European Stars and Stripes (Newspaper) - August 27, 1991, Darmstadt, Hesse                                Barefoot is Best most children Don t need orthopaedic shoes by Natalie Angier new York times parents beleaguered by the High Cost of children a footwear May be relieved to hear that in the opinion of Many a Ortho pudists the Best thing for growing feet is not that pair of adorable miniaturized glow in the dark running shoes or the sensible if aesthetically objectionable oxfords or even the Kmart flip flops but rather no shoes at All. In a new review that confirms and expands on what Many paediatricians have been saying of late or. Lynn t. Staheli director of orthopaedics at children a Hospital and medical Center in Seattle has concluded that the children with the Healthiest and most supple feet Are those who habitually go Barefoot. The myth of the Good solid shoe is like the fallacy of communism said Staheli. Quot people do better when they re free and the foot does better when it s free Quot he said. Staheli was led to make his conclusion by anthropological studies around the world of people who do not Wear shoes. Quot if you look at a place like China and you compare the feet of those who done to Wear shoes with the feet of those who do you find that the Nori shoe wearers have better flexibility and mobility Quot he said Quot their feet Are stronger they have fewer deformities and less complaints than the shoe wearing  Staheli said that in Western nations children must often Wear shoes to protect feet against Snow broken Glass or the occasional hypodermic syringe on the sidewalk among other things. But he said he believes that the More closely a child a shoe resembles the Barefoot state the better. A child a shoe should be lightweight flexible and shaped More or less quadrangular by like the foot he said. Above All the shoe should not have the Arch inserts or stiff sides once deemed necessary to lend the loot support. And whenever the ground is Safe enough to do so he said parents should allow their children to roam around Unsod. Quot the Bare foot is the Ideal position Quot said or. Lowell d. Lutter assistant clinical professor at Gillette children s Hospital in St. Paul Minn. Quot children a shoe Wear has two functions to protect and to decorate. Anything past that is an unnecessary use of  Staheli a respected paediatric Ortho Peist who himself _ has studied children s footwear is particularly opposed to those shoes branded Quot corrective Quot or Quot orthopaedic a a and the Best shoe possible try to find a shoe for. Your child that comes As close to the Barefoot experience As is practical while still providing Protection. Quot Tennis shoes Are commonly recommended but that encompasses a Large variety. Of types. Some Are Ideal but some have stiff soles and unyielding uppers. Look Tor a shoe that is 1. Squared off to conform to the Normal foot shape., with plenty of room for toes. 2. Flexible to allow free foot movement. 3. Flat with no Heel Elevation. 4. Porous with leather or permeable fabric uppers to prevent wet feet and fungal infections. Source Lynn sum of m d neither Slippery like some leather soles nor ground gripping like some rubber soles with sole friction equivalent to that of the Bare foot. 6. Light in weight to reduce Energy expenditure. 7. Above the ankle for toddlers to keep shoe from slipping off during running. 8. Acceptable in appearance to Fashio sensitive children. 9. Reasonably priced. Not which some doctors still advocate As a method for straightening foot and leg deformities like Flat feet Pigeon toes Knock Knees or Bowlegs. But Staheli and Many other Ortho pudists denounce that sort of medical intervention As unnecessary. For one thing they said there is no evidence that corrective shoes Correct anything. For another the supposed deformities Correct themselves Over time in the vast majority of cases. Quot in the orthopaedic Community there s a real cynicism about orthopaedic shoes Quot said or. Francesca m. Thompson an orthopaedic surgeon at Roosevelt Hospital in new York. Quot Mother nature takes care of nearly All orthopaedic problems on her own. What a child needs is a Protection from cuts and things not an ugly Brown  Staheli recommends that shoes be thought of in the same Way As any other item of clothing. Quot you Don t think of clothing As something that will. Influence the development of the trunk or the arms Quot he said. Quot it s worn for Comfort and the same should be planned for the  some paediatric Ortho pudists disagree with Staheli considering  extremist position. They insist that there is still a place for corrective shoes in cases in which children s foot problems do not improve Over time. Left unattended they said foot and leg problems in childhood when to see a foot doctor by the new York times children outgrow the vast majority of foot and gait problems but doctors say several conditions Merit consulting an Ortho Peist. A children with a difference in leg lengths of More than half an Inch to three quarters of an Inch should be taken to a physician