03.05.06 - Infant Feeding Procedures

Infant Feeding Procedures Policy Number and Last Update

Bottle Feeding

This procedure will be always followed when bottle-feeding infants:

  1. Infants must be fed "on demand." Flexible feeding schedules must be maintained. No less than the daily food requirement for children less than one year of age (see attached- CACFP Child Care Infant Meal Pattern) will be offered unless otherwise indicated in writing by a physician, in consultation with the parents.
  2. Wash hands using IMSHS Hand Washing Procedures.
  3. Inspect sanitized bottle and nipple for cleanliness and child's name. Programs should purchase enough bottles (at least three [3] per infant) to ensure a sterilized one is always available. Purchase and use only non-polycarbonate (#5) plastic or tempered glass bottles. Also, ensure that nipples (bottle and pacifier) are clear silicone, not plastic or latex (PVC #3.) Sanitize bottles by washing in a dishwasher or by boiling for five minutes or more just before refilling.
  4. Identify the child's formula or breast milk. (No other foods than these, except water, will be placed in a bottle for infant feeding.)
  5. Prepare formula according to manufacturers' instructions. If the formula needs to be reconstituted (i.e., is not ready-to-feed), use distilled water only. (If bottles are pre-filled, they will be refrigerated until immediately before feeding.)
  6. Warm the bottle in a bowl of hot water until formula or milk is lukewarm. (Never use a microwave oven for this purpose. The use of bottle warmers is also discouraged.) Wipe the outside of the bottle with a clean cloth when it is removed from the hot water.
  7. Always check the temperature of bottle contents before feeding the child.
  8. Wipe the child's teeth and/or gums with a dampened gauze pad when he is finished feeding
  9. Babies must always be held when being bottle fed. Hold the child in a comfortable position until she or he has completed feeding. Allow the child as much time as needed to feed. Burp the baby occasionally during the feeding to bring up air swallowed while sucking.
  10. When a child is able to sit up and hold his own bottle, she or he may be placed in a high chair for feeding. Never leave a child unattended while in the high chair. Always use a non-glass bottle when children feed themselves. Never feed a child in a crib, prop a bottle or allow a child to walk around with a bottle.
  11. When the child has stopped taking the bottle, put on the disposal glove, cover your finger with the dampened gauze pad and gently wipe the baby's teeth and/or gums. Then return the child to play or crib area.
  12. Destroy the remainder of fluids in the bottle.
  13. Wash the bottle and nipple thoroughly with soap and water, rinse well. Place bottle and nipples in a receptacle to be returned to the kitchen for sterilizing.
  14. Document feeding time and amount consumed on the Daily Infant Activity Record.
  15. Wash hands well using the IMSHS Hand Washing Procedures.
  16. STORAGE: Opened containers of unmixed concentrate, formula prepared from powder or concentrate and open containers of ready-to-feed formula must be labeled to identify the contents, dated and refrigerated. Containers and/or bottles of breast milk and individual bottles of prepared formula must also be labeled with the child's name. Prepared formula not used within 24 hours must be discarded. Breast milk may be stored up to 48 hours in the refrigerator or up to two weeks in the freezer before discarding.

 Solid Foods and Juices

  1. Infants must not be fed solid foods or juices until the age of four months or older.
  2. Introduce solid foods and juices according to the child's nutritional and developmental ability, in consultation with the child's parents and with the recommendation of the child's doctor or the program's Nutrition Consultant.
  3. Foods should be introduced according to the CACFP Child Care Infant Meal Pattern (see attached). Generally, rice cereal baby food, mixed with formula or breast milk, is the first food to be introduced.
  4. Only one new food, including juice, should be introduced at a time. At least two days should elapse before the introduction of a different new food. If signs of intolerance (such as vomiting, skin rash, diarrhea, or wheezing) occur, inform the child's parents. If the reaction is severe, follow the program's Medical Emergency procedures to get immediate assistance.
  5. Document each food fed to a child, the amounts and times fed on the Daily Infant Activity Record. The first time a food is given, circle that food in red on the Record. If a reaction develops, this will make it easier to identify the possible offending food.
  6. Juices should be introduced when the child is developmentally ready to drink from a cup, usually after seven months.
  7. Before preparing food and feeding, wash hands using the IMSHS Hand Washing Procedures.
  8. Feed the child from a dish and with an infant spoon, and never directly from a jar. If the child is not developmentally ready to sit up in a high chair, hold the child or place her/him in an infant seat. Feeding should be unhurried. The child needs time to practice this new skill.
  9. Discard any leftovers from the serving dish. Leftovers in the jar should be labeled with the infant's name, dated, refrigerated and served with 24 hours or discarded.
  10. When the child is developmentally ready to feed self, generally around eight months, place him in a high chair and assist him with his feeding. This is also the time to start offering finger foods such as small soft pieces of peeled fruits and vegetables, soft cheese cubes, unsalted crackers, toast squares, etc.
  11. By the age of 12 months, a child should be eating most of his food from the table. Foods from the menu should be cut and prepared to meet the child's developmental needs by the cook before delivery to the classroom.
  12. However, never feed children less than two years of age whole small berries, candies, raisins, corn kernels, raw carrots, whole grapes, hot dogs, nuts, seeds, popcorn, raw peas or peanut butter, as these foods may cause choking. Also, never give honey to a child less than one year. Pureed or mashed berries, cooked carrots, corn and peas can be given.
  13. Whole cow's milk can be introduced to a child in a cup after the age of 12 months, when recommended by the child's physician. Never give children less than two years of age 2% or skim milk, unless ordered in writing by the child's physician.
  14. When you have finished feeding the child or the child has finished feeding himself, clean the child teeth as described in #11 under Bottle Feeding and in the IMSHSP Tooth brushing Procedure
  15. Follow IMSHSP Infant/Toddler Rooms Daily Sanitation Guide to ensure feeding areas are always kept clean.