SUCCESSFUL SOLUTIONS PROFESSIONAL DEVELOPMENT LLC A Basic Approach to Feeding and Care Chapter 3 Infant Feeding

SUCCESSFUL SOLUTIONS PROFESSIONAL DEVELOPMENT

LLCA Basic Approach to Feeding and Care

Chapter 3Infant Feeding

The food program in a child care center serves many purposes. Proper food handling, food preparation, and serving children nutritious meals are extremely important. Eating meals together can help children to develop social skills and good eating habits.

Chapter 3

Infant Feeding

Chapter 4Food Safety

A Basic Approach to Feeding and Care

Chapter Topics

Some infants (often those born

prematurely) do not give cues that are very easy to read.

If you have difficulty understanding an infant's signals, talk with the parents about ways their baby communicates with them, or consult with a public health nurse.


Chapter 3 Infant Feeding

Tips on Infant Feeding

• Young infants do not have good head control and will need a hand behind the head for extra support.

• Hold infants so that their head is higher than their hips. This helps babies swallow and prevents choking.

• Hold the bottle or, when infants are old enough, let them hold it. NEVER prop a bottle.

• Stroke infants gently and give affectionate pats when you feed them. Touch is one of the most important ways of communicating and interacting with infants.



Tips on Infant Feeding

• Rock and gently move them. A rocking chair with arms is helpful for movement and to help you support an infant's position. Occasionally change an infant's position; this helps with burping. Talk and sing to them.

• To prevent tooth decay, do not give a bottle to a reclining infant unless the bottle contains only water, and offer juice only from a cup.



3. Bottles will not be washed and re-used at the center. The family will provide a sufficient number of bottles to meet the daily needs of the infant.

If bottles must be re-used, our center will wash, rinse and sanitize bottles or place them in a dishwasher with a sanitizing cycle. Used bottles cannot be cleaned in a food sink. They will be placed in a tub to be cleaned in the kitchen.

2. All bottles will be labeled with the child's full name, date prepared and time feeding begins (discard within one hour if not consumed).

Infant Bottle Feeding

Bottle Labeling and Cleaning

1. Hands will be washed at the hand-washing sink before handling bottles.

WAC 170-295-4060 requires child care programs to incorporate policies on infant feeding. Above are suggested policies as recommended in the Child Care Licensing

Guidebook in order to meet minimum licensing guidelines and best practices.

4. Nipples needing to be re-used will be washed, rinsed, and boiled for 1 minute and then allowed to air dry.5. All bottle nipples should be covered at all times (to reduce the risk of contamination and exposure).



3. Bottles will be stored in the coldest part of the refrigerator, not in the refrigerator door.

2. Bottles that babies have fed from will not be placed back in the refrigerator or re-warmed.

Bacteria from baby's mouth is introduced into milk and begin to multiply once bottles are taken from the refrigerator and warmed.


Refrigeration

1. Filled bottles will be capped and refrigerated immediately upon arrival at the center or after mixing, unless being fed to an infant immediately.

4. A thermometer will be kept in the warmest part of the refrigerator (usually the door) and will be between 35 degrees F. and 44 degrees F. at all times. It is recommended that the refrigerator be adjusted between 35 degrees F. and 41 degrees F. to allow for a slight rise when opening and closing the door.

5. Frozen breast milk will be stored at 10 degrees F. or less and for no longer than 2 weeks.





3. Centers with only one sink in the infant room must obtain a clean source of water for preparing bottles (i.e., water from the kitchen kept in an airtight container).

2. A minimum of eight feet will be maintained between the food preparation area and the diapering area. If this is not possible, a moisture-proof, transparent 24-inch high barrier of 1/4-inch Plexiglas or safety glass will be installed.


Bottle/Food Preparation Area

1. Before preparing bottles or food, staff will wash their hands in the hand washing sink. The food preparation sink and area will not be used for hand washing or general cleaning.

4. Used bottles and dishes will not be stored within eight feet of the diapering area or placed in the diapering sink.5. Preparation surfaces will be cleaned, rinsed and sanitized before preparing formula or food.

