may be as early as eight months and as late as 24 months.

What style of shoe is best for a baby who has just started walking?

There are varying opinions related to this. Some manufacturers provide very flexible first shoes to allow the foot to be protected outdoors but still function relatively normally (as if they were in their bare feet). Some authorities prefer a rigid shoe to ‘support’ the foot. This is really only required if the child has a diagnosed problem with their foot function. Boots are not necessary for a ‘normal’ foot.

My baby has flat feet, is this normal?

Nearly all babies appear to have flat feet when they walk at first. This is partly due to posture and partly associated with deposits of fat which make the foot 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, it walks 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.

Should I buy a baby-walker?

No. A baby-walker encourages loading of joints before nature intended, and unusual and abnormal walking patterns. Nature will decide when a child is ready to walk. Research has shown that they may cause a child to walk later than he/she would normally.

My child’s feet always seem to be cold, is this normal? Should I put him in socks and slippers?

This should not be an issue with older children but care should be taken to insulate the feet in babies with socks or bootees as they have a high surface area to volume ratio and lose heat very readily. Children enjoy being in their bare feet but if the feet are noticeably cold or they complain of this, some form of protection is necessary. Socks alone may be dangerous due to slipping. Slippers should only be worn as a short-term measure as they are not held properly on the foot and the foot may slop around inside them, leading to toe deformities in the future. Also, slippers do not come in half sizes and fittings and are generally bought off the shelf. A good pair of insulating socks and a trainer fitted by a shoe fitter is best if not wearing outdoor shoes.

How tightly should I pull the socks on my child’s feet before I put on their shoes?

Just like shoes, socks should be the correct size for the foot. They should be just larger than the size of the foot and not cram the toes or stretch over them. If you know the shoe size it should be possible to buy socks the same size but beware as the shoe manufacturer and sock manufacturer may use different sizing systems. Check the socks against the feet regularly, particularly with children who are dressing themselves, as tumble drying can result in shrinkage over time.

How often should I cut my child’s toenails and how should I cut them?

Many children will bite or pick their toenails particularly if they are too long. The rate of nail growth is variable from one child to another but the length should be checked weekly. Nails that are too long may be prone to splitting and hence in-growing. Cut toenails using proper nail clippers, which can be purchased from your local chemist. These are much safer and more accurate to use than scissors. Follow the shape of the nail at the end of the toe, cutting the nail so that the corners of the nail are free of the fleshy nail groove. Children’s nails are very fine and it is rarely necessary to file them after cutting. Leave approximately 1mm of growing nail.

How can I check that my child’s shoes fit properly?

This is best done by the shop where the shoes were bought, ideally by a trained shoe fitter who will also measure the feet. Some retailers will keep a note of the foot size and fitting or provide you with your own record card. An easy way to check the length yourself is to cut a strip of paper that is the same length as the inside of the shoe. Place this against the skirting board and get the child to stand on it. 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.

What shoes should I put my child in during the summer?

Ideally these are shoes that are well ventilated and of a natural material (leather). For younger children, ‘T’ bar sandals. Most children now wear trainers that are ideal if fitted properly by a trained shoe fitter. However, many are bought off the shelf and not only fit badly but are made from synthetic materials and cram the toes.

Should my child wear the same shoes everyday?

Not everyone is able to afford several pairs of everyday shoes for their child. Ideally, different shoes should be worn on alternate days to allow the shoe to dry out, as children’s feet can be particularly sweaty. Wearing damp shoes all the time can make the child more prone to athlete’s foot and verrucae.

Are plimsolls advisable?

Plimsolls are ideal for the purpose for which they were designed - as a flexible gym shoe worn for short periods.

However, they should not be worn for long periods every day (as is the practice in many primary schools) and left in shoe bags overnight where the sweat from the previous day does not dry out. They do not come in halft sizes and width fittings and it is reare to hear of any that are fitted by a trained shoe fitter. the soiling material tends to encouratge the foot to sweat and makes it more probe to athlete's foot and verrucae infections. Very young children are often encouraged to wear slip-on plimsolls, as they cannot tie their alces. This may result in toe deformities.

Shoe shops rarely seem to fit Wellington boots, canvas shoes and slippers, how can I make sure that this type of footwear fits properly?

Fit in a shoe relates to length and width (see above, how can I check that my child’s shoes fit properly?). If the purchase is found to be too small it can be exchanged. Feeling the broadest part of the foot (across the balls of the foot) can check the width against the upper of the shoe. They should be approximately the same width.

Are width fittings really important?

Shoes that are too wide or too narrow can do as much damage to a growing foot as shoes that are too short or too long.

Can a young child tell if her shoes hurt?

This is difficult to answer as children tend to adapt to what they regard as normal and accept it. Peer group pressure and the dictates of fashion may also stop a child complaining. This is why skilled shoe fitting and regular checks are so important, particularly with very young children.

My child seems to have knock-knees, is there anything I need to do?

Knock-knee is a normal development variant between the ages of approximately three and seven years. Little can be done to influence this and unless it is excessive or the dgree of knock-knee is different on both legs, nature should be allowed to take its course. Often the feet will accommodate the unusual posture of the foot by rolling inwards andit is best to provide a firm, well fitting shoe during this period to reduce the likelihood of this becoming excessive.

What socks are best?

Firstly the sock should fit and be the same size as the shoe. One hundred per cent cotton is best, particularly if the child has skin problems. Most cotton socks contain a small percentage of nylon. A 50 per cent wool/50 per cent mix is also very good. Avoid 100 per cent nylon socks as they will make the foot sweat and do not absorb moisture. Some modern walking socks have a wicking effect and when used with footwear with a Gore-Tex® lining, keep the foot dry. They are usually made from modern synthetic fibres but can be expensive.

Do I need to buy my children’s shoes from a specialist shoemaker?

Not necessarily, but ensure that they have trained staff. The Children’s Foot Health Register is a register of retailers who guarantee to be ‘centres of excellence for children’s shoe fitting’ and ‘provide comprehensive training for staff and offer children’s shoes in whole and half sizes and in up to four width fittings.’ (Children’s Foot Health Register, PO Box123, Banbury, Oxon OX156WB. Tel. 01295 738726. Website: www.shoe-shop.org.uk). There are many excellent independent retailers. Some high street chains offer the use of DIY measuring boards or they may have a trained person on the premises.

My child always wears trainers. Is this unhealthy for their feet?

No, as long as good foot health is practised, the feet are measured for the shoes and they have sensible features. i.e. 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, leather uppers, shock absorbing heel and sole.

Do trainers need to be fitted?

Fitted trainers are best but not always possible. Remember that many trainers are designed for particular sporting activities and may not be suitable for regular every day wear. Children often pick trainers 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.

Children as young as eight years of age have been noted wearing this type of footwear. You are right to be concerned regarding the long-term effects this will have and the practice should be discouraged and reserved for occasional use. The long-term 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.

Are there any warning signs I should look for when I check my child’s feet?

Yes. These 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 verruca.

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, particularly if the child complains of pain, the advice of your registered podiatrist should be sought.

Do I need to get my child's feet measured every time I buy shoes?

Yes. It is impossible to know the size of your child's foot otherwise, as growth can be erratic.