Children & Adolescents Clinic

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Clinical Reference Systems: Pediatric Advisor 10.0
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Shoes

The following information may help you make more rational decisions when you need to buy shoes for your infant.

SHOES VERSUS BARE FEET

  • The only purpose of shoes is protection from injury, cold, or burns (from hot asphalt surfaces). No shoes are needed except when your child walks in rough terrain. Children who are walking inside a house or outside on sand or grass do not require shoes.
  • Before your child starts walking, keep your child's feet warm with booties or socks during the winter.
  • Once your child begins to walk, he will prefer to walk barefoot because it gives him a better sense of where his feet are and enables him to use his toes for balance. Shoes may interfere with learning to walk.

TYPES OF SHOES

  • When your child finally needs shoes, buy tennis shoes (sneakers) or some other shoe with a flexible sole that allows free movement of the foot. Tennis shoes have the advantages of comfort, ventilation, and excellent traction. Many brands are easy to wash and inexpensive.

    During the first year of walking, moccasins are usually better than sneakers. Toddlers in sneakers may have too much traction, catch the rubber sole on things, and fall.

  • Hand-me-down shoes are fine if they fit and are still in good condition (the sole is still skidproof). It is not true that shoes with a previous wear pattern on the heels will cause leg or foot pains.
  • Expensive shoes have no advantage at any age for 99 percent of children. Arches do not "fall." Save your money for something more important.
  • Heels are not essential at any age, and they can cause tripping during the first 2 years.
  • High-top dress shoes are not useful, and children who wear them are often teased. Occasionally a toddler will need high-top sneakers because his or her feet continually slip out of low-cut shoes.
  • Even children with flat feet rarely need a special shoe or heel. Tennis shoes are fine for most of these children.

SHOE SIZE AND FIT

  • With a little practice, most parents can determine whether or not a shoe fits. Check the fit with your child standing and putting weight on the shoes. The shoe should be approximately one half inch (the width of an index finger) longer than the big toe. The width of the shoe is correct if you can grasp a small piece of shoe at the widest portion of the foot (the pinch test). The heel area should be snug enough to keep the shoe from flopping up and down during walking. Also, maximum flex should be where the foot flexes and not in the middle of the shoe.
  • In young growing children, shoes often become too tight before they wear out. During the second and third years of a child's life, shoe size can change three times a year. Check the fit every few months.
  • Fluoroscopy should not be used in fitting shoes because of the radiation exposure. Hopefully, all of these machines have been banished from shoe stores.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems