Podiatry

How do my child's feet grow?

Babies are born with only 22 bones in each foot, but by the age of five, this increases to 26 bones. The first few years are crucial, as the bones in your baby's feet are made of soft, flexible cartilage that gradually converts to bone over time. Your baby's feet are particularly vulnerable to injury if they're not cared for properly.

By the time your child is two her foot shape has become clear. There are three main shapes, and she'll have inherited one of these from you:

• - tapered: her big toe is the biggest of all her toes

• - rounded: her second or third toe is longer than her big toe

• - square: all her toes are roughly of equal length

How can I take care of my child's feet?

Looking after your toddler's feet now will help to prevent foot problems later on in her life.

Make sure that socks, soft booties and bedclothes allow your baby or toddler's toes plenty of room to straighten out and move around easily.

Check her feet regularly. This will help you to notice any problems, such as blisters. Wash your toddler's feet and dry them well between the toes. Cut her toenails straight across to prevent them from becoming ingrown.

Let your baby have some time every day with bare feet so she can exercise her feet and toes. Make a game of it by tickling your baby's feet and legs to encourage her to flex and stretch her foot muscles.

Shoes made from cotton or a cotton and wool mix (including those of Attipas) or socks are best and will keep her feet warm. Check the size of your child's socks regularly, especially if you tumble dry them. Socks can shrink, and if they are too tight, this can restrict how your toddler's feet grow.

When can my toddler have her first shoes?

A baby who's just started walking takes about 176 steps a minute. The longer your toddler walks in Attipas shoes, the more it will allow her feet to develop naturally.

When your toddler starts learning to walk, let her Attipas walking shoes, which have the effect of walking barefoot. Walking in Attipas shoes allows her feet to develop and strengthen without restriction.

Once your child can take a few steps confidently and perhaps walk outdoors on rough surfaces, protect her feet outdoors with early Attipas first shoes.

Which shoes are suitable for the first steps?

Choose shoes made from soft material, with lightweight flexible soles, padded ankles and non-slip bottoms. The shoes should come in whole and half sizes, and in a choice of widths, so that they fit properly.

Make sure that her shoes are fitted by a professional shoe-fitter. Aim for plenty of room and width in the toe area, and a secure fastening such as Velcro, a buckle or laces. They will hold the heel in place and stop your toddler's feet slipping forward and damaging her toes.

Your toddler's feet should be measured every six weeks to eight weeks. Children's feet grow, on average, two full sizes a year until they are four years old.

Allow at least 1cm (0.4in) of growing room between the end of your child's longest toe and the end of her shoe. The shoe also needs to be wide enough for all of her toes to lie flat. Children's feet grow faster in the spring and summer, and sometimes hardly at all in the winter.

What foot development problems can happen?

If you suspect a developmental problem with your child's feet, talk to your health visitor or GP. They can refer your child to a paediatric podiatrist, she needs it.

These are some of the developmental conditions which can affect a child's feet:

Talipes (club foot) is a congenital condition that affects one or two babies in 1,000. The shape of one or both feet bends inwards and downwards. Experts are unsure of the cause, but it's more common in boys, and sometimes runs in families.

Treatment begins soon after birth and usually involves physiotherapy to manipulate your baby's foot gently back into the right shape. She will also wear a cast and special boots.

Flat feet is something that all babies are born with, along with a waddle, when they first start walking.This is partly due to posture, and partly due to deposits of fat on your toddler's feet which make her feet look flat. It can be difficult to tell if your child has flat feet, as the arches may not fully develop until she's 10 years old.

Most children don't take adult-like heel-toe steps until they are about three years old. If an arch forms when your child stands on her tiptoes, don't worry. However, if your child still seems to have flat feet when she's five years or six years, and is in pain, see a podiatrist. Gentle inserts (orthoses) to support the arch may be prescribed.

Intoe-ing and outtoe-ing is when toddlers walk with their feet turning inwards ("pigeon-toed") or outwards. It usually corrects itself as your child becomes more confident on her feet. Talk to your health visitor or GP if the problem persists beyond toddlerhood, or worsens, especially if it only seems to affect one foot.

Toe walking is when a child walks on her toes without putting much weight on her heels. Persistant toe walking can be a sign of abnormally short achilles tendons, and may need treatment by a physiotherapist.

What minor foot problems should I watch out for?

Check your child's feet regularly, as it's unlikely that she'll tell you, or even be able to tell you, that her feet hurt.

Blisters are often caused by new or ill-fitting shoes. These can be quite bad, as your baby or toddler can't necessarily tell you that something is rubbing, or that her foot hurts.

Check your child's shoe-size in case her width-fitting or size has changed. Remove socks and shoes for a while to allow the blister to dry up. If the skin is broken, apply an antiseptic protective dressing. Don't burst her blisters, as it may cause infection.

Hand, foot and mouth disease is a common childhood, mild viral infection that causes blisters on your child's mouth, hands and feet. It is also sometimes accompanied by a slight fever. It usually resolves itself within a few days.

However, the rash can extend up the arms and legs, and often causes small blisters or spots around the nappy area.

Ingrowing toenails will cause the skin at side of your child's toenails to appear red or swollen. This is usually caused by her toenails not being cut correctly.

Cut your child's toenails, and her fingernails, straight across, rather than in a curve. Use nail clippers and file any sharp edges if necessary. Never cut down the side of your child's toenails or cut them too short. Just follow the line of the nail at the tip of the toe, and leave the corner of nail just clear of the fleshy part of the toe. If your child complains of sore toenails, ask your GP or health visitor to take a look.

Athlete's foot is a fungal infection that causes a red, itchy, moist rash, usually in the area between your child's toes. It's rare in babies and toddlers, but it may be more likely to happen if you take your child swimming a lot. This is because the fungus thrives in warm, damp areas.

Help to prevent athlete's foot by dressing your toddler in cotton Attipas shoes, and drying between her toes properly after baths and swimming. See your GP if you think your toddler has athlete's foot, as some over-the-counter treatments aren't suitable for young children.

Attipas - for the first steps of your child.

The Associations of podiatrists and orthopedic surgeons advises pediatricians footwear, developed for the first steps of your child. Flexible non-slip sole provides the necessary conditions for training of the foot muscles of your child.

Attipas shoes fulfil all the requirements for a good shoe for growing children:

• - Attipas protect the feet.

• - Attipas are lightweight and breathable.

• - Attipas don’t cramp the toes.

• - Attipas don’t impair the feet from adapting to the ground.

• - Attipas are reasonably priced.

• - They look great on!

Attipas shoes are recommended as a great start for babies who are newly walking, and toddlers who are growing at a rapid rate.