although doctors vary Over How great the discrepancy must be before a shoe lift is considered. A ii a child a Bowlegs or Knock Knees Are especially severe or affect Only one log. A physician should be consulted. Or. Michelle a. Larson who studies neuromuscular development at the University of Southern California in los Angeles said that Many children begin walking with hips and feet turned outward but that if a child maintained that gait in an exaggerated fashion alter six months of toddling it could indicate hip and joint difficulties that might need a Brace or surgery. A children who maintain a tiptoe step after six months of walking should also see a doctor or Larson said. Quot that could indicate a neuromuscular problem Quot she said Quot walking with a toe Heel gait too Long is one of the first key indications of muscular dystrophy although that s very . Don t Force kids to join the plate club by Susan Campbell the Hartford courant the father eating with his family at the red lobster restaurant had Good intentions. Quot cd Mon a he said to his Young daughter who was scowling Over a plate of crab meat. Quot finish  he tried to Fork some food into her Mouth but the girl who was probably no More than 4, turned her head away lips clamped shut. Quot you have to finish it Quot the Man pleaded. Quot it s Good for  no go. The girl would not Budge. Worrying about getting your child to eat is Normal. But when the table becomes a Battlefield the ramifications can last a lifetime. When parents try to Force their children to eat More than they want a remember being a member of the clean plate club a they Are teaching their children to ignore their feelings according to child development and eating disorders experts. Quot the main Rule of thumb is that your body really knows what you need and kids Are really Good at regulating Quot what they need said Liza g. Berzins director of the eating disorders program at the Institute of living in Hartford Conn. Quot if kids Are left to their own devices at one meal they May eat very Little and at the next one a lot. It balances  Margo Maine a psychologist and program director of Newington children s Hospital eating disorders service in Newington Conn., said that parents attempts to control their children s food intake teach the children to look outside for their eating cues. A Quot it really gets them to thinking that what they do for their bodies should please other people rather than themselves Quot Maine said. Quot i grew up with a people Are starving in Europe so eat everything on your plate Quot Berzins said. Quot in that Way you teach people to unlearn listening to their body signals and they begin eating or stopping eating in response to external  evidence indicates that obese people respond More to external cues than to internal ones. And it is not a far jump from ignoring body signals to responding to emotional signals. That is when people Start using food ass amps Art Wes Booher a substitute As a Way to fill an emotional void. Quot after a while they Don t know if they re full angry sad Quot Berzins said Quot everything is determined by what s outside of  said that infants first learn that they have Power through food. They cry their parents feed them and they Are satiated. That has contributed to More nursing mothers switching to breast feeding on demand rather than on a schedule Berzins said. But As a child grows parents become More reluctant to feed on demand out of concern that the child Eal properly. Quot we end up seeing children and a dulls who perhaps compulsively overeat or eat chaotically because they have never known How to figure out hunger and thirst Quot and to know How to healthily meet those needs Maine said. Parents tend to watch their children s eating habits very closely said Paul Haskew a psychologist at health services at the University of Connecticut. And that can Start a lifelong unhealthy relationship with food. Haskew said that eating problems that develop into More serious eating disorders often Stem from Quot family turmoil that has created a longstanding insecurity even in a student who is otherwise very Well adjusted and seems to be socially Weli adapted and does Well . For parents of Picky eaters the experts advise a humans have a built in drive to be healthy. Ii children Are not eating absolutely everything you think they should during one meat they More than Likely will eat better tomorrow or the next Day. A you know How your child wants you to Tell the same Story Over and Over again repetitive behaviour is. Comforting to a child. So is having the same Lood. As much As you can stomach it prepare favorite foods. A Mealtimes should be pleasant. If you want your child to eat better set a goal that he will try a new food once a week or once a month. Make it a game. A if the paediatrician says your child is growing despite seeming to subsist solely on swe Taits and or Pepper a do not worry about it. A if your paediatrician says worry about it work with the doctor and a dietitian or psychologist if necessary to set some eating