A Child'S World

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A CHILD’S WORLD
Infant Feeding Plan
Date_______________
Child’s Name__________________________________
Birthdate____________
Does this child take 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 Milk
___
Baby Foods
___
Table Foods ___
Formula
___
Other
___
What type formula is used?_____________________________________________________
Amount of formula to be given__________________________________________________
Updated amounts of formula_______________________
Date_________________
_______________________
Date_________________
_______________________
Date_________________
Does your child use a pacifier?
Yes___
No___
If yes, when:_________________________________________________________________
Food Likes__________________________________________________________________
Food Dislikes________________________________________________________________
Allergies (include any premixed formula)___________________________________________
___________________________________________________________________________
Infant’s Schedule
Time
Type and amount of food
Breakfast
_________
_______________________________________
Lunch
_________
_______________________________________
Dinner
_________
_______________________________________

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