Infant Feeding Schedule
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1Date Completed __________
Infant Feeding Schedule
(Must be completed for all children less than 15 months old.)
Child’s Name ____________________________________________ Date of Birth ___________________
Instructions:
Food / bottles brought daily (quantity) ___________________________________________
Instructions for feeding: ____________________________________________________________
o Bottles (breast milk, formula, milk, juice) ________________________________
________________________________________________________________________________
o Food (baby food, cereal, table food) _______________________________________
________________________________________________________________________________
o I plan to nurse ☐ Yes ☐ No - If yes, approximate times: ___________
________________________________________________________________________________
Parent Signature ______________________________________________ Date ______________________
Changes in Schedule (must be recorded as eating habits change)
Food
Date to
New Instructions
Parent or Staff
Introduce
Signature
Milk
Baby Food
Juice
Cereal
Table Food
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