foot is a complex structure of 26 bones and 35 joints,
held together and supported by scores of ligaments. A
baby's foot is padded with fat and is highly flexible.
Children begin to walk anywhere between eight and 18
months of age. Most toddlers are flat-footed when they
first start walking, or tend to turn their feet inwards,
because of poor muscle tone and weak ligaments in their
feet. This will improve as the feet strengthen. Always
see your podiatrist or doctor if you are concerned about
your child's feet or gait.
A child learning to walk receives important sensory
information from the soles of their feet. Shoes,
particularly those with hard and inflexible soles, can
make walking more difficult. Your toddler doesn't need
shoes until they have been walking for a couple of
months, and then only to protect their feet from sharp
objects. It is important to allow your child to go
barefoot regularly to help them develop balance,
coordination and posture. Have your child's shoes
professionally fitted, which should include measuring
each foot for length and width. Children's feet grow
very quickly and their shoe size may need updating every
few months. Shoes that are too tight can hamper your
child's walking and cause problems, such as ingrown
toenails and bunions.
Suggestions for shoes
Shoes for your toddler should ideally have features
comfortable fit both lengthways and widthways
of room for the toes
straps or equivalent to prevent excessive movement
or slipping of the foot inside the shoe.
The sole of a normally developed foot has an arch,
called the medial arch, formed by muscles and ligaments.
For the first two years, your child's feet will seem to
have fallen arches. Flat feet are normal in a young
child due to weak muscle tone in the foot, a generous
padding of fat, and loose ankle ligaments that permit
the foot to lean inwards. As your child masters walking,
the ligaments and muscles will strengthen and the fat
pads in the arch area won't be so noticeable. By around
five years of age, your child should have normal arches
in both feet.
Feet that turn inwards
Many toddlers walk 'pigeon-toed', with either one or
both feet turned inwards. In most cases, this is simply
a sign of developing posture and balance, and should
resolve by itself (without the need for medical
intervention) somewhere between the ages of three and
five years. However, if the in-toeing is severe, seems
to involve the leg and hip as well as the foot, or isn't
improving by the time your child is around one and a
half to two years of age, see your podiatrist for
assessment. Excessive in-toeing may be caused by a
variety of underlying difficulties, such as hip joint
Feet that turn outwards
Very occasionally, toddlers walk with their feet turned
outwards. This tends to be more common in children who
were born prematurely. In most cases, out-toeing
resolves by itself as posture and balance matures, but
see your podiatrist if you are concerned.
Problems that need professional attention
You should see your doctor or podiatrist if you are
worried about your child's feet or gait. Problematic
symptoms may include:
or other deformities
in the foot
child complains of pain while walking
in-toeing or out-toeing
feet beyond the age of five years
sudden change in the way your child walks
your child isn't walking at all by two years of age.
to get help
and Child Health nurse
toddlers are flat-footed when they first start
walking because the muscles and ligaments of their
feet are underdeveloped.
should go barefoot as often as possible to encourage
balance, posture and coordination.
your doctor or podiatrist if you are concerned about
your child's feet or gait.