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A Blog from Your Kaiser Permanente Pediatricians in Northern California

Kids' feet

All About Kids’ Feet: Flat Feet, Toe Walking, Warts, and More

“Left foot. Right foot.
Feet. Feet. Feet.
Oh, how many
Feet you meet.”
     Dr. Seuss

Flat feet, intoed feet, feet with funny toenails, feet with warts! Feet often have a long list of things that parents worry about. But most of them are actually nothing to be concerned about and never cause kids any problem. Let’s take a look at some of these.

Flat feet

Kids’ feet often look flat. Babies look that way because they have a fat pad that fills in the arch – making it look flat. In toddlers and school-aged kids, the flat appearance is caused by looser connective tissue. Their bones and joints are looser than ours, so when they stand up, the foot sinks and looks flat. When kids stand on their toes or point their feet you can see they actually have a great arch!

Over time as their joints tighten up, the flat appearance will go away. Children usually develop the appearance of an arch by age 5. Bottom line? Flat-looking feet are usually nothing to worry about. Talk to a doctor if your child complains of foot pain or stiffness. We may suggest you try arch supports as a first treatment.

Intoeing

Babies often have feet that look turned in. This appearance is usually normal – they were curled up in a ball inside their mother, and it takes months for their body to “straighten out.”

This form of intoeing at the front part of the foot is called metatarsus adductus and disappears by age one. Gentle stretching can help reduce the intoeing.

Sometimes intoeing is caused by a slight rotation at your baby’s hip or lower leg – both of which are outgrown over time. Your pediatrician will examine your baby’s feet, knees, and hips at birth and each checkup after. Be sure to let them know if you’re concerned.

Warts

Plantar warts occur on the bottom or “plantar” surface of the foot. They go away on their own over time, but if they’re hurting your child when they walk, contact your pediatrician for treatment options.

Toe walking

This can be completely normal and often becomes a habit for some kids. However, if your child is predominantly toe walking after age 2, see your child’s doctor.

Shoes

Babies don’t need shoes until they start to walk. Then shoes are needed to protect their feet when walking outside. Inside it’s fine to let them be barefoot – and can even help them learn balance and strengthen their feet.

After you start buying shoes you’ll be amazed at how fast your child’s feet grow! Check the fit often and expect to buy toddlers new shoes every few months. There should be a finger width of room between their toes and the end of the shoe. Shoes that are too tight can cause pain, ingrown toenails, and blisters.

Ingrown toenails

These happen when the toenail curves and grows into the skin around it. This usually occurs on the big toe and is caused by cutting toenails the wrong way or by wearing tight shoes. The nail cuts the skin, causes pain, swelling, redness and sometimes infection. Usually though, ingrown toenails can be treated without antibiotics. Start with having your child soak their foot several times a day in very warm water (it’s fine to add Epsom salts or soap to the water). You can also have them massage the skin away from the nail. Don’t use over-the-counter medicines. And don’t try to dig the nail out or cut it away – this can make the situation worse. And always cut toenails straight across, not down at the sides. Never tear the nails. Keep them shorter than the toe.

Here are things about feet that parents should look out for. Talk with a doctor if your child is:

  • Not walking by 15 months
  • Limping, refusing to bear weight. or complaining of pain 
  • Seems to be walking with an unsteady or waddling gait

Feet are fabulous things – they will take your child far and wide. Dr. Seuss has more wise words about feet:

“You have brains in your head.
You have feet in your shoes.
You can steer yourself
Any direction you choose.”

Find more resources for parents:

My Doctor Online
Intoeing
Flatfoot in Children and Adolescents

American Academy of Pediatrics:
Flat Feet
Intoeing

American Podiatric Medical Association:
What Are Ingrown Toenails

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