Infant Feeding Plan"*" indicates required fields591-1-1-.15 (2) Feeding of Children Under One (1) Year of AgeA signed written feeding plan for children under one (1) year of age shall be obtained from parents.Instructions from the parent shall be updated regularly as new foods are added or other dietary changes are made.The feeding plan shall be posted in the child's assigned room.Child's Full Name*Date of Birth* MM slash DD slash YYYY Does the child take a bottle? Yes NoIs the bottle warmed? Yes NoDoes the child hold own bottle? Yes NoCan the child feed self? Yes NoDoes the child eat?Check all that apply Strained food Formula Baby food Whole Milk Table food OtherWhat type formula used, if applicable?Center cannot mix powdered baby formulaAmount and time of formula/breast milk to be given?Updated amounts of formula/breast milk to be givenDate MM slash DD slash YYYY Time Hours: Minutes AMPM AM/PMAmountTypeDate MM slash DD slash YYYY Time Hours: Minutes AMPM AM/PMAmountTypeDate MM slash DD slash YYYY Time Hours: Minutes AMPM AM/PMAmountTypeDate MM slash DD slash YYYY Time Hours: Minutes AMPM AM/PMAmountTypeDoes child take a pacifier? Yes NoIf yes, when?Introduction of Solid FoodsThe introduction of age-appropriate solid foods should preferably occur at six months of age, but no sooner than four months. Has the parent discussed with the child’s primary caregiver that the child has met appropriate developmental skills for the introduction of solid foods? Yes NoCan hold his/her head steady? Yes NoOpens mouth/leans forward in anticipation of food offered? Yes NoCloses lips around a spoon? Yes NoTransfers food from front of the tongue to the back and swallows? Yes NoInstructions for the introduction of solid foodsFood likesFood dislikesAllergies (including any premixed formula)? Yes NoIf yes, please listChild's ScheduleTime Hours: Minutes AMPM AM/PMApproximate timeAmountTypeTime Hours: Minutes AMPM AM/PMApproximate timeAmountTypeTime Hours: Minutes AMPM AM/PMApproximate timeAmountTypeTime Hours: Minutes AMPM AM/PMApproximate timeAmountTypeAny updated instructions regarding adding new foods or other dietary changes, please list as needed.Parent's/Guardian's Name*NameThis field is for validation purposes and should be left unchanged.Δ
