Birth –2 years
The first year is a crucial time in the development of your child’s feet. During this period they will grow to approximately ½ the full adult length and width. So it is important that any observed abnormalities be referred to a suitably qualified and experienced podiatrist or health professional as problems noticed at birth will not always resolve.
As a carer for an infant you can assist normal development by some recommended methods:
(1) Ensure that bed covers are loose enough to allow for normal movement
(2) Exercising – kicking prepares the legs for weight bearing and walking
(3) Alter the baby’s position frequently so legs and feet are not put under excessive and continuous pressure
What is normal?
At the time of birth the baby’s legs will have a bow-legged appearance, this is normal and should disappear by the time the child reaches 2-3 years of age.
It is very unusual for an infant to have structural flat feet even though it often appears that their feet are flat.
The flattened appearance of infant’s feet can be due to the following:
1. Up to the age of approximately 3 years there is a fat pad located in the arch and this can often mask the arch shape.
2. The joints of a child’s foot are incredibly mobile and its supportive musculature is weak, so if the body is heavy, the foot will tend to collapse to some degree; so long as it is not extreme, this is normal.
3. There may be some structural issues in the legs or feet, where the body will use the large mobility to compensate.
When do I seek advice?
If the condition is normal and is just due to the first or second point above, you will note that the arch will be present when the infant or child is not taking any weight on their feet, but becomes flat only when they are weight bearing.
If you note that the arch is always flat whether they are standing or not, an assessment from an appropriately experienced podiatrist should be sought. Also if your child regularly trips over, has an awkward gait or complains when walking for more than a slight distance, an assessment would be appropriate.
What is abnormal?
The position of the fetus in the womb can cause pressure on the feet. This pressure or genetic predisposition may cause a baby to be born with its feet turned inward. This is known as Metatarsus Adductus.
- Metatarsus Adductus
While severe forms of this condition are usually recognized immediately after birth, it may not be until your infant starts standing (8 – 12 months) that a less severe form of the condition is noticed due to in-toed shape and awkwardness on standing or stepping. Early recognition may be corrected with stretching and manipulation, modification of sleeping habits or specialised booties.
An overriding 2nd digit is a common condition, especially in pre-walkers, it may correct itself as the infant begins to walk but it is advisable to seek professional assessment for this condition as if unresolved, future footwear fitting may be a problem. Early intervention can include taping or splinting.
An overriding 5th digit is generally congenital and generally no treatment is required.
Footwear now?
When your toddler begins to walk, shoes are not necessary to be worn indoors; in fact walking barefoot helps develop muscle strength. As toes grasp the ground, the muscles in the foot strengthen assisting in normal foot development.
When walking outside feet need to be protected, so shoes that are light and flexible and are made of natural fibres are recommended. It is not advisable for toddlers to walk barefoot outdoors as this exposes feet to cuts, contusions, also to viruses such as plantar warts.
WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.
