A Guide for Use

in the Child Nutrition Programs

United States Department of Agriculture

Food and Nutrition Service

FNS-258

Feeding

Infants
NOTE TO THE READER ON USING THIS GUIDE

This guide is intended primarily for use by those who care for and feed

infants under 12 months of age and participate in the Child and Adult

Care Food Program (CACFP). This information will also be useful to those

in facilities that participate in the U.S. Department of Agriculture’s (USDA)

other Child Nutrition Programs serving infants, i.e., National School Lunch

Program (NSLP), School Breakfast Program (SBP), and Summer Food

Service Program (SFSP). The guide presents information on infant development, nutrition for infants, breastfeeding and formula feeding, safe food

handling and food preparation, choking prevention, and some of the Infant

Meal Pattern requirements to help caregivers meet the challenge of nurturing and feeding the infants under their care.

This guide is designed to provide nutrition guidance and is not inclusive

of all current Food and Nutrition Service (FNS) policy memoranda, FNS

Instructions, or program regulations relating to infants in Child Nutrition

Programs. Providers and staff should contact their State agency for the

most up-to-date policies and Infant Meal Pattern. The Infant Meal Pattern

is used by caregivers and the term “caregiver” refers collectively to the different types of facilities—including schools, residential child care institutions, child care centers, family day care homes, and homeless shelters—

that provide meal services to infants in the Child Nutrition Programs. The

word “parent” is used to refer to an infant’s parent or guardian. 

Be aware that State agencies may establish policies that differ from the

Federal requirements presented in this guide. Always check with your

State agency if you have questions.

The figures found throughout the text are in black and white so that

they can be easily reproduced and used as handouts. We encourage use

of these handouts as part of training sessions. They can also be distributed to child care providers, parents, or others who are responsible for

feeding infants.

Every effort has been made to ensure the accuracy of the information in

this guide. The recommendations and guidelines in this publication are

not designed to serve as an exclusive nutrition care plan or program for all

infants. It is highly recommended that caregivers obtain written instructions related to feeding an infant from the parent and, if available, from

the infant’s doctor, and that this information be kept on file. It is the

caregiver’s responsibility to evaluate the appropriateness of the recommendations and guidelines in this guide given the information received from

each infant’s parents and doctor. If caregivers have questions regarding

the appropriateness of any recommendations or guidelines for a particular

infant, they should consult with the parents, who can consult with the infant’s doctor.

We are interested in your comments on this guide. Please help us by

completing the Reader Response Form on the next page.
2 Feeding Infants
Feeding Infants: A Guide for Use in the Child Nutrition Programs

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Please comment on the content of this guide:

Section

2: Infant Development

3: Feeding Breastfed Infant

4: Feeding Infant Formula

5: How to Feed Using A Bottle

6: Preventing Tooth Decay

7: Feeding Solid Foods

8: Drinking From A Cup

9: Choking Prevention

10: Sanitary Food Preparation

11: Commercial Baby Food

12: Home-Prepared Baby Food

Bibliography

Are you planning to use this guide? ___Yes ___No

If Yes, how will you use it?

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As a resource in talking with parents about feeding babies

As a resource in planning training sessions for caregivers

___Other (please describe)

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If yes, how?

If this publication was revised, what changes would you

suggest?

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READER RESPONSE

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U.S. Department of Agriculture

Food and Nutrition Service, CND

Alexandria, VA 22302-1594

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BUSINESS REPLY MAIL

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Postage will be paid by Food and Nutrition Service

NUTRITION SERVICES STAFF

OFFICE OF ANALYSIS, NUTRITION, AND EVALUATION

U.S. DEPARTMENT OF AGRICULTURE

FOOD AND NUTRITION SERVICE

3101 PARK CENTER DRIVE RM 1014

ALEXANDRIA, VA 22302-9943
A Guide for Use in the Child Nutrition Programs 5

1: INTRODUCTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

2: INFANT DEVELOPMENT AND FEEDING SKILLS . . . . . . 11

Figure 1: Sequence of Infant Development and Feeding 

Skills in Normal, Healthy Full-Term Infants . . . . . . . . . 12

Figure 2: Feeding the Baby For the First Year . . . . . . . . . 13

3: FEEDING THE BREASTFED BABY . . . . . . . . . . . . . . . . 15

Supporting Breastfeeding Mothers. . . . . . . . . . . . . . . . . . 15

Use of Breastmilk for Babies Over 12 Months of Age . . . . 16

Guidelines on Storing, Handling, and Feeding Breastmilk. 17

Figure 3: How To Store, Handle, and Feed Breastmilk . . . 20

4: FEEDING INFANT FORMULA . . . . . . . . . . . . . . . . . . . . 23

Iron-Fortified Infant Formulas. . . . . . . . . . . . . . . . . . . . . 23

Low-Iron Infant Formulas . . . . . . . . . . . . . . . . . . . . . . . . 24

Follow-up Formulas . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Exempt Infant Formulas. . . . . . . . . . . . . . . . . . . . . . . . . 24

Other Milks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Water Used to Mix Concentrated or Powdered 

Infant Formula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Use of Infant Formula for Babies Over 12 

Months of Age. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Purchasing, Storage, Sanitary Preparation, and 

Handling of Infant Formula . . . . . . . . . . . . . . . . . . . . . 25

Figure 4a: Preparation Checklist for Standard 

Ready-To-Feed Iron-fortified Infant Formula 

(using glass or hard plastic bottles) . . . . . . . . . . . . . . . 29

Figure 4b: Preparation Checklist for Standard Liquid

Concentrated Iron-fortified Infant Formula 

(using glass or hard plastic bottles) . . . . . . . . . . . . . . . 30

Figure 4c: Preparation Checklist for Standard 

Powdered Iron-Fortified Infant Formula 

(using glass or hard plastic bottles) . . . . . . . . . . . . . . . 31

5: HOW TO FEED A BABY USING A BOTTLE . . . . . . . . . . 33

Preparing for Feeding . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Signs of Hunger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Signs of Fullness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

How to Feed With a Bottle. . . . . . . . . . . . . . . . . . . . . . . . 34

Feed While Awake, Not Napping or Sleeping. . . . . . . . . . . 34

Burping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Drinking From a Cup . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Sleeping or Resting Position Before or After Feeding . . . . . 35

Figure 5: Tips on Feeding with a Bottle . . . . . . . . . . . . . . 38

C ontents
6 Feeding Infants

6: PREVENTING TOOTH DECAY. . . . . . . . . . . . . . . . . . . . 41

7: FEEDING SOLID FOODS . . . . . . . . . . . . . . . . . . . . . . . 43

Readiness for Solid Foods . . . . . . . . . . . . . . . . . . . . . . . . 43

Solid Foods and the Infant Meal Pattern . . . . . . . . . . . . . 43

Communication With Parents About Baby’s Eating. . . . . . 44

Food Allergy or Intolerance . . . . . . . . . . . . . . . . . . . . . . . 45

Babies with Delayed Development . . . . . . . . . . . . . . . . . . 45

Babies with Special Dietary Needs. . . . . . . . . . . . . . . . . . 46

Feeding Solid Foods Too Early. . . . . . . . . . . . . . . . . . . . . 46

Feeding Solid Foods Too Late . . . . . . . . . . . . . . . . . . . . . 46

Introducing New Foods . . . . . . . . . . . . . . . . . . . . . . . . . . 47

Iron-fortified Infant Cereal . . . . . . . . . . . . . . . . . . . . . . . 47

Vegetables and Fruits . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Meat and Meat Alternates . . . . . . . . . . . . . . . . . . . . . . . . 51

Bread and Crackers . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

Other Foods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

Use of Sweeteners and Sweetened Foods . . . . . . . . . . . . . 55

Figure 6: Basic Principles for Feeding Solid Foods . . . . . . 56

Figure 7: Good Habits Start Early . . . . . . . . . . . . . . . . . 58

Figure 8: How the Infant Meal Pattern Corresponds 

with Food Textures and Feeding Styles. . . . . . . . . . . . . 59

8: DRINKING FROM A CUP . . . . . . . . . . . . . . . . . . . . . . . 61

Weaning From a Bottle . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Breastmilk or Formula from a Cup . . . . . . . . . . . . . . . . . 61

Fruit Juice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Other Beverages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Whole Cow’s Milk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

Reduced-Fat and Fat-Free (Skim) Cow’s Milk . . . . . . . . . . 63

Other Milks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

9: CHOKING PREVENTION. . . . . . . . . . . . . . . . . . . . . . . . 65

Preventing Choking When Serving Foods . . . . . . . . . . . . . 65

Feeding and Eating Behaviors to Avoid . . . . . . . . . . . . . . 65

Acceptable Finger Foods . . . . . . . . . . . . . . . . . . . . . . . . . 66

Foods to Avoid That Can Cause Choking . . . . . . . . . . . . . 66

Food Preparation Techniques to Lower Choking Risk . . . . 67

Figure 9: You Can Help Prevent Choking . . . . . . . . . . . . 69

10: SANITARY FOOD PREPARATION AND 

SAFE FOOD HANDLING . . . . . . . . . . . . . . . . . . . . . . . 71

Hand Washing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

If a Caregiver Has an Illness or Infected Injury . . . . . . . . . 72

Food Preparation Areas Are Not For Diaper Changing. . . . 72
A Guide for Use in the Child Nutrition Programs 7

Cleaning and Sanitizing Food Preparation Areas, 

Equipment, Feeding Dishes and Utensils, 

and Dining Areas . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Clothing of Caregiver Involved in Food Preparation or

Handling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

Refrigerator and Freezer Temperature . . . . . . . . . . . . . . . 74

Reducing Lead Exposure from Food. . . . . . . . . . . . . . . . . 74

Figure 10: Hand Washing Tips . . . . . . . . . . . . . . . . . . . . 76

11: COMMERCIALLY PREPARED BABY FOOD . . . . . . . . . 79

Purchasing Baby Food . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Serving Baby Food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Storing Baby Food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

Figure 11: Using Commercially Prepared Baby Food . . . . 81

12: HOME-PREPARED BABY FOOD. . . . . . . . . . . . . . . . . 83

Equipment for Preparing Baby Food . . . . . . . . . . . . . . . . 83

Preparing Food. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

Vegetables and Fruits . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

Meats, Poultry, Fish, and Milk Products . . . . . . . . . . . . . 85

Home-Prepared Eggs . . . . . . . . . . . . . . . . . . . . . . . . . . . 88

Dry Beans or Dry Peas . . . . . . . . . . . . . . . . . . . . . . . . . . 88

Grain Products. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

Serving, Storing, and Reheating Home-Prepared 

Baby Foods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

Figure 12: Using Home-Prepared Baby Foods . . . . . . . . . 91

BIBLIOGRAPHY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

RESOURCES ON INFANT NUTRITION, 

FOOD SAFETY, AND RELATED TOPICS . . . . . . . . . . . 97

ACKNOWLEDGMENTS . . . . . . . . . . . . . . . . . . . . . . . . . 101

C 

ONTENTS
8 Feeding Infants
A Guide for Use in the Child Nutrition Programs 9

1 Introduction

Good nutrition is essential to the rapid growth and

development that occurs during a baby’s first year.

Providing babies with the right foods will promote

good health and give them the opportunity to enjoy new

tastes and textures as they establish good eating habits.

Also, feeding can help babies establish warm relationships

with their parents and caregivers. Positive and supportive

feeding techniques are essential in allowing babies to eat

well and to develop healthy attitudes toward themselves and

others.

During the first year, babies’ mouths develop from being

able only to suck and swallow to being able to chew. Their

digestive tracts mature from being able to take in only 

liquids, such as breastmilk or formula, to being able to 

receive a wide variety of foods. And at the same time, they

progress from needing to be fed toward feeding themselves.

As babies continually mature, their food and feeding 

patterns must continue to change.

