Clinical Reference Systems: Pediatric Advisor 10.0
Spanish version
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.
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Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
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Copyright 1999 Clinical Reference Systems
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