Infant Menu Template
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1Child's Name _____________ Age__ Type of Formula __________
INFANT MENU FORM
Provider Name _____________ Provider Signature ____________
.
8-11
Meal
0-3 Months 4-7 Months
Months
Monday
Tuesday
Wednesday
Thursday
Friday
BREAKFAST
Circle the ounce of formula served
1. Iron Fortifies Formula
or Breast Milk
4
6
8
4
6
8
4
6
8
4
6
8
4
6
8
4-6 fl. oz.
4-8 fl. oz
6-8 fl. Oz
2. Infant Cereal
n/a
0-3 tbsp
2-4 tbsp
3. Fruit/Vegetable
n/a
1-4 tbsp
n/a
AM SNACK
Circle the ounce of formula served
1. Iron Fortifies Formula
2-4 oz
or Breast Milk
4-6 fl. oz.
4-8 fl. oz.
4
6
8
4
6
8
4
6
8
4
6
8
4
6
8
or
2. Full Strength Juice
n/a
2-4 oz.
n/a
3. Bread / Grain
n/a
0-1/2 Slice
n/a
Crackers
n/a
0-2
n/a
LUNCH
Circle the ounce of formula served
1. Iron Fortifies Formula
or Breast Milk
4
6
8
4
6
8
4
6
8
4
6
8
4
6
8
4-6 fl. oz.
4-8 fl. oz
6-8 fl. oz
(optional)
2-4 tbsp
2. Infant Cereal
n/a
0-3 tbsp
and/or
Meat, Fish, Poultry, Egg
1-4 tbsp
Yolk, or
or
Cooked Dry Beans,
1/2-2 oz
Peas or Cheese,
or
Cottage Cheese,
n/a
n/a
1-4 oz
(optional)
Fruit / Vegetable
n/a
0-3 tbsp
1-4 tbsp
P.M. SNACKS
Circle the ounce of formula served
1. Iron Fortifies Formula
2-4 oz
or Breast Milk
4
6
8
4
6
8
4
6
8
4
6
8
4
6
8
4-6 fl. oz.
4-8 fl. oz.
or
2. Full Strength Juice
n/a
2-4 oz.
n/a
3.Bread / Grain
n/a
0-1/2 slice
n/a
Crackers
n/a
0-3
n/a
SUPPER / DINNER
Circle the ounce of formula served
1. Iron Fortifies Formula
or Breast Milk
4
6
8
4
6
8
4
6
8
4
6
8
4
6
8
4-6 fl. oz.
4-8 fl. oz
6-8 fl. oz
(optional)
2-4 tbsp
2. Infant Cereal
n/a
0-3 tbsp
and/or
Meat, Fish, Poultry, Egg
1-4 tbsp
Yolk, or
or
Cooked Dry Beans,
1/2-2 oz
Peas or Cheese,
or
Cottage Cheese,
n/a
n/a
1-4 oz
(optional)
Fruit / Vegetable
n/a
0-3 tbsp
1-4 tbsp
Formula Provided by: ___________________________________________
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Parent category: Miscellaneous