This guide will help you appropriately feed the babies in

your care as they change and develop. It answers some of

the common questions on infant development, nutrition for

babies, feeding practices, food preparation, safe food 

handling, and choking prevention. 

The parents will also give you important information to

help you in feeding their babies. You should communicate

frequently with them so that you can coordinate what

the babies are being fed at home with what you feed

them while in your care. In this way you can assure the

best care for the babies. 
10 Feeding Infants
A Guide for Use in the Child Nutrition Programs 11

baby’s developmental readiness determines which foods

should be fed, what texture the foods should be, and which

feeding styles to use. All babies develop at their own rate.

Although age and size often correspond with developmental readiness, these should not be used as sole considerations for deciding

what and how to feed babies. It is important to be aware of babies

rapidly developing mouth patterns and hand and body control so

that you know the appropriate food and texture to serve them and

the appropriate feeding style to use at each stage of their development, as shown in Figures 1 and 2.

Figure 1 summarizes the development of a baby’s mouth patterns

and hand and body control and how these affect both the baby’s

ability to eat foods of different textures and how the food is fed.

The ability of newborn babies to only suck and swallow liquids is

due to their limited level of development and the way their mouths

are designed. As babies mature, they are able to begin learning to

eat infant cereals and strained solid foods from a spoon. Eventually

they are able to feed themselves small pieces of food by hand and

later by spoon. 

The rate at which each baby progresses to each new food texture

and feeding style is determined by the baby’s own skills and 

attitudes. Some babies are cautious, others venturesome. Babies

always do better if they are supported in progressing at their own

rate. As shown in Figure 1, there is an overlap of ages to allow for

differences in development.

Figure 1 describes different reflexes involved in feeding and eating.

Some of these reflexes are defined as follows:

• Rooting reflex—When a baby’s mouth, lips, cheek, or chin are

touched by an object, the head and mouth turn towards the 

object and the baby opens its mouth. This reflex allows a baby to

seek out and grasp a nipple.

• Suck/swallow reflex—After opening the mouth when baby’s lips

and mouth area are touched, suckling or sucking movements 

begin. As liquid moves into the mouth, the tongue moves it to

the back of the mouth for swallowing.

• Tongue thrust reflex—When the lips are touched, the baby’s

tongue moves out of the mouth. This reflex allows for feeding

from the breast or bottle but not from a spoon or cup.

• Gag reflex—When an object, such as a spoon or solid food, is

placed way back in the mouth, the object is quickly moved back

out of the mouth on the tongue. This reflex is one reason for

waiting until a baby is 4 to 6 months old to feed solid foods.

These reflexes may be stronger or weaker, or last longer than 

normal, in babies who are delayed in their development.

Infant Development 2 & Feeding Skills

A
12 Feeding Infants

Birth through 5

months

4 months through 

6 months

5 months through 

9 months

8 months through 

11 months

10 months 

through 

12 months

Figure 1 

Sequence of Infant Development and Feeding Skills 

in Normal, Healthy Full-Term Infants*

DEVELOPMENTAL SKILLS

*Developmental stages may vary with individual babies. See the Bibliography, page 93, for references used to develop this chart.

• Suck/swallow reflex

• Tongue thrust reflex

• Rooting reflex

• Gag reflex

• Draws in upper or lower

lip as spoon is removed

from mouth

• Up-and-down munching 

movement 

• Can transfer food from

front to back of tongue

to swallow

• Tongue thrust and rooting

reflexes begin to disappear

• Gag reflex diminishes

• Opens mouth when sees

spoon approaching

• Begins to control the position of food in the

mouth

• Up-and-down munching

movement

• Positions food between

jaws for chewing

• Moves food from side-toside in mouth

• Begins to curve lips

around rim of cup

• Begins to chew in rotary 

pattern (diagonal movement of the jaw as food 

is moved to the side or 

center of the mouth)

• Rotary chewing (diagonal

movement of the jaw as

food is moved to the

side or center of the

mouth)

• Poor control of head,

neck, trunk

• Brings hands to mouth

around 3 months

• Sits with support

• Good head control

• Uses whole hand to

grasp objects (palmer

grasp)

• Begins to sit alone 

unsupported

• Follows food with eyes

• Begins to use thumb and

index finger to pick up

objects (pincer grasp)

• Sits alone easily

• Transfers objects from

hand to mouth

• Begins to put spoon in

mouth

• Begins to hold cup

• Good eye-hand-mouth 

coordination

• Swallows liquids but

pushes most solid objects from the mouth

• Takes in a spoonful of

pureed or strained food

and swallows it without

choking

• Drinks small amounts

from cup when held by

another person, with

spilling

• Begins to eat mashed

foods

• Eats from a spoon easily

• Drinks from a cup with

some spilling

• Begins to feed self with

hands

• Begins to eat ground or 

finely chopped food

and small pieces of soft

food

• Begins to experiment

with spoon but prefers

to feed self with hands

• Drinks from a cup with 

less spilling

• Eats chopped food and

small pieces of soft,

cooked table food

• Begins self-spoon feeding with help

Baby’s Approx. Age Mouth Patterns Hand and Body Skills Feeding Skills or Abilities
A Guide for Use in the Child Nutrition Programs 13

Birth through 3 Months

4 months through 7 months

8 months through

11 months

• Only suck and swallow

• Draw in upper or lower lip as

spoon is removed from mouth

• Move tongue up and down

• Sit up with support

• Swallow semisolid foods without 

choking

• Open the mouth when they

see food

• Drink from a cup with help, 

with spilling

• Move tongue from side to side

• Begin spoon feeding themselves 

with help

• Begin to chew and have some

teeth

• Begin to hold food and use their 

fingers to feed themselves

• Drink from a cup with help, with 

less spilling

LIQUIDS ONLY

• Breastmilk

• Infant formula with iron

ADD SEMISOLID FOODS

• Infant cereal with iron

• Strained vegetables*

• Strained fruit*

*may be started later in the age

range

ADD MODIFIED TABLE FOODS

• Mashed or diced soft fruit

• Mashed or soft cooked vegetables

• Mashed egg yolk

• Strained meat/poultry

• Mashed cooked beans or peas

• Cottage cheese, yogurt, or

cheese strips

• Pieces of soft bread

• Crackers

• Breastmilk, iron-fortified formula,

or fruit juice in a cup

Figure 2 

Feeding the Baby For the First Year 

BABIES AGE: WHEN BABIES CAN: SERVE:

Babies grow quickly during the first year of

life and make many changes in the types of

foods and textures of foods they are able to

eat. As babies grow and develop, watch for

the following signs which will tell you when

they are ready for a new food.
14 Feeding Infants
A Guide for Use in the Child Nutrition Programs 15

reastmilk is the best food for babies. It is the only food a

baby needs during the first 4 to 6 months of life, and it

continues to be an important source of nutrients for the

first year. Breastmilk contains the right balance of nutrients to

meet the baby’s needs and changes over time. Breastmilk is easy

to digest and contains natural substances that help protect 

babies from infection and food allergies. Babies fed breastmilk

tend to have fewer illnesses. Breastfeeding also benefits the

mother by:

— helping her body recover from pregnancy and get back into

shape more quickly, 

— saving her time and money, and

— possibly protecting her against breast cancer.

By causing certain hormones to be released into the mother’s

body, breastfeeding brings feelings of relaxation and well-being 

to the mother. Breastfeeding also builds a special closeness 

between a mother and her baby.

Consult with your State agency for more information 

on reimbursement for meals containing breastmilk. For more 

information on how to help breastfeeding mothers with babies in

child care, refer to FNS’ “Breastfed Babies Welcome Here” packet.

This packet includes an attractive poster, a guide for child care

providers, and a mother’s guide. This packet is available, at a

small cost, from:

NFSMI

University of Mississippi

Attn: Sales Department

P.O. Drawer 188

University, MS 38677-0188

Phone: 1-800-321-3054

Website: http://www.olemiss.edu/depts/nfsmi

Supporting Breastfeeding Mothers

Encourage breastfeeding mothers to continue breastfeeding

when returning to work or school. Babies in child care who are

breastfed may be:

• breastfed by their mothers during visits to the facility,

• bottle-fed their mother’s expressed breastmilk by the caregiver,

and/or

3 Feeding the Breastfed Baby

B
16 Feeding Infants

• bottle-fed the type of infant formula prescribed by the baby’s

doctor while at child care (caregivers should feed formula only

if the mother requests its use with her baby).

To help the mother breastfeed successfully:

• If she wishes to breastfeed her baby when she comes to the 

facility, offer or provide her a:

— Quiet, comfortable, and private place to breastfeed (this

helps her milk to letdown),

— Place to wash her hands, 

— Pillow to support her baby on her lap while nursing,

— Nursing stool or stepstool for her feet so she doesn’t have to

strain her back while nursing, and

— Glass of water or other liquid to help her to get enough fluid

for nursing.

• Encourage her to get the baby used to being fed her expressed

breastmilk by another person before the baby starts in child

care.

• Discuss with her the baby’s usual feeding schedule and

whether she wants you to time the baby’s last feeding so that

the baby is hungry and ready to breastfeed when she arrives.

Ask her to leave her schedule with you and ask her to call if

she is planning to miss a feeding or is going to be late. 

• Encourage her to provide a back-up supply of frozen or 

refrigerated expressed breastmilk in case the baby needs to 

eat more often than usual or her visit is delayed.

• Share with her information about other places in the 

community that can answer her questions and concerns 

about breastfeeding.

• Give her a copy of the “Mother’s Guide” from the “Breastfed

Babies Welcome Here” packet and discuss it with her.

Use of Breastmilk for Babies Over 12 Months of

Age 

Some parents may request that the caregiver continue feeding

their babies breastmilk after 12 months of age. Continue to

serve babies their mother’s milk as long as the mother is able

and wishes to provide it. Mothers who wish to continue providing breastmilk for their babies older than 12 months of age can

do so without having to submit a medical statement. Breastmilk

is a substitute for cow’s milk in the meal pattern for children. 
A Guide for Use in the Child Nutrition Programs 17

Guidelines on Storing, Handling, and Feeding

Breastmilk

Breastmilk needs to be stored and handled safely to keep it

from spoiling. Follow the specific health and safety regulations

that are required by your State and local authorities for safe food

handling. General tips for handling breastmilk follow.

Handling of Breastmilk Before Arriving at the

Facility

Ask mothers to:

• Store their breastmilk in the refrigerator or freezer right after

they express it and label the bottles with:

— the baby’s name, and

— the date and time the breastmilk was collected.

• Store the milk in hard plastic bottles if possible because these

are unbreakable.

• Fill the bottles with the amount of breastmilk the baby usually

drinks at one feeding. Some babies may consume less than 

4 ounces at a feeding. The mother can freeze some bottles with

1 to 2 ounces of breastmilk for times when the baby wants

some extra breastmilk.

• Carry bottles of fresh or frozen breastmilk to the facility in a

cooler with an ice pack to keep the milk at a cold temperature.

Handling and Storing Breastmilk at the Facility

• Breastmilk from a mother is designed specially to meet the

needs of her baby. If more than one baby or child is drinking

from bottles, make sure that each bottle is clearly labeled with

the respective baby’s or child’s name and never accept an 

unlabeled bottle from a parent. Do not use unlabeled bottles

that have been accidentally accepted. 

• Refrigerate bottles immediately when they arrive and until

ready to use. 

• Use bottles of breastmilk only for the baby for whom they are

intended.

• To prevent spoiling, do not allow bottles of breastmilk to stand

at room temperature. 

3 FEEDING THE BREASTFED BABY
18 Feeding Infants

• Use refrigerated bottles of fresh breastmilk, kept at 

40° Fahrenheit or below, within 48 hours from the time 

they were collected. Throw out unused breastmilk if not

used within 48 hours. Although some suggest that fresh 

breastmilk can be stored for longer than 48 hours, the 

48-hour period assures safety.

