What Podiatrists and Research Actually Say

If your child appears to have flat feet, you have probably been told one of two things: get orthopedic shoes with arch support, or do not worry, they will grow out of it. The reality is more nuanced than either of those answers, and the footwear choice you make right now may matter more than you think.

This article brings together what pediatric podiatrists and peer-reviewed research actually say about flat feet in children, what causes them, when they are a real concern, and whether barefoot shoes can genuinely help.

📋 What this guide covers:  Why almost all toddlers have flat feet · What the research says about arch development · What podiatrists say about barefoot shoes and flat feet · When flat feet DO need specialist attention · What to look for in a shoe if your child has flat feet

First: Are Flat Feet in Children Normal?

Almost always, yes. This is one of the most important things for parents to understand, and one of the most commonly misunderstood.

At birth and throughout the first years of life, the arch of the foot is hidden beneath a layer of fat tissue. This fat pad is completely normal and gradually reabsorbs as the foot muscles develop and the child grows. What looks like a flat foot in a toddler is, in the vast majority of cases, a physiologically normal foot at its correct stage of development.

"The foot of a healthy child has to be chubby, flat and very lax."

— Neus Moya, pediatric podiatrist and author of 'Pasito a Pasito'. Interview with Hacer Familia, 2023.

Neus Moya is one of Spain's most widely followed pediatric podiatrists, with over 700,000 Instagram followers and two published books on children's foot health. Her position on flat feet in toddlers is consistent with the current clinical consensus: what parents see as a problem is usually a developmental phase, not a pathology.

The arch typically becomes visible between the ages of 4 and 6 as the fat pad reabsorbs and the foot muscles develop. However, the key word here is develop. That development requires the foot to be active, not passively supported.

💡 Key fact:  True flat feet requiring medical intervention are generally not assessed until age 5 to 6. If your toddler or preschooler appears flat-footed, this is almost certainly a normal developmental stage, not a condition that needs correcting with orthopedic insoles.

The Problem With Arch Support in Healthy Children

When parents see flat feet, the instinct is to provide arch support. The logic feels intuitive: if the arch is missing, add it externally. But this reasoning works against the body's natural process.

The arch of the foot is built through muscle activity. Every barefoot step on a varied surface, every toe grip, every balance adjustment, activates the intrinsic muscles of the foot and contributes to the gradual formation of the medial longitudinal arch. A shoe that provides the arch externally removes the stimulus the foot needs to build it itself.

"When it is conventional, the musculature does not work, which causes hypotonia and this is a secondary cause of deformities: hammer toes, bunions, plantar fasciitis. And all of it comes from weakness of the foot itself."

— Neus Moya, pediatric podiatrist. Interview with Informativos Telecinco, May 2024.

This is not a fringe position. The 2023 systematic scoping review published in Healthcare (Basel) by researchers at Ningbo University, covering multiple studies on children's footwear, found consistent evidence that barefoot shoes assist foot strength, muscle strength and balance improvement in children. The review concluded that barefoot shoes show minimal impact and similar motion patterns to being completely barefoot.

Wang et al., Healthcare (Basel), 2023. PMC10218108.

🔬 The science in plain terms:  A shoe with built-in arch support does the work that the foot muscles should be doing. Over time, those muscles do less, develop less, and the foot becomes weaker, not stronger. A barefoot shoe lets the foot work naturally and build genuine strength.

What Barefoot Shoes Actually Do for Flat Feet

Barefoot shoes do not have arch support, a raised heel, or rigid structure. This is not an oversight. It is the point. Here is what happens when a child with developmentally flat feet wears a properly designed barefoot shoe:

• The foot muscles engage with every step, including the intrinsic muscles responsible for arch formation.

• The toes spread and grip naturally, activating the entire plantar surface rather than a narrow contact zone.

• The zero drop sole means the heel and toe are at the same height, distributing weight naturally and avoiding the forward pitch created by a raised heel.

• The thin, flexible sole allows sensory feedback from the ground, which is essential for proprioception and the neural development that supports good posture and gait.

