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    Lillian M. Beard, M.D, a Fellow of the American Academy of Pediatrics, is an associate clinical professor at the George Washington University School of Medicine and Health Sciences in Washington, D.C. She is a frequent guest expert and spokesperson on national television programs, discussing issues related to children's health. Dr. Beard practices pediatrics in Washington, D.C.

    Q: When should I have my infant fitted for walking shoes? Is it important to spend on a quality shoe?

    A: Ironically, the need for walking shoes doesn't coincide with your infant's starting to walk. A few months before your child's first birthday, he'll begin to courageously pull himself up to standing positions, and eventually he'll take some tentative steps while holding on to whatever is nearby for support. As your child progresses to this point, it's better for him to remain without shoes. During this period he'll use his fingers to grasp objects like furniture for needed support. Within a short time frame, he'll gain the confidence needed to "let go" and actually walk. For his sense of balance and his security, it helps him to feel the floor beneath his feet as he uses his toes to grasp its steady surface. Shoes only hamper his ability to do this comfortably. In fact, the longer you allow him to be safely shoeless, the better it is for the strengthening of his foot muscles.

    As he starts to walk with more independence, he will need shoes to protect his feet. Look for comfortable shoes. I recommend the "first step walkers," which have soles hard enough for support, but flexible enough to bend with his foot as he steps. Nonskid soles help him avoid sliding and slipping on smooth floors. I prefer the high-tops, (although their value for ankle support has been debated). While a true arch is not apparent until later (between the second and third birthdays), I still recommend shoes with arch support. High cost does not ensure the best shoe for your baby. His safety and comfort index are most important. And don't forget to check the fit of his shoes regularly, at least every few months. As he grows and develops, so will his feet.

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    The content on these pages is provided as general information only and should not be substituted for the advice of your physician.



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