• Breastmilk can be stored in a freezer (with a separate door

from the refrigerator), for up to 3 months from when it was

collected. Freezer temperature should be 0° Fahrenheit or

below. If the freezer is not working or if there is a power

failure, frozen milk may thaw out and become spoiled before

3 months. See page 74 on checking the temperature of

your freezer.

• Rotate frozen breastmilk, using the oldest milk first.

• Protect breastmilk in an air-tight container (hard plastic

bottles are recommended) while in the freezer. Once the

breastmilk is removed from the freezer and thawed, 

refrigerate it at 40° Fahrenheit or below and use it within 

24 hours; do not refreeze it.

• Do not save and reuse breastmilk leftover from bottles.

• Wash skin on which breastmilk has spilled with soap and

water immediately.

Preparing and Using Stored Breastmilk for

Feeding

• Wash your hands, as described on page 71.

• Thaw a bottle of frozen breastmilk in the refrigerator or hold

it under running cold water. Thaw only as much frozen

breastmilk as you think a baby will need for a feeding.

• Do not thaw frozen breastmilk at room temperature, by

heating on a stove, or in a microwave. Liquid may become

very hot when microwaved even though the bottle feels cool.

The hot liquid could seriously burn babies. Also, heating

damages special substances in breastmilk that protect

baby’s health.

• If breastmilk has a bad odor after thawing, it may have

spoiled and should be thrown out.

• Once thawed, do not refreeze breastmilk.

• For those babies who prefer a warm bottle, hold the bottle

under running warm (not hot) water immediately before
A Guide for Use in the Child Nutrition Programs 19

feeding the baby. Warm only as much breastmilk as you

think a baby will need for a feeding. Feed breastmilk 

immediately after warming.

• Shake the bottle of breastmilk before feeding the baby 

because breastmilk separates into two layers when it is

stored.

• After a feeding, throw out any unused breastmilk left in 

a bottle and wash the bottle with soap and hot water 

immediately.

• Follow the baby’s lead in the amount of breastmilk to feed.

Feed the baby until he or she is no longer hungry.

Cleaning Bottles

• Clean and sanitize bottles and their parts before reusing or

filling with new expressed breastmilk as shown in Figure 4a,

Steps 1-4 on page 29 in Chapter 4 on Preparing Formula.

Throw out disposable nursing bags, if used, after each use.

See Figure 3 on how to store, handle, and feed breastmilk, 

on pages 20-21.

3 FEEDING THE BREASTFED BABY
20 Feeding Infants

Breastmilk needs to be stored and handled safely to keep it from spoiling. Follow health and safety 

regulations required by your State and local authorities for safe food handling. Here are general tips for 

handling breastmilk:

Figure 3 

How to Store, Handle, and Feed Breastmilk

Baby Gabe

8/14/98

4:30 p.m. Baby Tony

8/2/98

8:30 a.m.

Baby Jose

8/12/98

10:30 a.m. Baby Jane

8/12/98

2:30 p.m.

Baby Eva

8/19/98

12:00 p.m.

Handling of Breastmilk Before Arriving at the

Facility

Ask mothers to:

• Store their breastmilk in the refrigerator or freezer right after they collect it

and label the bottles with:

—the baby’s name, and

—the date and time the breastmilk was collected.

• Store the milk in hard plastic bottles if possible because they do not break.

• Fill the bottles with the amount of breastmilk the baby usually drinks at one

feeding. The mother can freeze some bottles with 1 to 2 ounces of 

breastmilk for times when the baby wants some extra breastmilk.

• Carry bottles of fresh or frozen breastmilk to the facility in a cooler with an

ice pack to keep the milk at a cold temperature.

Handling and Storing Breastmilk at the Facility

• Breastmilk from a mother is designed specially to meet the needs of her

baby. Make sure that each bottle is clearly labeled with the correct baby’s

or child’s name. Never accept an unlabeled bottle from a parent.

• Refrigerate bottles immediately when they arrive and until ready to use.

• Use bottles of breastmilk only for the baby for whom they are intended.

• To prevent spoiling, do not allow bottles of breastmilk to stand at room

temperature.

• Use refrigerated bottles of fresh breastmilk, kept at 40° Fahrenheit or 

below, within 48 hours from the time they were collected. Throw out 

unused breastmilk if not used within 48 hours.

• Breastmilk can be stored in a freezer (with a separate door from the 

refrigerator), for up to 3 months from when it was collected. Freezer 

temperature should be 0° Fahrenheit or below. If the freezer is not 

working or if there is a power failure, frozen milk may thaw out and 

become spoiled before 3 months. Rotate frozen breastmilk, using the 

oldest milk first.

• Protect breastmilk in an air-tight container (hard plastic bottle) while in 

the freezer. Once the breastmilk is removed from the freezer and thawed,

refrigerate it at 40° Fahrenheit or below and use it within 24 hours; do not

refreeze it.

• Do not save and reuse breastmilk leftover from bottles.

• Wash skin on which breastmilk has spilled with soap and water 

immediately.

Preparing and Using Stored Breastmilk for Feeding

• Wash your hands well (see Figure 10 on “Hand Washing Tips”).

• Thaw a bottle of frozen breastmilk in the refrigerator or hold it under 

running cold water. Thaw only as much frozen breastmilk as you think a

baby will need for a feeding.

• Do not thaw frozen breastmilk at room temperature, by heating on a stove,

or in a microwave. Liquid may become very hot when microwaved even

though the bottle feels cool. The hot liquid could seriously burn babies.

Also, heating damages special substances in breastmilk that protect baby’s

health.

Thomas

4/10
A Guide for Use in the Child Nutrition Programs 21

• If breastmilk has a bad odor after thawing, it may have spoiled and should

be thrown out.

• Once thawed, do not refreeze breastmilk.

• For those babies who prefer a warm bottle, hold the bottle under running

warm (not hot) water immediately before feeding the baby. Warm only as

much breastmilk as you think a baby will need for a feeding. Feed 

breastmilk immediately after warming.

• Shake the bottle of breastmilk before feeding because breastmilk separates

into two layers when it is stored.

• Follow the baby’s lead in the amount of breastmilk to feed. Feed the baby

until he or she is no longer hungry.

• After a feeding, throw out any unused breastmilk left in a bottle and wash

the bottle with soap and hot water immediately.

• Clean and sanitize bottles and their parts before reusing or filling with new

expressed breastmilk (See Figure 4a, Steps 1-4 for more information).

Throw out disposable nursing bags, if used, after each use.

IMPORTANT STEPS TO PREVENT BABIES OR CHILDREN FROM

DRINKING ANOTHER CHILD’S BOTTLE OF EXPRESSED BREASTMILK:

• Make sure that parents clearly label each child’s bottle of breastmilk 

with the child’s name and date and time expressed. Only use a bottle labeled for the correct child.

• Never accept an unlabeled bottle from a parent.

• Do not use any unlabeled bottles that have been accidentally accepted.

• Do not leave any bottles of expressed breastmilk sitting around so that

other babies or children could accidentally drink them.

• After a feeding, throw out any unused breastmilk left in a bottle and wash

the bottle with soap and hot water immediately. Do not leave the bottle

anywhere where other children can reach it.

• Do not let babies or children carry around bottles (or cups) of expressed

breastmilk. If a child drops a bottle, pick it up immediately, place it out of

reach of other children, and clean up any spilled breastmilk with soap

and water.

• At the end of the day, send all bottles that contained expressed 

breastmilk home with the parent who brought the bottles. Never leave

used bottles sitting around.

• If a child has been mistakenly fed or has drunk from another child’s 

bottle of expressed breastmilk, follow the newest guidance from the

Centers for Disease Control and Prevention (CDC) for steps to take

(check CDC’s web site at http://www.cdc.gov).

Recent guidance from CDC on safe handling of breastmilk is in:

“The ABCs of Safe and Healthy Child Care: A Handbook for Child Care

Providers,” Department of Health and Human Services, U.S. Public Health

Service, Centers for Disease Control and Prevention, 1996. This 

publication can be downloaded through the above web site or obtained by

writing to:

Office of Health Communication

National Center for Infectious Diseases

Centers for Disease Control and Prevention

Mailstop C-14

1600 Clifton Road

Atlanta, GA 30333

Figure 3 (continued)

How to Store, Handle, and Feed Breastmilk
22 Feeding Infants
A Guide for Use in the Child Nutrition Programs 23

he decision about which infant formula to feed a baby is

one for the baby’s doctor and parents to make together.

Thus, consult with parents on the brand of formula 

prescribed by the baby’s doctor for each baby in your care.

Caregivers must offer an iron-fortified infant formula in order to

obtain reimbursement unless breastmilk is provided. The baby’s

parent can decide to decline the infant formula offered and bring

formula from home. A caregiver should ask the parent what kind

of formula is being sent to the facility in home-prepared bottles

and make sure the bottles are labeled with the baby’s name, and

the date and time the formula was prepared.

Iron-fortified infant formula is required to meet the meal 

pattern. In choosing iron-fortified formula, make sure the 

formula label says “with iron” or “iron-fortified.” Soy-based, 

lactose-free milk-based, and specialized formulas are prescribed

for a baby by a doctor and are used specifically for a medical

problem. When one of these formulas has been prescribed, only

that type of formula should be fed to the baby. If a baby’s doctor

indicates that a baby should be fed a special formula or a 

low-iron formula, a written statement from a doctor or other 

recognized medical authority must be on file at the facility in 

order for the formula to be reimbursable. The statement should

specify the medical or other special dietary need that requires a

different formula, the formula to be omitted, and the formula

that may be substituted. See below for information on different

types of formula.

Iron-Fortified Infant Formulas

Iron-fortified infant formula is the best food for the baby when

he or she is not being breastfed or when a supplement to 

breastfeeding is needed. Iron-fortified infant formula is specially

formulated to have the right balance of nutrients and to be easily

digested by the baby. Iron is a very important nutrient during

the baby’s first year and serving iron-fortified infant formula is

the easiest way to ensure adequate intake of iron. Some people

may avoid iron-fortified formula because they think that the iron

causes stomach aches and intestinal problems, but studies show

that iron-fortified formula does not cause these symptoms.

T

4 Feeding Infant Formula
24 Feeding Infants

Low-Iron Infant Formulas

Formula labels that say “low iron” do not meet the meal 

pattern. These formulas may be served only as a dietary 

substitution if an infant is unable to consume iron-fortified infant

formula because of medical or other special dietary needs. These

substitutions can be made only when supported by a statement

from a recognized medical authority that indicates the recommended infant formula.

Follow-up Formulas

Follow-up formulas are designed for older babies and toddlers

who are consuming solid foods and are not intended for dietary

use as a sole source of food for babies. A statement from a 

recognized medical authority may be required under certain 

circumstances in order to serve these formulas to infants.

Exempt Infant Formulas

Exempt infant formulas are special infant formulas that are 

intended for use by babies who have an inborn error of 

metabolism or low birth weight or who otherwise have an 

unusual medical or dietary problem. Many of these formulas 

are iron-fortified, but still require a statement from a recognized

medical authority for meals to be reimbursed.

Contact the State agency if you have questions about the types

of infant formula that are approved or need a medical statement

to be served in the Infant Meal Pattern.

Other Milks

The following milks are not recommended for babies less than

12 months of age and are not reimbursable in the Infant Meal

Pattern: 

• cow’s milk,

• evaporated cow’s milk or home-prepared evaporated cow’s milk

formula, 

• sweetened condensed milk, 

• goat’s milk, 

• soy milk (usually called soy beverage), or 

• imitation milks, including those made from rice or nuts (such

as almonds) or nondairy creamer. 

These milks do not contain the right amounts of all the 

nutrients that babies need and can harm a baby’s health.