"Barefoot allows the development of the child's foot as if they had never worn shoes. The maturation of the foot happens through movement. If we prevent movement with a shoe, we affect the maturation of the foot. Barefoot allows the passage of stimuli from the ground to the foot and also gives it movement and space."

— Neus Moya, pediatric podiatrist. Interview with Informativos Telecinco, May 2024.

Moya also directly addresses the old-fashioned approach to flat feet with rigid shoes:

"Traditionally it has been said that children will not develop well or will not walk well if we do not put shoes on them. A shoe that helps, that reinforces like a splint, that gives structure. We need to break out of that cycle."

— Neus Moya, pediatric podiatrist. Interview with Informativos Telecinco, May 2024.

Flat Feet Are Not Always a Problem to Fix

One of the most important shifts in modern pediatric podiatry is moving away from automatically pathologising flat feet. Many feet that appear flat function perfectly well. The question is not only what the foot looks like, but how it moves and what it can do.

"Not all cavus or flat feet are a problem: some are strong, agile and perfectly functional. A clear example is Usain Bolt, who has flat feet and was the fastest man in the world. What matters is not only the shape of the foot, but how it moves and how it functions."

— Neus Moya, pediatric podiatrist. Interview with Hola.com, September 2025.

This does not mean ignoring genuine structural issues. It means that a flat-looking foot in a child under 6 is almost always normal, and that the response to it should be movement and freedom, not external correction.

⚠️ When to see a specialist:  If your child is over 6 and still appears significantly flat-footed, if one foot is notably more affected than the other, if your child complains of foot or ankle pain during normal activity, or if you notice a change in their gait, a pediatric podiatrist assessment is appropriate. Neus Moya recommends first assessment from around 3.5 years, as this is when a proper biomechanical gait study becomes possible.

What to Look for in a Shoe if Your Child Has Flat Feet

Whether your child has physiologically flat feet (normal in under 6s) or a confirmed condition assessed by a specialist, these are the features that support healthy development:

The Role of Barefoot Time

Beyond footwear, the single most effective thing for a child with flat feet is time spent completely barefoot on varied natural surfaces. Grass, sand, pebbles, uneven ground: these surfaces provide the richest sensory input and the most varied muscle activation for developing feet.

In the UAE, this is more challenging than in cooler climates because outdoor barefoot time is limited by heat from May through September. This makes the quality of footwear during that period more important, not less, because the shoe is doing more of the developmental work that barefoot time would otherwise do.

🌡️ UAE-specific note:  Dubai's indoor marble and tile floors are actually a good surface for barefoot time at home. Encourage your child to be barefoot indoors as much as possible, and choose a genuine barefoot shoe for any time when shoes are necessary.

  Every Bambas shoe is designed around the principles the experts recommend.

  Zero drop, wide toe box, flexible sole, no arch support, no rigid heel counter. Made in Spain from premium leather and cotton canvas. Delivered next day across the UAE.

  → Shop Toddlers: bambasfootwear.ae/collections/babies-and-toddlers

  → Shop Kids: bambasfootwear.ae/collections/kids

  → Questions? hello@bambasfootwear.ae  · Same-day delivery in Dubai, Abu Dhabi, Sharjah and Ajman.

Sources & References

Neus Moya, pediatric podiatrist (@neusmoya.podologa, 700K+ followers). Interview: Informativos Telecinco, May 2024. telecinco.es

Neus Moya. Interview: Hacer Familia, July 2023. hacerfamilia.com — "El pie de un niño sano tiene que ser gordito, plano y muy laxo."

Neus Moya. Interview: Hola.com, September 2025. hola.com — On flat feet and foot function.

Neus Moya & Jesús Serrano (physiotherapist, founder of Improv Clinica, @jesus.serrano.fisio). Podcast: Be Levels, Episode 88. belevels.com — "El desarrollo empieza por los pies."

Wang Y, Jiang H, Yu L et al. Understanding the Role of Children's Footwear on Children's Feet and Gait Development: A Systematic Scoping Review. Healthcare (Basel). 2023 May 13;11(10):1418. PMC10218108.