As a pediatrician, I get a lot of questions about shoes and kids.
At first, this caught me off guard--they didn't teach us much about shoes in medical school (or about breastfeeding or other practical parenting topics). So I had to do some learning--from people like Dr. Tom Vorderer, the lead podiatrist in the Division of Sports Medicine at Boston Children's Hospital.
Here are the answers to the most common questions I get, with help (and some extra advice) from Dr. Vorderer.
1. When should my child start wearing shoes? Babies don't need shoes. Being barefoot is best for learning how to walk. If it's too cold for barefoot, socks are usually enough (although for outside weather, especially in winters like we just had, shoes may be necessary just for warmth!)
2. When I buy my child shoes, what kind should I buy? Flexibility is key, especially at the joint where the toes meet the rest of the foot. If they are too rigid, it makes it harder to walk.
3. My child has flat feet. Should I buy special shoes or inserts? Most of the time, flat feet really aren't a problem--but you should mention it to your pediatrician to be sure it's not the kind of flat feet that we worry about (and that need a visit with an orthopedist). Assuming your child has the usual, non-worrisome kind of flat feet, special shoes aren't really necessary. Arch supports (you can buy them in stores, or talk to your doctor about getting custom ones) are an option, but Dr. Vorderer says that he only recommends them when a child's feet really turn in, when there is pain, or when there is a family history of problems from flat feet. As for the other question I often get about shoes for flat feet....
4. Do high tops help keep a child's foot more steady? Not really, says Dr. Vorderer. And because they restrict motion, they can cause other problems.
5. Should I worry if my child's shoes are showing excessive wear on one side? Probably not. But mention it to your doctor, especially if your child is complaining of any discomfort in the legs or feet, or walks in a way that you think is different from other children.
6. When is it okay for my daughter to wear high heels? It depends on how high, says Dr. Vorderer. A little heel (say less than an inch) is fine. For actual high heels (the real deal kind), he suggests waiting until bones are mature, which is when girls reach adult height. Usually that is a year or two after a girl gets her period. By age 14, Dr. Vorderer says, heels are probably okay to wear (but don't overdo it).
Here's one more piece of advice from Dr. Vorderer: make sure that kids always untie and retie their shoes when taking them off and putting them on! He sees lots of injuries from kids just sliding their shoes on, including jammed toes (with infections) and injured tendons and nerves. Those few extra moments are worth it!