Breastmilk is the most ideal for a baby and iron-fortified infant

formula is the best substitute for breastmilk.
A Guide for Use in the Child Nutrition Programs 25

Water Used to Mix Concentrated or Powdered

Infant Formula

If concentrated or powdered infant formula is prepared by the

caregiver, he or she must ensure that the water used to mix the

formula is from a source approved by the local health department.

If there is doubt, the local health department should be asked to

test the water to see if it is safe and does not contain anything that

might harm a baby or child, such as lead, bacteria, nitrate, 

pesticides, or other chemicals. If the water is not safe for a baby 

to drink, the local health department should recommend a safe

source of water to use or ready-to-feed formula can be used.

Always sterilize the water used to mix with concentrated or 

powdered formula by bringing cold water to a very bubbly boil,

boiling it for 1 to 2 minutes, and then allowing it to cool. Excessive

boiling (over 5 minutes) is not recommended because it can 

concentrate lead and nitrate in the water. If tap water is used,

collect only cold tap water for boiling by letting the cold tap run

for 2 minutes and then collect the water; this procedure tends to

reduce the amount of lead in the water should the pipes contain

lead.

Use of Infant Formula for Babies Over 12 Months

of Age

Some parents may request that the caregiver continue feeding

their babies infant formula after 12 months of age. A transition

time of 1 month (from the date an infant turns 12 months to 

13 months of age) is permitted during which a medical statement

is not required. If a parent requests that the caregiver continue to

serve infant formula beyond the age of 13 months, a statement

from a recognized medical authority needs to be on file.

Purchasing, Storage, Sanitary Preparation, and

Handling of Infant Formula

Infant formula needs to be purchased, stored, prepared, and

handled properly in order to be safe for a baby. Follow the 

specific health and safety regulations that are required by your

State and local authorities for safe food handling. General tips 

for use of infant formula follow. See Figures 4a, 4b, and 4c for

preparation checklists on how to prepare standard ready-to-feed,

liquid concentrate, and powdered iron-fortified infant formula 

using sanitary methods.

Purchasing Cans of Formula

• Ready-to-feed formula is the most convenient and sanitary. 

• If you are preparing liquid concentrate or dry powdered formula,

it must be mixed very carefully according to directions on the

container (Figures 4a, 4b, and 4c include preparation checklists

for these standard, not special or exempt, infant formulas).

FEEDING INFANT FORMULA 4
26 Feeding Infants

Adding too little water to formula puts a burden on the baby’s

kidneys and digestive system and may lead to dehydration.

Adding too much water to formula may interfere with the

baby’s proper growth because it does not contain adequate

calories and nutrients and can cause water intoxication.

• Instructions on using special formulas should be provided by

the baby’s doctor.

• Make sure the label says “with iron” or “iron-fortified.”

• Do not purchase cans of infant formula that have dents,

bulges, pinched tops or bottoms, puffed ends, leaks, or rust

spots. The formula in such cans may be unsafe.

• Check the formula’s expiration date on the lid or label to make

sure the product is not too old. If the expiration date has passed,

the nutrient quality of the formula may have deteriorated and you

should not select the can.

Storing Cans of Formula

• Before using stored formula, check the expiration date on the

lid or label to make sure the product is not too old. If the 

expiration date has passed, throw out the can.

• Store unopened cans of infant formula in a cool, dry indoor place—

not in a refrigerator or in vehicles, garages, or outdoors (in these

places, the cans are exposed to water and temperature extremes

which can rust the can or affect the quality of the formula).

Handling of Formula Prepared By Parents

If parents prepare formula themselves and bring it to the

facility, ask them to:

• Label the bottles with:

• Store the formula in hard plastic bottles if possible because

these are unbreakable.

• Fill the bottles with the amount of formula the baby usually

drinks at one feeding. Some bottles with 1 to 2 ounces of 

formula can be prepared for times when the baby wants some

extra formula during the day.

• Carry bottles of formula to the facility in a cooler with an

ice pack to keep it at a cold temperature.

Preparing Formula

• Clean and sanitize your workspace (see page 73).

• Wash your hands with soap and warm water (see page 71).

Baby Gabe

8/14/98

4:30 p.m. Baby Tony

8/2/98

8:30 a.m.

Baby Jose

8/12/98

10:30 a.m. Baby Jane

8/12/98

2:30 p.m.

Baby Eva

8/19/98

12:00 p.m.

–the baby’s name

–the date and time the formula

was prepared. {
A Guide for Use in the Child Nutrition Programs 27

• Wash all equipment (nipples, bottles, rings, and caps) in hot soapy

water and scrub, using bottle and nipple brushes.

• Rinse all equipment well in hot water.

• Disinfect nipples, bottles, rings, and caps by boiling for 5 minutes

in a pot with enough water to cover, then remove with sanitized

tongs, let cool, and air dry.

• If disposable plastic bottle liners are used:

— Throw out the bag after one use; and

— Clean and sterilize the nipples, rings, and caps, as described

above.

• Before opening a formula can, wash can lid with soap and clean

water and rinse to remove dirt that could contaminate the 

formula. Before using, wash the can opener with soap and hot

water.

• Prepare the formula properly according to directions on the 

formula container. See Figures 4a, 4b, and 4c for a checklist of 

instructions for preparing standard ready-to-feed, liquid 

concentrated, or powdered iron-fortified infant formula.

• Put a clean nipple right side up on each bottle and cover with a

nipple cap.

• Do not put cereal or other food in a bottle because this interferes

with the baby’s natural ability to obtain the right amount of 

calories, forces the baby to eat cereal, and may cause the baby to

choke. Feeding cereal does not affect baby’s ability to sleep.

Storing Bottles of Formula

• Make sure the bottles are labeled with the baby’s name and the

date and time the formula was prepared. Use bottles of formula

only for the baby for which they are intended.

• Refrigerate prepared bottles until ready to use and use them within 48 hours from the time they were prepared. Store in the back

of the refrigerator (colder area).

• To prevent spoiling, do not allow prepared bottles of formula to stand

at room temperature. Do not feed a baby a bottle left out of the 

refrigerator for 1 hour or longer. Throw out prepared formula not

used within 48 hours. 

• Opened cans of formula should be covered, refrigerated, and used

within 48 hours. Throw out formula that is not used within 

48 hours.

• Do not freeze infant formula.

• Throw out any unused formula left in a bottle after a feeding 

and rinse the bottle in cool water to remove formula. Do not

reuse a bottle containing formula after the baby has fed from it.

FEEDING INFANT FORMULA 4
28 Feeding Infants

The mixture of formula with baby’s saliva promotes the growth

of disease-causing germs.

• Clean and sanitize bottles and their parts before reusing them,

as described in figures 4a, 4b, and 4c.

Warming Infant Formula

• For babies who prefer a warm bottle, warm the bottle 

immediately before feeding by holding it under running warm

water. Warm only as much formula as you think the baby will

need for a feeding.

• Always test the temperature of the liquid before feeding to

make sure it is not too hot or cold. Shake the bottle well and

test the temperature by squirting a couple of drops of the liquid

onto your wrist or back of your hand. The temperature is 

correct when it feels neither warm nor cold.

• Never use a microwave oven to heat the bottles—This is 

dangerous. Liquid may become very hot when microwaved

even though the bottle feels cool. The hot liquid could 

seriously burn babies. Covered bottles, especially vacuumsealed, metal-capped bottles of ready-to-feed formula, can 

explode when heated in a microwave.

Thomas

4/10
A Guide for Use in the Child Nutrition Programs 29

Refrigerate until feeding time. Use

within 48 hours. Do not leave

formula at room temperature.

To warm bottle, hold under running warm water. Do not microwave

bottles. If formula is left

in the can, cover and refrigerate open can until

needed. Use within 48

hours.

Figure 4a

Preparation Checklist for Standard Ready-to-Feed Iron-fortified

Infant Formula (using glass or hard plastic bottles)

1 Wash your hands, arms,

and under your nails,

very well with soap and

warm water. Rinse thoroughly. Clean and sanitize your workspace.

2

Squeeze clean water

through nipple holes to

be sure they are open.

3

4 Put the bottles, nipples, caps, and rings in

a pot and cover with water. Put the pot

over heat, bring to a boil, and boil

for 5 minutes. Remove with sanitized tongs, allow the items to cool,

and air dry.

5 Wash the top of the can

with soap and water

and rinse well to remove dirt. Wash the

can opener with soap

and hot water.

6 SHAKE CAN WELL and

then open the can.

Pour the amount of

ready-to-feed formula

for one feeding into a

clean bottle. Do not add

water or any other liquid.

8

9

10

11

If more than one bottle

is prepared, put a clean

nipple right side up on

each bottle and cover

with a nipple cap. Label

each bottle with the

baby’s name and the

date and time that it 

was prepared.

Attach nipple and cap

and SHAKE WELL. Feed

prepared formula immediately.

7

Baby Jane

8/12/98

2:30 p.m.

Baby Tony

8/11/98

4:30 p.m.

Baby Gabe

8/14/98

4:30 p.m. Baby Tony

8/2/98

8:30 a.m.

Baby Jose

8/12/98

10:30 a.m. Baby Jane

8/12/98

2:30 p.m.

Baby Eva

8/19/98

12:00 p.m.

Wash bottles and nipples, using bottle and

nipple brushes, and

caps, rings, and preparation utensils in hot

soapy water before using. Rinse thoroughly.

Throw out unused formula left in bottle after

feeding or which has

been unrefrigerated for

1 hour or more. Store

unopened cans in a cool,

dry indoor pantry shelf.

Use before the expiration date.
30 Feeding Infants

Figure 4b

Preparation Checklist for Standard Liquid Concentrated Ironfortified Infant Formula (using glass or hard plastic bottles)

If more than one bottle

is prepared, put a clean

nipple right side up on

each bottle and cover

with a nipple cap. Label

each bottle with the

baby’s name and the

date and time that it

was prepared.

1 Wash your hands, arms,

and under your nails, very

well with soap and warm

water. Rinse thoroughly.

Clean and sanitize your

workspace.

2 Wash bottles and nipples,

using bottle and nipple

brushes, and caps, rings,

and preparation utensils

in hot soapy water before

using. Rinse thoroughly.

Squeeze clean water

through nipple holes to

be sure they are open.

3

4 Put the bottles, nipples,

caps, and rings in a pot

and cover with water. Put

the pot over heat, bring

to a boil, and boil for 5

minutes. Remove with

sanitized tongs, allow the

items to cool, and air dry.

5 For formula, bring water to a very bubbly boil.

Keep boiling it for a minute or two, then let it cool.

Use this water to mix the formula. Use water from

a source approved by the local health

department. If tap water is used for

boiling, collect only

cold tap water 

allowed to run for 

2 minutes first.

6 Wash the top of the can

with soap and water and

rinse well to remove dirt.

Wash the can opener

with soap and hot water.

SHAKE CAN WELL and

then open the can.

8

9

10

11

12

Attach nipple and ring

to the bottle and SHAKE

WELL. Feed prepared

formula immediately. If

formula is left in the

can, cover and refrigerate can until needed.

Use within 48 hours.

Throw out unused formula left in bottle after feeding or which has been unrefrigerated for 1 hour or

more. Store unopened

cans in a cool, dry indoor

pantry shelf. Use before

the expiration date.

Pour needed amount of

formula into a clean bottle using ounce markings

to measure formula and

add an equal amount of

cooled boiled water.

Thus, if 4 oz. of formula is

poured into the bottle, 4

ounces of water should

also be added.

7

Baby Jane

8/12/98

2:30 p.m.

Baby Tony

8/11/98

4:30 p.m.

Baby Gabe

8/14/98

4:30 p.m. Baby Tony

8/2/98

8:30 a.m.

Baby Jose

8/12/98

10:30 a.m. Baby Jane

8/12/98

2:30 p.m.

Baby Eva

8/19/98

12:00 p.m.

