13A.18.12.06

.06 Feeding Infants and Toddlers.

A. The provider shall ensure that the written feeding schedule for each infant and toddler, as required by COMAR 13A.18.03.02C, is:

(1) Followed; and

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

B. Self-Feeding by Children Younger than 18 Months Old.

(1) The child shall be held for each bottle feeding except when developmentally able and insistent upon self-feeding.

(2) The child may hold the bottle only:

(a) When seated; and

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

C. Except as specified by §D of this regulation, a provider may serve a child younger than 18 months old 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 provider or the parent that are consumed the same day.

D. Only whole, pasteurized milk will be served to a child younger than 2 years old who is not receiving formula or breast milk, except that skim milk, reconstituted nonfat dry milk, or 1 or 2 percent milk may be served upon the written prior approval of the child’s parent and health care provider.

E. A provider shall ensure that:

(1) All food and bottles intended for consumption or use by a child younger than 18 months old are labeled with the child’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 child care home;

(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 children younger than 2 years old 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.