13A.16.12.06

.06 Infant Feeding.

A. The operator shall ensure that the written feeding schedule for an infant or toddler, as required by COMAR 13A.16.03.02D(1), is:

(1) Followed; and

(2) Updated as necessary or at least every 3 months while the child is in care.

B. Infant Self-Feeding.

(1) An infant shall be held for each bottle feeding except when the infant or toddler is developmentally able and insistent upon self-feeding.

(2) When an infant or toddler holds the bottle, the infant or toddler may do so only:

(a) When seated; and

(b) If the bottle is made of unbreakable material.

C. Except as specified by §D of this regulation, an operator may serve an infant or toddler only developmentally appropriate:

(1) Commercially prebottled formula;

(2) Breast milk, formula, juice, or water which has been prebottled for the child and provided by the child's parent;

(3) Commercially processed baby food that is opened and used the same day;

(4) Commercial infant formula, in concentrate, powder, or ready-to-feed form, if the:

(a) Child's parent has provided prior written authorization for the use of the formula; and

(b) Formula is prepared directly from a factory-sealed container and in accordance with the manufacturer's instructions; and

(5) Other foods supplied by the operator or the parent that are consumed the same day.

D. Only whole, pasteurized milk will be served to an infant or toddler who is not receiving formula or breast milk, except that skim milk, reconstituted nonfat dry milk, or 1—2 percent milk may be served upon the written prior approval of the child's parent and health care provider.

E. An operator shall ensure that:

(1) All infant foods and bottles are labeled with the infant's name, dated, and refrigerated at 40 F or below if potentially hazardous;

(2) All nipples on bottles are protected;

(3) Breast milk or formula which has been bottled for the child is:

(a) Placed immediately in a refrigerator when brought to the center;

(b) Warmed to the desired temperature immediately before feeding; and

(c) Served to the child at a temperature that is safe and conducive to the child's comfortable feeding;

(4) Foods that present a high risk of choking for infants and toddlers are not served to them; and

(5) Reusable bottles and nipples are:

(a) Reused only after they have been washed, rinsed, and sanitized; or

(b) If supplied by the child's parent, rinsed after use and returned daily to the parent.