Dr Jinan Harith Darwish is a paediatric allergy specialist and clinical immunology fellow at the King Faisal Specialist Hospital & Research Center. Each month she answers your parenting questions.
Question: My teenage daughter is taking an interest in fashion for the first time, she’s always been a tomboy up till now. My worry is that she wants to wear high heels and I know these are bad for her feet and general development. Can you please tell me the risks and how I can minimise them without spoiling her fun? I’ll make sure to show her your answer.
Answer: There is a huge distinction between young girls wanting to emulate adults as part of role-play and permitting them to wear heels every day.
Children wearing high heels for long periods is a colossal concern. Children are growing, so their bones are very soft. Children’s feet are shaped differently to adults’; they are rounder, plumper, softer and more pliable. If you alter the pose of the foot, then their bones can ossify into a misshapen position. It is not about aesthetics, we are having a discussion about her feet becoming functionally imperfect. The human foot does not finish developing until around 18 years of age. When the heel is held higher than the ball of the foot, the Achilles tendon shortens. Extended weight-bearing by the ball of the foot can crush the toes together, forcing them into a bent shape and, in a number of cases, causing nerve damage. It’s not only the foot that is debilitated by wearing heeled shoes. Calf muscles may become shorter and tighter. The pelvis and spine are pushed out of alignment and amplified pressure is placed upon the knees. The bones of the legs do not finish growing and forming until the mid-teens and the changes to posture inflicted by wearing heeled shoes could well lead to permanent deformity in the bones of the ankles, knees and hips.
Question: My 16-year-old son seems to have developed an issue with hygiene. On school days he will get himself up and get ready just fine, but when he doesn’t have to go to school, he doesn’t shower for days on end or even brush his teeth. It sounds funny but, frankly, he’s getting a bit smelly! I haven’t said anything so far but would welcome some advice on how to broach the subject.
Answer: Personal hygiene is essential for all children but it becomes a particularly serious business after puberty. Failing to practise good head-to-toe hygiene as a teenager can be repulsively obvious to those in close proximity. Good hygiene practices during the teen years can preserve, improve and avert a teenager’s self-esteem from taking a nose dive. Conversations about your son’s hygiene should include puberty and the emotional and physical changes a teenager can expect.
Steer clear of power struggles over hygiene, but be adamant that personal hygiene is his responsibility and, like other responsibilities, there are consequences for neglecting his duties. It is imperative not to dance around these issues, but to be straightforward and candid.
Continue to chat about hygiene issues in the context of the facts about puberty, body changes and why daily attention is important to health and cleanliness. Context will help your son understand hygiene is not just his problem.
Interestingly, a survey of 904 14- to 17-year-old children from secondary schools around Nairobi was done to find out if there was any relationship between tooth brushing frequency and personal hygiene habits. The students completed a questionnaire anonymously in class. Of those students who brushed their teeth more than once a day, 52 per cent bathed daily, 22 per cent used perfumes/deodorants daily and 50.1 per cent always washed their hands after visiting the lavatory. No relationship was found between washing of hair and tooth brushing frequency. These findings indicated that tooth brushing was closely related to personal hygiene habits.
If you have a question for Dr Jinan, please email firstname.lastname@example.org