Children's foot health important for a firm foundation

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Children's foot health important for a firm foundation

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Volume 45
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Issue 5
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Foot health is an important component of a child’s overall well-being, allowing them to play and be active. The C.S. Mott Children’s Hospital National Poll on Children’s Health asked a national sample of parents of children 3-10 years old about their experience with foot health and related habits about shoes.

Ten percent of parents report their child has complained of foot pain, and 8% have thought there was something wrong with their child’s feet or the way they walk. Overall, 15% of parents report either type of concern, which they suspect is due to growing pains (33%), walking on their tiptoes or in-toeing (23%), tired from too much exercise (17%), shoes that did not fit well (14%), flat feet (11%), injury (7%), an ingrown toenail (5%), or athlete’s foot or other infection (4%). Parents of children 6-10 years are more likely than parents of children 3-5 years to report foot health concerns (19% vs 9%).

Half of parents (51%) report that foot health was addressed during their child’s most recent well-child visit, such as the provider watching their child walk (36%), examining their child’s feet (29%), or speaking with parents about foot health (6%). Parents who report concern about their child’s foot health are not more likely to say the most recent well-child visit included a foot health discussion or examination.

Two-thirds of parents (67%) rate themselves as very confident that they can tell when their child needs new shoes. In selecting shoes, 57% of parents are very confident they can tell if the shoes are the right fit for their child, 35% are very confident they can tell if shoes have good support, and 31% are very confident they can tell if their child has flat feet. Parents who report foot health concerns are less confident in each of these areas.

Parents identify factors that are important when buying new shoes for their child as the shoes not being too tight (89%) or too loose (70%), cost (58%), child’s preferred brand or style (38%), a breathable material (35%), parent’s brand preference (17%), and having shoes fitted by a professional (11%). Parents who say it’s important to have their child’s shoes fitted by a professional are more confident that they can tell if shoes are the right fit and have good support.

Parent considerations when buying new shoes for their child age 3-10. Not too tight: 89%; not too loose, 70%. Cost: 58%. Source: C.S. Mott Children's Hospital National Poll on Children's Health, 2024

Highlights

  • 1 in 7 parents have had concerns about their child’s feet or the way they walk.
  • Only 6 in 10 parents are very confident they can tell if shoes are the right fit for their child.
  • Only 1 in 3 parents are very confident they can tell if their child has flat feet.

Implications

Foot health is important across the lifespan due to its implications for posture, alignment, and mobility. For children, poor foot health can impact their physical activity, preventing them from fully engaging in play and social development.

Fifteen percent of parents in this Mott Poll have suspected a problem with their child’s feet or walking—in some cases, due to the child complaining of pain. Some parents attributed this to growing pains—soreness or throbbing pain, usually in legs—which could cause the child to walk gingerly. Growing pains are typically short-lived and harmless. Other causes of pain include flat feet (fallen arches) which sometimes require additional support or exercises; plantar warts which can be treated with over-the-counter therapies, duct tape, or with cryotherapy in the office; and a range of overuse injuries that can occur as a result of a activity without the use of supportive shoes, and often resolve with adequate rest. However, if the child complains of pain in the legs or feet for an extended period of time, parents should raise the issue with the child’s primary care provider.

Many foot-related problems are the result of improper foot hygiene, including hangnails and infections. With younger children, parents should be responsible for proper foot hygiene, including daily sock changes, as well as washing and adequately drying the feet. Careful toenail clipping should be done, using a nail scissors or nail clippers to cut straight across to avoid the development of ingrown toenails. As children get older, parents should teach them how to handle these tasks themselves.

Another foot health problem is trauma that results from a child stubbing their toe or if a heavy object falls on the foot. In addition to tenderness from bruising, the child’s toenail may turn colors, become dislodged, or even fall off. If this happens, parents should take care to keep the nail bed clean and dry, and covered with a bandage; parents should watch for signs of infection, including swelling and redness, pus, or the child complaining of pain. Foot injuries can be avoided by making sure children wear sturdy shoes, particularly when playing outside.

A key to promoting optimal foot health is well-fitting shoes, since improperly fitting shoes can aggravate the feet and inhibit proper development. Children’s feet grow at a faster rate than any other part of the body, so parents should keep in mind that a child’s shoe size can change every few months. Replacing shoes can be costly; however, parents should not buy shoes that are too big as a way to make shoes last longer as the child grows; this can lead to unnatural walking patterns, inadequate ankle or calf support, and an increased risk for blisters or falls.

It is best practice to have the child present when buying new shoes so they can be sized properly and can try on multiple options. In addition, since feet are rarely precisely the same size, buy shoes based on the larger foot. While shoe shopping may become more difficult as children develop preferences for color and style, parents should continue to prioritize function over fashion. Special attention should be given to selecting shoes with a stiff heel for bone support, optimal toe flexibility and a rigid middle to support the sole.

Many parents in this Mott Poll acknowledged a lack of confidence in ensuring their children are wearing properly fitting shoes. If parents have questions about how to determine which shoe size is appropriate, they should consider visiting a children’s shoe store and asking an experienced salesperson to explain and demonstrate how to find the right size and how to tell if a shoe has adequate support.

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Data Source & Methods

This report presents findings from a nationally representative household survey conducted exclusively by Ipsos Public Affairs, LLC (Ipsos) for C.S. Mott Children’s Hospital. The survey was administered in February 2024 to a randomly selected, stratified group of adults who were parents of at least one child age 1-18 years living in their household (n=2,057). Adults were selected from Ipsos’s web-enabled KnowledgePanel® that closely resembles the U.S. population. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 61% among panel members contacted to participate. This report is based on responses from 1,083 parents with at least one child age 3-10. The margin of error for results presented in this report is ±2 to 8 percentage points.

Findings from the C.S. Mott Children’s Hospital National Poll on Children’s Health do not represent the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.

Citation

Clark SJ, Schultz SL, Ewing L, Gebremariam A, Woolford SJ. Children's foot health important for a firm foundation. C.S. Mott Children's Hospital National Poll on Children's Health, University of Michigan. Vol 45, Issue 5, July 2024. Available at: https://mottpoll.org/reports/childrens-foot-health-important-firm-foundation.

Poll Questions (PDF)