Classroom Emergency Information (Page 2 of 7) in pdf

Classroom Emergency Information Page 2

The Clifton School

Infant Feeding Plan

Child’s Name________________________________ Date________________________

Birthday_____________________________

Does the child take a bottle?

Yes [ ] No [ ]

Is the bottle warmed?

Yes [ ] No [ ]

Does the child hold own bottle? Yes [ ] No [ ]

Can the child feed self?

Yes [ ] No [ ]

Does the child eat:

Strained foods [ ]

Whole milks [ ]

Baby foods

[ ]

Table foods [ ]

Formula

[ ]

Other

[ ]

What type of formula is used? _____________________________

Amount of formula to be given? ____________________________

Updated amounts of formula:

Date

Amount

Does the child take a pacifier? Yes [ ] No [ ]

When?______________________________________________________________________________

Food Likes_______________________________ Food Dislikes________________________________

Allergies including any pre-mixed formulas_________________________________________________

Child’s Feeding Schedule

Time

Types and approximate food amount

Breakfast

Lunch

Dinner

Morning Nap

Instructions for the introduction of solid foods:

____________________________________________________________________________________________________________

As needed, please list updated instructions regarding adding new foods or other dietary changes.

Parent/Guardian Signature________________________________________________________

Date________________________

Classroom Emergency Information Page 2