Children’s Feet

The feet of a newborn child are lovely to look at and usually make us want to touch them. (Ask any new parent or grandparent). Unfortunately many parents easily forget that those feet need nurturing and protecting for the next 18 years, if they are to reach adulthood and still retain their ‘good looks".

At birth a foot contains 22 partially developed bones and is about 7cms long, which makes it relatively long compared to the leg it is attached to. Some of the bones are even ossified enough to show on X-ray, but it’s going to take up to 18 years for each bone to reach its own unique shape and position. Nevertheless, the newborn foot resembles the adult foot in every respect; it has normal contours and arches and fat padding, but when the foot bears weight it will look abnormally flat – this is one reason why all babies should be allowed to develop at their own pace and parents must resist the desire to get them up on their feet before they are ready. Over the next few years, the original 22 bones become as many as 45 for a short time and finally the normal foot skeleton has 26 individually shaped bones fitted together in a tightly arched but flexible structure that enables us to stand, walk and run.

A newborn foot is usually triangular in shape, broadest at the toes with a narrow heel. The shape and position is also very important, giving clues to any underlying neuromuscular or skeletal pathology. Podiatrists involved in managing children’s feet look for altered shape, restricted movements, stiffness and deviations in different parts of the feet.

For the first 6 months of life the feet are mostly cartilage, so they can be easily deformed by an ill-fitting sock or ‘babygro’ or sleepsuit. A sleepsuit  that is tight or short will limit the normal neuromuscular development of the feet and lower limbs because the legs of a baby are meant to move, stretch, kick and wriggle as part of normal growth. Freedom of movement is the keyword at this time, which means that devices such as pram-shoes are really unnecessary and tight pram and cot blankets must be avoided. 

Here are some more important milestones to remember on this 18-year journey. Around 2 years old, although the bone structure is developing there are still large gaps between the bones, especially in the toes. By about 8 years, the forefoot (metatarsals) and toes (phalanges) are well formed showing bone and cartilage growth points. At puberty it is common for boys especially to suffer from severe pain in the heels at these growth points. The condition is called Sever’s Disease. The development of the total bony skeleton is usually complete by about age 14 in girls and 18 in boys.

Obviously, throughout this entire process correctly fitted footwear is essential, as is the diagnosis and management of any disorder or anomaly, so if you are concerned about your child’s foot health, have their feet checked by a podiatrist.