BOIL COOL

Refrigerate until feeding

time. Use within 48

hours. Do not leave formula at room temperature. To warm bottle,

hold under running

warm water. Do not

microwave bottles.
A Guide for Use in the Child Nutrition Programs 31

Wash your hands, arms, and under

your nails, very well with soap and

warm water. Rinse thoroughly.

Clean and sanitize your workspace.

Figure 4c

Preparation Checklist for Standard Powdered Iron-fortified

Infant Formula (using glass or hard plastic bottles)

Wash bottles and nipples, using

bottle and nipple brushes, and

caps, rings, and preparation utensils

in hot soapy water before using.

Rinse thoroughly.

Squeeze clean water through nipple holes to be sure they are open.

Put the bottles, nipples, caps, and

rings in a pot and cover with water.

Put the pot over heat, bring to a

boil, and boil for 5 minutes.

Remove with sanitized tongs, allow

the items to cool, and air dry.

For formula, bring water to a very bubbly

boil. Keep it boiling for a minute or two,

then let it cool. Use this water to mix the

formula. Use water from a source approved by the local health 

department. If tap water is used

for boiling, collect only cold tap

water allowed to run for 

2 minutes first.

Remove plastic lid; wash lid with

soap and clean water and dry it.

Write date on outside of plastic lid.

Wash the top of the can with soap

and water, rinse well, and dry.

Wash the can opener with soap

and hot water. Open the can and

remove scoop. Make sure that the

scoop is totally dry before scooping out powdered formula. Only

use the scoop that comes with the

formula can.

If more than one bottle is prepared, put a clean nipple right

side up on each bottle and cover

with a nipple cap. Label each

bottle with the baby’s name and

the date and time that it was

prepared.

To be used again, the scoop

should be washed with soap and

hot water, rinsed thoroughly, and

allowed to air dry. When making

formula again, the scoop should

be totally dry before using it to

scoop powder out of the can.

Store unopened cans in a cool,

dry indoor pantry shelf. Use before the expiration date.

Attach nipple and ring to the bottle and SHAKE WELL. Feed prepared formula immediately.

Make sure that no water or other

liquid gets into the can of powder.

Cover opened can tightly and

store in a cool dry place (not in

the refrigerator). Use within 4

weeks after opening to assure

freshness.

For each 2 ounces of cooled boiled

water added to a clean bottle, carefully add 1 level scoop of powdered

formula. Thus, if 8 ounces of

water is poured into the bottle,

4 level scoops of formula

should be added.

Refrigerate until feeding time.

Use within 48 hours. Do not leave

formula at room temperature.

To warm bottle, hold under

running warm water.Do not

microwave bottles.

Throw out unused formula left in

bottle after feeding or which has

been unrefrigerated for 1 hour or

more.

1

2

3

4

5

6

7

8

9

10

11

12

13

Baby Jane

8/12/98

2:30 p.m.

Baby Tony

8/11/98

4:30 p.m.

Baby Gabe

8/14/98

4:30 p.m. Baby Tony

8/2/98

8:30 a.m.

Baby Jose

8/12/98

10:30 a.m. Baby Jane

8/12/98

2:30 p.m.

Baby Eva

8/19/98

12:00 p.m.

BOIL

COOL
32 Feeding Infants
A Guide for Use in the Child Nutrition Programs 33

nsure that bottle feeding is sanitary. See Chapter 3,

Feeding the Breastfed Baby, on the storage, handling, and

feeding of breastmilk, and Chapter 4, Feeding Infant

Formula, on the purchasing, storage, sanitary preparation, and

handling of infant formula. Basic principles on feeding a baby

using a bottle follow below and in Figure 5, page 38.

Preparing for Feeding

These steps are recommended when preparing for feeding:

• Wash your hands well with soap and warm water before 

feeding (see page 71 on hand washing).

• Gently and slowly calm and position the baby to get ready for

feeding.

• Feed in a smooth and continuous fashion following the baby’s

lead on when to feed, how long to feed, and how much to feed.

Avoid disrupting the feeding with unnecessary burping, wiping,

juggling, and arranging.

• Make sure that if you hold the bottle upside down, falling

drops from the nipple hole follow each other closely but do not

make a stream (a stream means the nipple hole is too big).

Also, adjust the nipple ring so that some air can get into the

bottle to avoid a collapsing nipple.

Signs of Hunger

Feed a baby when he or she seems to be hungry, unless the

parent provides written instructions indicating that the baby

should be on a feeding schedule for medical reasons. A baby

who is hungry may:

• wake and toss,

• suck on a fist,

• cry or fuss, or

• look like he or she is going to cry.

Respond to the early signs of hunger. Do not wait until the baby

is upset and crying hard from hunger.

Signs of Fullness

Continue to feed a baby until he or she indicates fullness.

Signs of fullness include:

• Sealing the lips together,

• A decrease in sucking,

• Spitting out the nipple,

E

5 How to Feed a Baby Using a Bottle
34 Feeding Infants

• Turning away from the bottle, or

• Pushing the bottle away.

Some babies may eat less than the portions offered if they

are not hungry. Never force a baby to finish what is in the

bottle. Babies are the best judge of how much they need.

Babies may want to eat less if they are not feeling well and

more if they are going through a growth spurt.

How to Feed With a Bottle

When feeding a bottle, remember to:

• Hold the baby during feedings in the cradle of your arm,

partially upright. This makes baby feel secure, helps you 

to read baby’s cues, and helps to prevent the baby from

choking during feeding. When the baby’s head is a little

higher than the rest of the body this prevents milk from

backing up in the inner ear and causing an ear infection.

Tip the bottle so that milk fills the nipple and air does not

get in.

• Hold the bottle during feeding. Do not prop bottles for a

baby. Propping means a young baby is given a bottle to

drink by itself and the bottle is propped up (with a pillow,

for example) so that it can flow into the baby’s mouth.

Propping a bottle can:

— cause choking and suffocation, 

— possibly cause ear infections and baby bottle tooth 

decay, and 

— deprive the baby of important cuddling and human 

contact.

Older babies may be fed a bottle while sitting up in a high

chair. Always hold babies who cannot sit while bottle 

feeding.

Do not allow a baby to carry a bottle around. Babies who

carry around a bottle can develop tooth decay, may drink too

much liquid, and may share their bottles with other babies.

The liquid in a bottle carried around for a long time can spoil.

Carrying of glass bottles can be dangerous if the baby drops

the bottle and it breaks.

Feed While Awake, Not Napping or Sleeping

Feed a baby while he or she is awake. Do not offer the

bottle in bed at nap or sleep time. Allowing a baby to sleep
A Guide for Use in the Child Nutrition Programs 35

5 

HOW TO FEED A BABY USING A BOTTLE

in a crib with a bottle can lead to choking, ear infections,

tooth decay or other dental problems, and problems with

speech later on.

Burping

Wait for the baby to stop drinking before burping. Burp by

gently patting or rubbing the baby’s back while the baby is

resting on your shoulder or sitting on your lap. Do not be

surprised if the baby brings up some milk along with the

swallowed air or if the baby does not burp.

Drinking From a Cup

• You can start by offering breastmilk or infant formula from

a cup when a baby reaches about 8 months of age. Babies

usually consume less breastmilk or formula as their eating

of solid foods and drinking from a cup increases.

• It is recommended to wean the baby off the bottle and onto

a cup by about 12 to 14 months of age. See page 61 on

weaning and on tips on drinking from a cup.

Sleeping or Resting Position Before or After

Feeding

Ask the parents if the baby’s doctor recommends that the

baby be placed in a certain position after feeding. Doctors

usually recommend placing babies on their backs to rest or

sleep, unless there is some medical reason not to. Doctors

and nurses believe that fewer babies will die of Sudden Infant

Death Syndrome (SIDS) if most babies sleep on their back.

However, especially if a baby was born with a birth defect, 

often spits up after eating, or has a breathing, lung, or heart

problem, it is very important for the parent to check with the

doctor about the best sleeping position. 
36 Feeding Infants

The Back to Sleep Campaign recommends these tips that

parents and caregivers can take to help lower the risk of SIDS:

• Place a baby on his or her back to sleep, at nighttime

and naptime.

This is the best way to reduce the risk of SIDS. 

• Place a baby on a firm mattress, such as in a safetyapproved crib.

Don’t put babies to sleep on soft mattresses, sofas, sofa

cushions, waterbeds, sheepskins, or other soft surfaces. 

• Remove all fluffy and loose bedding from the sleep area.

Make sure you take all pillows, quilts, stuffed toys, and 

other soft items out of the crib. 

• Make sure the baby’s face and head stay uncovered 

during sleep.

Keep the baby’s mouth and nose clear of blankets and other

coverings during sleep. Use sleep clothing with no other 

covering over the baby. If you do use a blanket or another

covering, make sure the baby is “feet-to-foot” in the crib.

Feet-to-foot means that the baby’s feet are at the bottom of

the crib, the blanket is no higher than the baby’s chest, and

the blanket is tucked in around the crib mattress. 

• Don’t smoke before or after the birth of the baby.

Create a smoke-free zone around the baby. Make sure no

one smokes around the baby. 

• Don’t let the baby overheat during sleep.

Keep the baby warm during sleep, but not too warm. The

baby’s room should be at a temperature that is comfortable

for an adult. Too many layers of clothing or blankets can

overheat a baby. 

The Back to Sleep Campaign is sponsored by the National

Institute of Child Health and Human Development, the

Maternal and Child Health Bureau, the American Academy of

Pediatrics, the SIDS Alliance, and the Association of SIDS and

Infant Mortality Programs. For more information about the

Back to Sleep campaign, call toll-free 1-800-505-2742. Or

write to: Back to Sleep/NICHD, 31 Center Drive, Room 2A32,

Bethesda, MD, 20892-2425. The website is

http://www.nichd.nih.gov/sids.
A Guide for Use in the Child Nutrition Programs 37

The U.S. Consumer Product Safety Commission (CPSC), an

independent Federal agency, recommends that parents and

caregivers take these precautions to prevent deaths or injuries

to children in playpens:

• Before using a playpen, make sure it has not been recalled.

Contact CPSC at 1-800-638-2772 or check the recalls 

section of CPSC’s web site.

• Always put a baby down to sleep on his or her back in 

a playpen or crib with no soft bedding, such as quilts, 

comforters and pillows. This can help reduce the risk of

SIDS and prevent suffocation.

• Use only the mattress provided by the manufacturer. Do 

not add additional mattresses in playpens. Children can

suffocate in the spaces formed between mattresses or from

ill-fitting mattresses. 

• Check that the playpen is in good shape. Using a modified

or improperly repaired unit can create hazards.

• Make sure the top rails of the units lock into place 

automatically. More than 1 million older playpens with 

top rails that had to be manually rotated into a locked 

position have been recalled.

• Do not use playpens with catch points, such as protruding

hardware. More than 9 million older units with protruding

hardware have been recalled. 

• If using a mesh-sided playpen, make sure the mesh is less

than 1/4 inch in size and that it is attached securely. This

will help prevent strangulation. 

For more information on playpen safety, visit the 

publications section (Children’s Furniture) of CPSC’s web 

site, http://www.cpsc.gov, or call (800) 638-2772. You can

get free copies of CPSC’s brochures and posters in English

and Spanish, related to their “Sleep Safe/Play Safe” campaign,

through the website or by writing to CPSC, Washington, DC

20207. 

5 

HOW TO FEED A BABY USING A BOTTLE
38 Feeding Infants

Preparing and Storing Bottles:

• Ensure that bottlefeeding is clean and sanitary.

• Do not allow bottles of breastmilk or formula to

stand at room temperature to prevent spoilage.

Refrigerate prepared bottles until ready to use.

• For those babies

who prefer a warm

bottle, hold the bottle under running

warm (not hot) water

immediately before

feeding.

• Shake a bottle of

breastmilk before

feeding because

breastmilk separates

when it is stored.

