Parents often ask the physician when their child should begin wearing shoes and what kind of shoe should be worn. In answering these questions, the reasons for wearing shoes must be borne in mind. The shoe has two functions, the most important of which is protecting the feet from trauma and extreme temperatures. Protection implies comfort; therefore the shoe must fit properly to prevent discomfort to the foot. The 2nd function of the shoe is to provide style. Older children will often sacrifice comfort for style despite parental or medical advice to the contrary.

Support to the foot and ankle is not a function of the shoe except when a pathological condition is present. Athletes in all sports that place the feet and ankles under severe strain wear low shoes that have soft uppers. Ski boots are worn not to support the foot and ankle but to make them one with the ski, to ensure response to movements originating in the knee and lower leg. Babies and toddlers usually wear ankle-high shoes, not to provide support to the foot and ankle but to make removing the shoes more difficult for the child.

Style is the only reason for a baby to wear shoes at all until the child begins walking outdoors or is taken out in cold weather. Some babies may gain a certain degree of stability from hard-sole shoes when beginning to stand, but this circumstance has not been shown to enhance learning to walk. In fact, shoes that are rigid prevent foot motion and may diminish the development of the intrinsic musculature of the feet. Properly fitting shoes that have flexible, smooth soles and soft uppers should be recommended initially and subsequently. They need not be expensive. Toddlers can go barefoot in a protected environment, such as indoors. Sneakers are perfectly adequate for summer wear and for winter indoor wear for older children, but toddlers may stumble in sneakers, which can stick to the floor during the stance and step-off phases of the toe-to-heel gait that typifies this age group.[1] [2]