6. Microwave ovens will not be used to heat formula, breast milk or baby food.7. Bottles will be warmed no longer than 5 minutes.8. If a crockpot is used the water temperature must be

monitored and held below 120 degrees F., and contain no more than 1 1/2 inches of water (crockpots pose a risk of scalding). The crockpot must be secured to the counter for earthquake safety. Crockpots will be cleaned and sanitized daily. Consider replacing the crockpot with a bottle warmer, which heats with steam and has an automatic turn-off or heat bottles by holding the bottle under warm running tap water until the fluid is no longer cold. All unused formula and non-frozen breast milk will be returned to the parent when they pick up their child at the end of each day.



3. No medication will be added to breast milk or formula.2. Written permission from the child's licensed health care provider will be required if an infant is to be fed Pedialyte or a special diet formula.


Contents of Bottle

1. Infants will be fed breast milk or iron-fortified infant formula until they are one year of age.4. No honey, or products made with honey, will be given to infants less than 12 months of age, because of the risk of botulism.

5. Bottles will only contain formula or breast milk. Juice will be given only in a cup.





2. Formula will be mixed as directed on the can. The water will be from the food preparation sink or bottled water. Water from the hand washing sink may NOT be used for bottle preparation.


Formula

1. Powdered formula in cans will be dated when opened and stored in a cool, dark place. Unused portions will be discarded or sent home 1 month after opening.





2. Frozen breast milk will be thawed in the refrigerator or in warm water (under 120-176 degrees F.) and then warmed as needed before feeding. Thawed breast milk will not be refrozen.


Breast Milk

1. Frozen breast milk will be stored at 10 degrees F. or less and for no longer than 2 weeks. The container will be labeled with the child's full name and date.

3. Unused thawed breast milk will be returned to the family at the end of the day.





Although parents choose most food for their own babies, your understanding of nutrition and feeding is important so you can be a resource when they have questions. The choice of foods for babies should come from their nutritional and developmental needs.

For most babies, breast milk or formula is the best source of nutrients throughout the first year of life. At four or five months of age, however, most babies are becoming interested in semi-solid foods.

Starting Solid Foods



Babies may be ready to start infant cereal when they can sit without support, hold their head and neck steady, and keep food in their mouth to swallow. These developmental signs of readiness usually appear between 4-6 months of age. If there is a family history of food allergies it is a good idea to delay starting solid foods until six months of age.

With parent's instruction, caregivers should feed infants semi-solid food,

such as cereal with a spoon, not through a bottle.




Chewing, gumming and swallowing skills are necessary for infants' language development.

Sucking food from a bottle does not allow infants the opportunity to gain tongue skills for language.




Ask the parents what foods they are starting at home and follow that plan at the center. Introducing only one new food per week is a good idea. If an infant has an allergic reaction, it is easier to pinpoint which food is causing the problem.

Intolerance of a food or an allergic reaction should show up in that time period. If symptoms of intolerance such as a rash or diarrhea occur, stop giving the recently added food. Try again in a few months if the reaction is a mild one.




It is time to offer other foods when infants are older and can sit without support and can sip from a cup.

These include mashed soft fruits and vegetables and sips of water from a cup. This phase is typically seen at around 6-8 months of age. When infants have mastered

picking up items between their thumb and forefinger and bringing them to their mouths, it is time to offer safe "finger foods" to promote self-feeding skills.




Finger foods may include soft pieces of cooked vegetable or peeled soft fruit, toast squares, unsalted crackers, bite-size cereal, small pieces of chicken, fish, tofu or ground meat, grated cheese, cooked plain rice or noodles.

At this stage, infants may also try to hold their own spoons and try to feed themselves. It is a good idea to offer a small hard plastic spoon with a short handle for infants to "practice" with.




The finger food stage usually develops around 10-12 months of age. As infants get more skilled at using their fingers, you can add more foods such as cooked kidney beans, cooked egg yolks and other foods that are more challenging to pick up. By 10-12 months of age infants can start eating three meals a day plus snacks and use a cup for beverages with meals. Soon infants will be eating foods

the rest of the children in care are enjoying. Special attention needs to be given to foods that pose a choking risk.




Baby food in jars can quickly spoil once opened.

Use a clean spoon to put the portion you plan to use in a bowl or cup. Never feed directly from the jar unless you are planning to throw the jar away when done. Use another clean spoon, not the one you have been using to feed the baby, to get more food from the jar.Throw away the unused portion in the bowl or cup. Always refrigerate opened jars of baby food and discard or send home after 48 hours.




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SUCCESSFUL SOLUTIONS PROFESSIONAL DEVELOPMENT LLC A Basic Approach to Feeding and Care Chapter 3 Infant Feeding