• Never use a microwave oven to heat the bottles because they may explode or the milk may

get too hot. Since the liquid heats unevenly, it

can be much hotter than it feels. Microwave heating can destroy special substances in breastmilk.

• Do not put cereal or other food in a bottle since

this forces the baby to eat food this way.

• Throw out unused breastmilk or formula left in a

bottle and wash the bottle with soap and hot water immediately. Clean and sterilize bottles before

reusing them.

Feeding the Baby:

• Feed when the baby indicates hunger. Respond

to the early signs of hunger. Do not wait until the

baby is upset or crying from hunger.

• Gently and slowly calm and position the baby to

get ready for feeding.

• Feed in a smooth and continuous fashion following the baby’s lead on when to feed, how long to

feed and how much to feed. Avoid disrupting the

feeding with unnecessary burping, wiping, juggling and arranging.

• Always hold the baby during feedings. Tip the

bottle so that milk fills the nipple and air does not

get in. Propping a bottle can cause ear infections

and choking, and it deprives the baby of important cuddling and human contact.

• Hold the baby’s head a little higher than the rest of

the body to prevent milk from backing up in the

ear and causing an ear infection.

• Do not offer the bottle at nap time or let a baby

carry a bottle around. Allowing a baby to go to

sleep with a bottle may lead to tooth decay.

• Wait for the baby to stop eating before burping.

Burp by gently patting or rubbing the baby’s back

while the baby is resting on your shoulder or sitting on your lap.

• Continue to feed until the baby indicates he or

she is full. Signs of fullness include sealing the

lips, decrease in sucking, spitting out the nipple, and turning from bottle or pushing

bottle away.

• Never force a baby to finish what is in the bottle.

Babies are the best

judge of how much they

need.

• Older babies may be fed

a bottle while sitting up

in a high chair.

Figure 5 

Tips on Feeding with a Bottle

Thomas

4/10

Baby Gabe

8/14/98

4:30 p.m. Baby Tony

8/2/98

8:30 a.m.

Baby Jose

8/12/98

10:30 a.m. Baby Jane

8/12/98

2:30 p.m.

Baby Eva

8/19/98

12:00 p.m.
A Guide for Use in the Child Nutrition Programs 39
40 Feeding Infants

Photographs courtesy of: Dr. Norman Tinanoff, DDS, MS, Professor, University of Connecticut Health Center, School of Dental

Medicine, Department of Pediatric Dentistry, Farmington, Connecticut

Photograph of healthy teeth

Photographs below show teeth with mild to severe cases of early childhood caries

Examples of Healthy Teeth and 

Early Childhood Caries

(or Baby Bottle Tooth Decay)
A Guide for Use in the Child Nutrition Programs 41

aby bottle tooth decay, or early childhood caries, can occur

when:

• Babies with teeth are regularly allowed to fall asleep with a bottle

in their mouths. Less saliva is made in the mouth when a baby

falls asleep, and liquid from the bottle can pool around the teeth.

• Babies are allowed to drink from a bottle (containing juice, sweet

liquids, or formula) for long periods.

The sugar in juice, sweet liquids, and formula are used by bacteria

in the mouth to produce acids which can cause serious tooth decay.

See the photographs on the opposite page of healthy teeth and teeth

with baby bottle tooth decay. To prevent tooth decay in babies:

• Feed only breastmilk or formula from a bottle.

• Do not feed juice from a bottle.

• Offer the bottle only at feeding time, not at nap time. If a baby

falls asleep during feeding, move the baby around a bit to 

stimulate swallowing before putting the baby down to sleep.

• Do not leave a bottle in a baby’s crib or playpen or prop bottles.

• Only give a baby a plain clean pacifier. Never give a baby a pacifier

dipped in honey, syrup, sugar, or other sweet substance.

• Do not put water sweetened with honey, sugar, or corn syrup;

soda pop; sweetened iced tea; sports drinks; sweetened

gelatin water; juice drinks; or other sweetened drinks in the bottle

or cup. 

• Do not use a bottle of cold juice to soothe a teething baby’s gums.

Instead, offer a clean favorite rattle or teething ring that has been

cooled in the refrigerator (not the freezer).

• Provide juice only in a cup (do not feed more than 4 ounces of

fruit juice per day).

• Do not let a baby carry around and continuously drink from a 

bottle or sippy cup.

• Do not feed a baby sweetened foods, such as lollipops, sweet 

candies, candy bars, cookies, cakes, or sweetened cereals, or

sticky sweet foods such as dried fruit.

• Gradually begin shifting bottle feedings to cup feedings any time 

between 6 and 12 months of age as the baby consumes more solid

foods and drinks liquids from a cup. It is best to wean babies from a

bottle to a cup by about 12 to 14 months of age.

Discuss the topic of cleaning the baby’s gums and teeth with each

baby’s parents; they can consult with the baby’s doctor about this

subject.

6 Preventing Tooth Decay

B
42 Feeding Infants
A Guide for Use in the Child Nutrition Programs 43

y age 4 to 6 months, most babies reach a point in their 

development when they can benefit from having foods 

other than breastmilk or infant formula added to their diets.

This chapter reviews information on readiness for solid foods.

communication with parents, food allergies and intolerances, and

when and what foods to introduce.

Readiness for Solid Foods

During the first 4 to 6 months, a baby requires only breastmilk

or iron-fortified infant formula. Babies’ swallowing and digestive

systems are not developmentally ready to handle solid foods until

they are between 4 to 6 months of age. During this period the

baby’s tongue no longer pushes most solid objects out of the

mouth. A baby’s weight or age alone does not determine his or

her readiness for solid foods. Each baby develops at a different

rate. Babies begin to show their desire for food by opening their

mouths and leaning forward.

Babies are mature enough to begin learning to eat from a

spoon when they can:

• hold their necks steady and sit with support,

• draw in their lower lips as a spoon is removed from their

mouths, and

• keep food in their mouths and swallow it rather than 

push it back out on their chins.

Babies show disinterest or fullness by:

• leaning back,

• turning away,

• pushing the food out of their mouths,

• sealing their lips together,

• playing with the food, and

• pushing the bottle or spoon away.

Solid Foods and the Infant Meal Pattern

When a baby is developmentally ready to accept them, solid

foods must be served to make a reimbursable meal in the Child

Nutrition Programs. Figure 8 shows how the Infant Meal Pattern

corresponds with changes in food texture and feeding style 

during a baby’s first year. Young babies, under 6 months of age,

do not follow rigid schedules and may need to eat every 11

/2 to 3

hours. Some older babies also will need to eat more frequently

B

7 Feeding Solid Foods
44 Feeding Infants

and larger quantities than the specified feedings. Babies should

be fed when they are hungry and not restricted to a rigid

schedule. Meals in the Infant Meal Pattern are specified as a

guideline only. It is important to avoid feeding solid foods before a

baby is developmentally ready for them and before the parent, in

consultation with the baby’s doctor, has indicated to begin serving

them. A caregiver can be reimbursed for a meal offered to a baby

as long as he/she offers the baby the minimum serving size of the

required meal components in the meal. The food offered does not

have to be totally consumed by the baby for the meal to be reimbursable. Also, a meal is reimbursable as long as the required

meal components in the respective meal are offered to the baby

during the course of the day while the baby is in child care. Thus,

for example, if a baby is not hungry for a meal component required

at lunch, it can be offered as a snack when baby is hungry.

Babies younger than 4 months of age should not be fed solid foods

unless the baby’s doctor authorizes them.

Communication With Parents About Baby’s Eating

Good communication between the caregiver and the parents is

essential for successful feeding in general, including when introducing solid foods. The decision to feed specific foods should be

made in consultation with the parents. It is recommended that the

caregiver be given written instructions on the introduction and

feeding of foods from the parents and baby’s doctor. Caregivers

can use or develop a take home sheet for parents in which the

caregiver records the food consumed, bowel movements and number of wet diapers, sleep patterns, and other important notes on

the baby, each day. Continue to consult with each baby’s parents

concerning which foods they have introduced and are feeding.

Then, the caregiver can follow that schedule of introducing new

foods and more easily identify possible food allergies or 

intolerances. Let parents know what and how much their babies

eat each day. Consistency between home and the child care 

setting is essential during the period of rapid change when babies

are learning to eat solid foods.

In order to accommodate the needs of babies of parents from 

different cultures, it is important to learn about those cultures, 

including the foods they usually feed their babies. Thus, gather 

information from the parents on how and what they feed their babies and families. Resource publications on this subject include: 

• “Cross-Cultural Counseling: A Guide for Nutrition and Health

Counselors,” FNS-250, 1986; available for loan from the Food

and Nutrition Information Center, National Agricultural Library,

USDA, phone: (301) 504-5719; e-mail address:

fnic@nal.usda.gov.
A Guide for Use in the Child Nutrition Programs 45

• “Celebrating Diversity: Approaching Families Through Their

Food,” 1998; available for purchase from the National Maternal

Child Health Clearinghouse, toll free phone 1-888-434-4MCH,

web site: http://www.nmchc.org.

Food Allergy or Intolerance

Ask parents for a list of foods, if any, that each baby has 

reactions to or which should not be fed to the baby. To make it

easier to identify a possible food allergy or intolerance when 

introducing new foods, it is recommended to follow and coordinate

these steps with the parents:

• Introduce foods to a baby that have been previously introduced,

with no problems, by the baby’s parents; 

• Introduce new foods one at a time;

• Introduce new foods gradually, for example, wait at least 1 week

(7 days) between each new food;

• Introduce a small amount (e.g., about 1 to 2 teaspoons) of a new

food at first (this allows a baby to adapt to a food’s flavor and

texture);

• Use single-ingredient foods at first to easily see how the baby 

reacts to each new food. Caregivers who are preparing foods at

home for a baby and older children should separate the baby’s

portion before adding other ingredients; and

• Observe the baby closely for reactions after feeding a new food

(see below on the types of reactions that babies can have). If

there is a reaction, stop feeding the food and discuss this with

the parents. Consult with the parents, who should contact their

baby’s doctor, before introducing that food in the future.

By following the above steps, a baby will have time to become 

acquainted with each new food. Also, it will be easier to identify

foods that a baby has a reaction to, has trouble digesting, or 

refuses to eat. 

A baby having an allergic or other reaction to food may have any

one of these symptoms: diarrhea, vomiting, coughing and wheezing, congestion or stuffiness, ear infection, stomach pain, hives,

skin rash, extreme irritability; or more severe reactions, like shock

or difficulty breathing. If a baby has a severe reaction to a food,

contact the rescue squad or Emergency Medical Service and his or

her parents immediately.

Babies with Delayed Development

Babies’ development does not always match their actual age.

Babies may be developmentally delayed in their feeding skills due to:

• prematurity,

7 FEEDING SOLID FOODS
46 Feeding Infants

• multiple hospitalizations,

• low birth weight,

• failure to thrive,

• cleft lip or cleft palate,

• a medical condition, like Down’s syndrome or cerebral palsy,

• neuromuscular delay,

• abuse or neglect, or

• not having eaten by mouth (i.e., fed only from a tube in the

stomach or inserted in a vein) for a long time.

Parents of babies who are developmentally delayed due to 

prematurity or any one of the above conditions should have 

instructions from their baby’s doctor concerning proper feeding.

For such babies, it is vital that the caregiver follow the feeding 

instructions from the baby’s doctor. If any portion of the 

instructions is unclear, it is the caregiver’s responsibility to seek

clarification. For more information about the special dietary

needs or developmental delay of a baby, ask the parents to obtain

additional information for you from the baby’s doctor.

Babies with Special Dietary Needs

USDA regulations require school food authorities and 

institutions to make substitutions or modifications for babies

whose disabilities restrict their diets, at no additional charge to

the baby’s household. For more information, see FNS-Instruction

783-2, Meal Substitutions for Medical or Other Special Dietary

Reasons, and the publication, “Accommodating Children With

Special Dietary Needs in the School Nutrition Programs:

Guidance for School Food Service Staff.” Your State agency can

also provide you with guidance on accommodating babies with

special dietary needs.