goals. Can Lead to considerable discomfort in adulthood. A Quot the author of the article has a vendetta Quot against corrective shoes said or. Seymour Zimbler a clinical professor of paediatric orthopaedics at Tufts University school of Medicine in Boston. Quot with some mild deformities i believe a shoe with some correctives has an ability to help but its difficult to  Stap Efi said that his new review is not an attempt to. Undermine the children s shoe Industry but rather to summarize prevailing opinion about How the foot normally develops and How Best to encourage its Healthiest growth. Most babies Are bom with what look like foot abnormalities. Nearly All have Flat feet because the foot Bottom is covered by a thick pad of fat and because it is Only through walking that the intricate mesh of Muscles and ligaments in the foot strengthen and Puli upward into a genuine Arch. Following 442 children in a study conducted several a years ago Staheli found that in most cases the Arch is fully developed by 6 to 8 years of age. Doctors emphasize that the joints and ligaments of the legs and feet Are extremely flexible in a Newborn and that they require several years to attain their mature shape and position. As the limbs develop they May assume any number of unusual variations nearly All of which Are outgrown. A Many babies have feet that Point inward Pigeon style usually As a result of having been cramped into the familiar fetal position for so Many months in the uterus. Other children have hip Bones or lower leg Bones that rotate inward a bit More than they do outward also causing the feet to Point inward Pigeon toes generally Correct themselves by 6 months to 3 years of age. Many other children begin walking with their feet rotated outward More like a Duck s than a pigeons but most will assume a More straightforward gait within six months of toddling the great majority of youngsters also begin to walk with a sort of Ballet movement striking the ground toe first and Heel second or even to remain on tiptoes. Most will master the Normal Heel first stride by about 18 months of age. Bowlegs and Knock Knees Are also extremely common. Quot kids usually grow out of these problems by the age of 16.&Quot said Thompson and often much earlier. School Day should begin with a Good breakfast school has begun and parents Are shopping for supplies. But a nutritionist at the children a nutrition research Center in Houston says one obvious entry on the annual checklist is often overlooked a breakfast Quot it is the most important meal of the Day especially for children Quot said Janice stuff a research instructor at Baylor College of Medicine in Houston Quot breakfast supplies Ono fourth to one half of the recommended daily allowance of vitamins and minerals. If you skip breakfast it is hard to catch up during the  mastering the three is requires a lot of Energy. Without breakfast children Are usually hungry by mid morning. A hungry child is too tired and Cranky to concentrate on schoolwork. Stuff said. Quot breakfast gives a child an Energy boost improving his or her behaviour attitude and physical and mental  breakfasts draw on several of the Basic food groups. Parents can fortify their mini scholars by serving a Dairy product a protein a bread or Cereal and a fruit. However it is of to vary the menu and offer foods that do not fit the traditional breakfast Ideal. Stuff suggests the following alternatives. A Peanut butter and Jelly Sandwich a Yogurt and Toast with Jelly a fresh fruit and cottage cheese a cheese and crackers a soup a Popcorn a breakfast Taco a leftover before parents Rush to the store and. Overstock the pantry with breakfast Quot goodies Quot stuff encourages them to read labels. A parents May discover they Are giving their child a product  lists sugar sodium or fat As a main ingredient a she said. Sugar coated cereals Are an example. Stuff recommends that children be introduced to a variety of natural whole grains. Discretion is urged when selecting breakfast meats As Well. A a number of breakfast meats Are marked lean or Lite. They May have fewer calories but 70 percent or those calories May come from fat Quot stuff said. To add protein to the morning meal she recommends either Canadian Bacon or Ham that has been prepared in a non Slicks amps Ait Wes Booher Skillet or microwave oven. Only 45% of the calories in Canadian Bacon or Ham come from fat. Despite Good intentions parents May undermine efforts to Start their child a Day in a healthy note. According to stuff children s food choices and eating habits Are influenced by the preferences of their parents. Quot parents must set a Good example and Mam is an especially important role Model. If she sips Coffee and munches on a doughnut w lat kind of message is she sending her child Quot a when possible parents should also include the child in menu planning shopping and meal preparation the entire family should practice the abcs of Good nutrition a Baylor College of Medicine Page 14 b the stars and stripes tuesday August 27, 1990 the stars and stripes Page 15