INFANT/TODDLER FEEDING PLAN

Child’s name ______________________________________  Date ______________________

Birthday ____________________ Parent’s Signature _________________________________

Does child take a bottle?                                       _______yes     _______ no

Does the bottle need to be warmed ?                    _______yes     _______ no

Does the child hold their own bottle?                   _______yes     _______ no

Can child feed themselves?                                   _______yes     _______ no

Does the child eat the following?

______  Baby foods           ______  Whole milk            ______  Other

______  Formula                  ______  Table foods

What type of formula is used? ____________________________________________________________

Amount of formula to be given ___________________________________________________________

Does the child take a pacifier? _____ yes    _____ no   When? ___________________________________

Allergies (food, formula, medicine) _________________________________________________________

Child’s Schedule:  Breakfast ________________                        ____________________________________

                                                    (approximate time)                                 (kind and approximate amount of food)

                                  Lunch __________________                        ____________________________________

                                                (approximate time)                                      (kind and approximate amount of food)

                                  Bottles _____________________________________________

                                                                (approximate times and ounces)

Nap schedule ___________________________________________________________________________