Feeding Solid Foods Too Early

Feeding solid foods too early may increase the risk that babies

will:

• choke on the food,

• develop food allergies or intolerances, or

• consume less breastmilk or formula and not get enough 

calories and other nutrients for proper growth and 

development.

Feeding solid foods before babies are ready will not help them

sleep through the night or make them eat fewer times in a day.

Feeding Solid Foods Too Late

Delaying the introduction of solid foods beyond the time when

a baby is developmentally ready for them increases the risk that

babies will:
A Guide for Use in the Child Nutrition Programs 47

• not learn to eat solid foods properly,

• become malnourished,

• develop iron-deficiency anemia, and

• not grow normally.

Most babies are ready to eat solid foods between 4 to 6 months of

age. 

Introducing New Foods

This section reviews the different types of food that are 

commonly fed to babies. Babies can be fed commercially or

home-prepared baby foods. See Chapter 11, Commercially

Prepared Baby Food, and Chapter 12, Home-Prepared Baby Food.

Depending on the cultural preferences of families, there may be

some different foods eaten than those discussed below (see page

44 on meeting the needs of families from different cultures).

Iron-fortified Infant Cereal

Iron-fortified infant cereal is a good first solid food because it is

easy to digest. To meet the Infant Meal Pattern, the cereal in

meals must be iron-fortified dry infant cereal, as iron is an 

important nutrient for babies. Iron-fortified dry infant cereal is

usually found in the baby food section of grocery stores labeled

“Cereal for Baby.” These cereals are enriched with a form of iron

that may be easier for infants to absorb than other forms of iron

found in other cereal products. 

Type of Cereal to Feed

Consult with parents about which cereals are being introduced

at home so that you can serve the same food at the same time.

Iron-fortified infant rice cereal is usually the best

choice for baby’s first cereal because it:

• is easily digested,

• is least likely to cause an allergic reaction,

• contains important nutrients, and

• can be altered in consistency to meet a baby’s 

developmental needs.

Dry infant cereal can be prepared with expressed

breastmilk or infant formula to produce a smooth

cereal that is not too thick and is easy for a young

baby to swallow and digest. Water or fruit juice (for

babies 6 months or older who have tried juice and

had no reaction to it) can also be mixed with cereal.

The consistency of all cereals can be thickened by

adding less liquid as the baby matures. Measure the dry cereal

before adding the liquid.

7 FEEDING SOLID FOODS
48 Feeding Infants

Remember these points about other cereals:

• Oat and barley infant cereal can be added at 1-week intervals

after rice cereal.

• Wait to serve wheat cereal until babies are 8 months old 

because wheat is the grain most likely to cause a reaction in

babies. The risk of intolerance decreases by age 8 to 9

months.

• Serve mixed-grain cereals only after the baby has been 

introduced to each grain separately.

• These cereals are not reimbursable in the Infant Meal

Pattern:

— Jarred “wet” infant cereals,

— Iron-fortified dry infant cereals containing fruit,

— Cereals designed for older children and adults. These 

cereals are not recommended for babies because they:

❑ often contain mixed grains,

❑ are usually higher in salt and sugar than infant cereals, 

❑ may contain vitamins and minerals in forms or amounts

not ideal for babies, and

❑ may contain small hard pieces of food that could cause a

baby to choke (e.g., raisins, dates, nuts, or uncooked

whole grain flakes).

— Enriched farina, regular oatmeal, and corn grits; although

these are not reimbursable as a substitute for infant cereal,

they can be fed as additional foods.

Vegetables and Fruits

Vegetables and fruits may be introduced when the baby

readily accepts 2 to 3 tablespoons of infant cereal at each

meal. Consult with the parents about which vegetables

and fruits are being introduced at home so that you can

serve the same food at the same time. Babies often start

on vegetables and fruits around 6 months of age. 

Types of Vegetables and Fruits to Feed

Commercially or home-prepared vegetables or fruits can be fed

to babies. Examples of vegetables and fruits to feed include:

• Commercially prepared baby food such as: green beans, green

peas, squash, sweet potatoes, carrots, beets, spinach, 

applesauce, apricots, bananas, peaches, pears, and plums.

• Home-prepared vegetables (cooked and processed to the 

appropriate texture), such as: asparagus, broccoli, cabbage,

cauliflower, green beans, green peas, kohlrabi, plantain, 
A Guide for Use in the Child Nutrition Programs 49

potatoes, summer or winter squash, and sweet potatoes.

Home-prepared collard greens, carrots, spinach, turnips and

beets should only be fed to babies 6 months of age and older.

(See page 50 for more information.)

• Home-prepared fruits (which can be mashed after peeling if

ripe and soft) such as: apricots, avocado, bananas, 

cantaloupe, mango, melon, nectarines, papaya, peaches, pears,

and plums. Stewed pitted dried fruits can be pureed or

mashed. Apples, pears, and dried fruits usually need to be

cooked in order to be pureed or mashed easily.

Commercially prepared baby food vegetables and fruits are 

reimbursable in the Infant Meal Pattern if they:

• list vegetable or fruit as the first ingredient in the ingredient

listing on the label, or

• list vegetable or fruit as the first ingredient and contain 

multiple vegetables or multiple fruits. Check with the parent

that an infant has tried, and had no reaction to, all the 

vegetables or fruits in these mixed products before serving

them. 

These commercially prepared baby foods are not reimbursable

in the Infant Meal Pattern (but can be served as additional foods):

• jarred cereals, desserts, or puddings that list a fruit as the first

ingredient in their ingredient listing.

• commercially prepared baby food vegetable or fruit with a label

stating that the first ingredient is water.

Make sure to carefully read the ingredient listing of 

commercially prepared baby food fruits and vegetables. 

Plain commercial baby food vegetables and fruits generally:

• contain more nutrients ounce for ounce, 

• do not usually contain concentrated sweeteners (e.g., sugar) or

salt, and 

• may contain fewer ingredients that could possibly cause an 

allergic reaction.

Babies who cannot consume milk products because of milk 

allergies, lactose intolerance, or galactosemia should not be fed

commercial baby food dinners, vegetables, or other products 

containing milk products such as milk, cheese, whole milk solids,

yogurt, or nonfat dry milk (e.g., some creamed corn products,

creamed spinach). Read food labels to check ingredients.

Watching for Reactions

A wide variety of vegetables and fruits can be introduced over

time. However, the recommendations to introduce one new food

at a time still apply. Wait at least 1 week between each new food

7 FEEDING SOLID FOODS
50 Feeding Infants

and watch the baby closely for reactions. Observe babies closely

for reactions when introducing citrus fruits (e.g., orange, tangerine,

grapefruit) because these foods may cause allergic reactions; these

foods should not be introduced before 6 months of age.

Preparation of Vegetables and Fruits

Babies between 6 and 12 months of age may be served a 

soft-cooked vegetable or fruit as long as the texture of the food 

is appropriately modified. As a baby’s mouth skills progress, 

gradually increase the thickness and lumpiness of vegetables and

fruit. Use cooked, fresh, or frozen vegetables or fruits, and

progress from pureed to ground to fork mashed and eventually to

diced. Or you may purchase commercial baby foods that progress

in texture. Ripe bananas do not need cooking but need to be

mashed to the proper consistency. Avoid canned or frozen 

vegetables or fruit that are high in added sugar or salt. Also, do

not add salt, sugar, fat, and other seasonings to vegetables and

fruits. Remove baby’s portion before preparing and seasoning 

vegetables and fruits for others.

Warning About Home-Prepared Vegetables High in Nitrates

The following home-prepared vegetables should only be fed to

babies 6 months of age and older: beets, carrots, collard greens,

spinach, and turnips. Those vegetables, when prepared at home,

are high in nitrates. The naturally occurring nitrates in these 

vegetables can be converted to nitrites in very young babies. The

nitrites bind the iron in the blood and make it difficult to carry

oxygen. If the nitrites are high enough in a very young baby, this

can result in a condition called methemoglobinemia in which a

baby has blue skin and difficulty breathing. Commercially 

prepared baby food spinach, beets, and carrots contain only 

traces of nitrate and are not considered a risk to babies less than 

6 months of age.

Warning About Vegetables and Fruits That May Cause Choking

Due to the risk of choking, do not feed babies the following 

vegetables and fruits:

• Raw vegetables (including green peas, string beans, celery,

carrot, etc.);

• Cooked or raw whole corn kernels;

• Whole pieces of canned fruit;

• Hard pieces of raw fruit such as apple, pear, melon;

• Whole grapes, berries, cherries, melon balls, or cherry and grape

tomatoes (cut these foods into quarters, with pits removed, before feeding to older babies); and 

• Uncooked dried fruit (including raisins).
A Guide for Use in the Child Nutrition Programs 51

Meat and Meat Alternates

Meat and meat alternates include meat, poultry, fin fish, cheese,

yogurt, cooked dry beans and peas, and eggs. Meat and meat 

alternates are generally introduced by 8 months of age, but some

doctors recommend introducing them between 6 and 8 months of

age. By 8 months, babies will have already been introduced to 

cereal, vegetables, and fruits and will be ready for new foods and

other sources of iron. Consult with the parent about which meats

and meat alternates are being introduced at home so that you can

serve the same food at the same time. It is not necessary to add

oil, butter, margarine, lard, cream, salt, or seasonings to these

foods.

Peanut butter, other nut or seed butters, nuts, and seeds should

not be fed to babies and are not reimbursable as meal components

in the Infant Meal Pattern. These foods cause choking and may

cause an allergic reaction in some babies.

Meats, Poultry, and Fish

Lean meat and poultry are preferable. Examples include:

strained or pureed well-cooked lean beef, pork, lamb, veal, 

chicken, turkey, liver, and boneless fin fish. As the baby’s 

feeding skills mature, meat and poultry can be served ground or

finely chopped.

Do not serve fin fish to a baby until the parents have 

introduced this type of fish to the baby first with no problems.

Observe a baby closely when introducing fish because some 

babies can have allergic reactions to fish. Any fish must be closely

examined for bones, and any bones removed, before 

serving to a baby. Check with the State agency to see if fresh 

water sport fish is reimbursable as a meat/meat alternate in the

Infant Meal Pattern. Before feeding babies any fresh water sport

fish, consult your State department of health or natural resources

for information on the safety of these fish. Do not feed any 

shellfish (includes shrimp, lobster, crab, crawfish, scallops,

oysters, clams) to babies less than 1 year of age—these types

of seafood can cause severe allergic reactions in some babies.

Do not feed any of the following fish (which may contain high

levels of harmful mercury) to babies or young children: shark,

swordfish, king mackerel, or tilefish.

Avoid feeding babies these foods (they are higher in fat, 

lower in protein): hot dogs, sausage, bacon, bologna, salami, 

luncheon meats, other cured meats, fried meats, and the fat and

skin trimmed from meats. 

Commercial baby food meats with meat or poultry as the first 

ingredient in the ingredient listing are reimbursable as a

7 FEEDING SOLID FOODS
52 Feeding Infants

meat/meat alternate in the Infant Meal Pattern. Such products 

contain primarily meat or poultry. If commercial baby food is used,

plain meat or poultry generally contains more meat or poultry (and

more protein and iron) ounce for ounce than combination baby food

dinners. Plain meats can be mixed with plain vegetables or fruits to

serve to a baby as some babies will accept meat better when mixed. 

These foods are not reimbursable as meat/meat alternates in the

Infant Meal Pattern:

• Commercial fish sticks, other commercial breaded fish products,

canned fish with bones, hot dogs, and sausages—these are not 

reimbursable because they are not designed by their manufacturers for consumption by infants (less than 12 months of age).

