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Infant Feeding Plan
*All fields are required for us to better assist you.
Child's Name:
Date:
Date of Birth:
Does the child take a bottle? Yes
No
Is the bottle warmed? Yes
No
Does the child hold its own bottle? Yes
No
Can the child feed itself? Yes
No
Does the child eat:
Strained Foods
Baby Foods
Formula
Whole Milk
Table Food
Other
What type of formula is used?
Amount of formula to be given?
Does the child take a pacifier? Yes
No
At what time(s)?
Food Likes:
Food Dislikes:
Allergies (including any pre-mixed formulas):
Child's Schedule
Breakfast
Time:
Type & approximate amount of food:
Lunch
Time:
Type & approximate amount of food:
Dinner
Time:
Type & approximate amount of food:
Morning Nap Time:
Afternoon Nap Time:
Instructions for introduction of solid food
Signatures needed upon visit to the facility.
Parents
ESCC
Press
Vendors
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