How your baby's feet develop

At birth your baby only has 22 out of the full 26 bones in her feet and the remaining few develop slowly throughout childhood, with the whole process finishing at around 16 to 18 years old.

The first few years in particular are crucial as the bones in your baby's feet are formed from soft, pliable cartilage which makes them more susceptible to malformation. "A baby's foot contains more flesh and cartilage than actual bone which makes it more fragile and pliable," says Dr Hawkins. 

Taking care of her feet

Walking and first shoes

A baby who's just started walking takes 176 steps a minute!
Experts say that the longer a child is allowed to walk without shoes, the better as this will allow their feet to develop naturally. Certainly when your toddler starts learning to walk indoors, let her walk barefoot as long as the floor is clean and safe, as this allows the feet to develop and strengthen without restriction.

Once your baby can take a few steps confidently and may be walking outdoors on rough surfaces, protect her feet with early first shoes made of flexible, lightweight and natural materials, such as soft leather, with flexible soles and non-skid bottoms.

Make sure these first shoes (and future ones) are fitted by a children's shoe fitter (see Help for you, below) as your little one will require a specific width (D to H, with F and G being the most common) and length of shoe (babies' shoes start at size 3). "Aim for plenty of room and width in the toe area, a secure fastening such as velcro or laces, a supportive heel cup and, obviously, a low heel," says Dr Hawkins.

Have the shoes checked every six to eight weeks as children's feet grow, on average, two full sizes a year until they are four or five years old. There needs to be at least 18mm growing room between the end of your child's longest toe and the end of her shoe. Children's feet grow faster in the spring and summer and sometimes hardly at all in the winter.

Possible foot development problems

If you suspect a developmental problem with your child's feet, talk to your health visitor or GP in the first instance, but do press for a referral to a podiatrist specialising in paediatrics if you think there's something seriously wrong. "I'm appalled by how many GPs turn parents away with serious foot problems because they perhaps don't know where to refer children or are simply dismissive" says Dr Hawkins. 'But don't be turned away unless you've been reassured as foot problems can cause serious knock-on effects in the long-term, such as lower back and knee pain."

Here are some of the more common developmental disorders affecting babies' feet:

• Talipes (clubfoot) Talipes is a foot deformity present at birth that affects the shape of one or both feet, making them bend inwards. It's thought to be caused by a lack of balance in the foot's muscles and can run in families. Treatment begins soon after birth and may involve physiotherapy to manipulate the foot gently back into the right shape, possibly accompanied by a splint. More severe cases may require surgery. To read more about talipes, click here.

• Flat feet All babies are born with "flat feet" and have a waddling gait when they first start walking. The high inside arch seen on most adults' feet doesn't start to develop until around two years old and children don't take adult-like heel-toe steps until around three years old. However, if your child still seems to have flat feet by the age of three, see a podiatrist who can prescribe gentle inserts to support the arch.

• Intoe-ing and outtoe-ing Some toddlers walk with their feet turning inwards (commonly called "pigeon-toed") or outwards, but most cases correct themselves 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, as there could be an underlying developmental problem that needs checking out.

Some minor foot health problems to watch out for

Check your child's feet regularly for signs of damage or minor infection as they probably won't or can't tell you if they've got sore feet!

• Athlete's foot This is a fungal infection that causes a red, itchy, moist rash. It's not very common in babies and toddlers, but it can occur if you take your child swimming a lot as the fungus thrives in warm damp areas, for example, between wet toes. Prevent it by drying in between toes properly after baths and swimming, and treat with anti-fungal cream or powder from your GP if it does occur.

• Blisters These are commonly caused by ill-fitting socks or shoes and can be quite nasty as your baby or toddler can't necessarily tell you that something is rubbing or their foot hurts. Have your child's shoes rechecked in case her width fitting or size has changed and leave off socks and shoes to allow the blister to dry up. Don't be tempted to burst a blister as you could introduce infection.

• Hand, foot and mouth disease Hand, foot and mouth disease is a common childhood viral infection that causes blisters on the mouth, hands and feet, possibly accompanied by a slight fever. It usually resolves itself within a few days, but let the skin breathe by leaving off socks and shoes at home.

• Ingrowing toenails Reddened or swollen skin at the side of your child's toenails could indicate an ingrowing toenail, usually caused by incorrect cutting of the toenails. Make sure you cut your child's toe- and hand nails straight across, rather than in a curve, and file away sharp edges if necessary. If your child complains of sore toenails, ask your GP or health visitor to take a look.

• Verrucas Small warts on the feet, often with a black speck, or "root", at their centre, that are most often picked up at the swimming baths. Encourage older children to wear flip-flops or protective footwear around the poolside and carry toddlers if possible. Most disappear within two years of appearing, but can be treated if necessary - ask your GP's advice. Cross infection is common so give your child their own bathmat and towel if they've got veruccas.