• Reference Number: HEY1478/2024
• Departments: Paediatrics
• Last Updated: 31 July 2024

Nights and Naps

Once the 12 weeks Boots and Bar treatment period is complete and providing your child still has good range of movement of their feet, they will only need to wear the ‘boots and bar’ for sleep time. This is known as ‘nights and naps’ and will continue until age 5.

Your child needs to wear the boots and bar for 12 to 14 hours each day which can easily be accommodated overnight and in daytime naps.

The reason for the naps, even if you have got the 12 to 14 hours overnight, is to ensure continuity. Your child should be consistent in wearing the boots and bar whilst in their normal place of sleep.

The Ponseti team will monitor the movement of your child’s feet and will make any minor adjustments if necessary.  Any problems with wearing the boots need to be reported immediately to the Ponseti team.

During the day your child needs to wear well fitted shoes.

At this stage, the Ponseti team do not book any more routine appointments, but you will be reviewed by the Paediatric Orthopaedic team at three months and then at intervals of the following several years..

The ‘nights and naps’ stage will continue until your child is 5 years old to prevent re-occurrence of the original foot position. However, continued infrequent monitoring of your child will continue for several years to ensure no problems arise as they grow.

It is important that your child does not use a baby bouncer or walker as this encourages them to point their foot downwards which is the position the treatment has been working against.

New Boots

As children grow very quickly, they will regularly need replacement boots. If your child’s toes are at the end of the boots or they are starting to get skin marking they may be ready for a new pair. If you contact the department, we will either arrange to supply a new pair or assess the fit if they have not been checked in a while.

It is important that you bring the old boots and bar with you when collecting the new boots so we can check them.

If you have any concerns regards skin marks or pressure, please contact us and we will arrange a review as the boots and bar may need changing or adjusting.

Important Information

Although your child’s foot / feet now look normal they must continue to wear the boots and bar to maintain the corrected position as we know that there is a gene related to the relapse of the CTEV position, which is active until age 5 years old.

There is evidence that poor compliance can cause relapse and so it is vital that strict compliance to this stage is maintained to minimise this risk.

The Ponseti team is able to help advise if you are struggling with any aspect.

Contact Numbers: tel: 01482 674539 or  01482 674532 (Monday to Friday 8am to 4pm)

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats your child, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to your child. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your child’s condition, the alternatives available for your child, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about your child

We collect and use your child’s information to provide your child with care and treatment. As part of your child’s care, information about your child will be shared between members of a healthcare team, some of whom you may not meet. Your child’s information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide your child with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your child’s doctor, or the person caring for your child.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about your child. For further information visit the following page: Confidential Information about You.

If you need information about your child’s (or a child you care for) health and wellbeing and their care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.