Infants may choke on these foods and fish sticks and other 

breaded fish products may have an accidental bone.

• “Baby food” meat sticks (which look like miniature hot dogs)—

these are not reimbursable because, by the manufacturer’s 

declaration, they are designed to match the skills of children over

12 months of age. Hot dogs or similarly shaped products are not

recommended for babies because they can cause choking, even

when cut into round slices.

• Home-canned meats—these meats should not be served at all 

because they may contain harmful bacteria if improperly canned. 

• Commercially prepared baby food combination dinners—the

amounts of the various food components in the dinners are 

difficult to determine. Information on the exact percentage of 

ingredients is proprietary and thus not available to the public.

Given the small percentage of meat required to be in these foods,

these dinners may not be a primary source of meat/meat alternate

for a baby. These dinners generally have less nutritional value by

weight than single-ingredient meats and vegetables or fruit mixed

together. If a parent requests, these dinners can be served as 

additional foods within a reimbursable meal. The parent can 

provide the dinner if they desire to do so.

Eggs

Egg yolk may be introduced to infants at or after 8 months of age.

Do not introduce egg whites and whole egg (it contains egg white) to

children younger than 1 year. Egg whites contain substances that

may cause allergic reactions in babies. All eggs should be carefully

handled, properly refrigerated, and properly cooked to reduce the 

possibility of contamination with harmful bacteria. Before cooking,

wash eggs with water. Cook eggs thoroughly and hard cook the yolk

to kill bacteria (no runny soft eggs). Never feed raw uncooked or 

undercooked eggs (including in beverages) to babies or anyone else
A Guide for Use in the Child Nutrition Programs 53

because they may contain bacteria (Salmonella) that can cause 

illness. See page 88 for more information on proper handling of

home-prepared eggs. 

Cheese and Yogurt

Cheese may be introduced to infants 8 months or older. Small thin

slices or strips of cheese are easier and safer. Do not feed chunks of

cheese, which can cause choking. If serving cheese, regular cheese

(such as natural cheddar, colby, or mozzarella) and cottage cheese are

the best choices. Cheese food, cheese spread, and pasteurized

process cheese are generally higher in salt than regular cheeses or

cottage cheese. Commercially prepared plain yogurt, made from 

low-fat or whole milk, may be introduced and served in small

amounts to infants 8 months and older. Since cheeses and yogurt

are made from cow’s milk, observe babies closely for reactions if fed

these foods.

Dried Beans or Peas

Any cooked dry beans and dry peas, such as kidney beans, lima

beans, pinto beans, or chick peas, may be served to babies 8 months

or older. Serve small quantities (1 to 2 teaspoons) of mashed or

pureed cooked beans or peas at first. Modify the texture of cooked

dry beans and dry peas for a baby (cooked whole beans or peas could

cause choking). Home-prepared dry beans or dry peas are more 

economical and lower in sodium than commercially canned beans.

However, if canned beans are used, drain the salty water and rinse

the beans with clean water before using. As with any food, if a baby

does not like beans or appears to have difficulty digesting them, do

not serve them. To prepare dry beans and peas, follow cooking 

instructions found on the package label or in many basic cookbooks.

Bread and Crackers

Bread or crackers may be served at the snack or with

meals throughout the course of the day. Consult with

each baby’s parent about bread and crackers being 

introduced at home so that you can serve the same food 

at the same time. At 8 or 9 months of age, babies enjoy

having finger foods so they can practice picking up the

foods. Also, at that age a baby’s risk of having a reaction

to wheat decreases. Examples of foods to serve babies 

include:

• Strips or small pieces of dry bread or toast or crackers,

• Plain crackers preferably low in salt such as low salt soda crackers

(avoid crackers with seeds, nuts, or whole grain kernels),

• Small pieces of soft tortilla or soft pita bread, or

• Teething biscuits.

7 FEEDING SOLID FOODS
54 Feeding Infants

Check the food label to make sure the crackers or bread 

are made from whole-grain or enriched meal or flour. 

The types of bread and crackers that are reimbursable 

on the Infant Meal Pattern include:

Bread

• Breads (white, wheat, whole wheat, French, Italian, and similar

breads, all without nuts, seeds, or hard pieces of whole grain kernels),

• Biscuits,

• Bagels (made without nuts, seeds, or hard pieces of whole grain 

kernels),

• English muffins,

• Pita bread (white, wheat, whole wheat),

• Rolls (white, wheat, whole wheat, potato),

• Soft tortillas (wheat or corn).

Crackers

• Crackers—saltines, low salt crackers, or snack crackers made

without nuts, seeds, or hard pieces of whole grain kernels;

• Graham crackers made without honey.

Only serve bread or crackers if the parent, in consultation with 

the baby’s doctor, agrees for them to be served and after they have

previously been introduced to the baby with no problems. If any of

the above foods are served, prepare them in a form that a baby can

eat without choking. That is, serve small thin strips of bread rather

than a whole or half of an uncut hard bagel, English muffin, wheat

roll, or soft tortilla, or bread with a hard crust.

AVOID

Do not feed babies these foods, which present a choking risk:

• Snack potato or corn chips, pretzels, or cheese twists,

• Cookies or granola bars,

• Crackers or breads with seeds, nut pieces, or whole grain kernels

such as wheat berries, and

• Whole kernels of cooked rice, barley, or wheat; these should be finely

ground or mashed before feeding to babies.

Other Foods

Other foods that are not listed in the Infant Meal Pattern chart may

be served. They are in addition to all the foods listed in the meal 

pattern requirements and may not substitute for any of the required

food. Some examples are bread at meals other than the snack, and

rice, pasta, noodles, or macaroni at any meal—these foods are 

usually introduced to infants 8 months or older. Check with the 
A Guide for Use in the Child Nutrition Programs 55

parents regarding what type of pasta the baby can eat (e.g., plain,

protein-fortified, whole wheat, etc.). Remember to serve foods that

are appropriate for a baby’s developmental age. Also, pieces of soft

cooked fruit or vegetable may be appropriate as a finger food or snack

for babies 8 months or older.

Do not provide family-style meal service to babies because it is 

important to feed them food that is appropriate for their development.

Some foods often fed to older children are not appropriate for babies,

such as pizza, hot dogs, french fried potatoes, or dishes made from a

mixture of foods and condiments such as casseroles. These foods

tend to be high in salt and contain a mixture of ingredients that a

baby may not have tried before and, thus, may have a reaction to. 

Use of Sweeteners and Sweetened Foods

Sweeteners (e.g., sugar, syrups), eaten alone, added to foods, or in 

prepared foods, add calories to the diet and promote the development of

tooth decay in babies. Sweetened foods may fill up the baby without 

providing essential nutrients. Therefore, avoid feeding babies:

• Commercially prepared baby food desserts, 

• Commercial cakes, cookies, candies, and sweet pastries,

• Chocolate—some babies have allergic reactions to this food, and

• Added sugar, glucose, molasses, maple syrup, and corn syrup or

other syrups in the baby’s food, beverages, or water.

Honey

Honey should never be fed to babies less than 1 year of age. Honey

may contain substances that can cause “infant botulism,” a serious

type of food-related illness that can make a baby very sick. Do not

feed babies honey alone or in cooking or baking or as found in 

prepared foods (e.g., yogurt with honey, peanut butter with honey,

honey graham crackers). Even the honey in prepared foods could

cause this illness in babies.

Artificial Sweeteners

Do not feed artificially sweetened foods or beverages to babies.

Babies, who are growing rapidly have no need for low calorie foods

and drinks. Also, artificial sweeteners have not been proven safe for

consumption by babies.

Figure 6 summarizes how to introduce semisolid foods, how to feed

solid foods, and which foods to avoid. Figure 7 covers general tips on

starting good eating habits early.

7 FEEDING SOLID FOODS
56 Feeding Infants

Introducing Solid Foods:

Starting out

• Talk with the parents before introducing solid

foods. Only introduce solid foods when babies

are developmentally ready for them.

• Coordinate with each baby’s parents so that the

same new foods and textures are introduced at

the same time as at home.

• Do not serve solid foods to a baby younger than 4

months of age without a doctor’s written instructions.

How to Feed When Baby is Ready for

Solid Foods

• Sit directly in front of the baby to encourage the

baby. Offer the spoon. Wait for the baby’s mouth

to open before attempting to feed. If babies are

not ready to eat from a spoon they are not ready

to eat solid foods.

• In feeding solid foods, use a small spoon and

place a tiny amount of food between a young

baby’s lips. At first much of it may slide out of the

mouth, but gradually the baby will learn to move

the food to the back of the mouth for swallowing.

• Do not force the baby to finish the serving.

Babies are the best judge of how much food they

need. Let them decide how much they eat. Feed

until the baby indicates fullness by:

– not opening the mouth,

– pulling away from the spoon,

– turning away,

– pushing food or spoon back out of the mouth, or

– throwing the food on the floor.

• Be calm and friendly but not overwhelming.

Follow the baby’s lead on when to feed, what to

feed, and how much to feed.

• Do not put cereal or any other solid food in a bottle

or infant feeder. Use a spoon for feeding instead.

An infant feeder is a hard plastic container with a

spout at one end and a plunger at the other end

which is used to push a liquid mixture of solid food

into a baby’s mouth. Babies fed food in a bottle or

infant feeder are forced to eat the food, can choke,

and may not learn to eat foods properly.

• Any special equipment needed for feeding

children with disabilities should be used.

Consult with the parents on how to feed babies with special needs.

• Make the texture of the food appropriate for the

baby’s stage of development. Providing new 

textures encourages the baby’s further 

development.

Feeding Safety

• Test the temperature of foods before feeding them

to make sure they are not too hot.

• When feeding solid foods, seat babies in highchairs appropriate for their age and development.

Fasten the baby into the highchair with safety

straps before feeding. Keep the highchair away

from a table, counter, wall, or other surface so

that the baby cannot push off from it.

• Babies being fed and older babies learning to

feed themselves should be closely supervised by

an adult seated at the same table or next to the

baby’s highchair. Make sure that the baby does

not eat while talking, crying, or laughing. Also,

the adult can watch for “squirreling” (keeping 

several pieces of food in the mouth without 

swallowing) which can cause choking.

• To prevent choking, make sure that babies (and

children) are not eating while they are talking, 

crying, laughing, crawling, walking, running, 

playing, lying down, or riding in a vehicle.

• Use a small spoon, made of unbreakable material

that will not splinter, that easily fits into the mouth

(do not use plastic utensils). Place food in a

clean small plastic unbreakable bowl or dish with

edges that are not sharp.

• Keep hot liquids or foods out of reach of babies

and children, not on the edge of a counter or

table, or on a tablecloth that could be pulled

Figure 6

Basic Principles for Feeding Solid Foods
A Guide for Use in the Child Nutrition Programs 57

down. Make sure that staff do not consume hot

liquids near babies or children. Babies and 

children can be burned from hot liquids or foods

tipped over.

Watching for Reactions • Reinforce the introduction of new foods by serving

the same foods as the parents are feeding. Wait

at least 1 week between introducing new foods to

watch for reactions (diarrhea, rashes, vomiting,

coughing, wheezing, general irritability, hives,

stomach pain).

• If a baby seems to be having a severe reaction to

a food (e.g., hives, difficulty breathing, or shock),

contact the rescue squad or Emergency Medical

Service and the baby’s parents immediately.

• If a baby does not like the taste of a new food at

first, you can try offering it again 3 or 4 weeks 

later after discussing this with the parents.

Drinking Water

• A baby’s doctor may recommend feeding a small

amount of sterile water in a cup when solid foods

are introduced. Consult with the baby’s parents

about the feeding of water. Sterile water is water

that is brought to a very bubbly boil, boiled for 1 to

2 minutes, and then allowed to cool.

Do Not Feed Babies These Foods:

• Cow’s Milk—it is not as nutritious and may cause

anemia in babies. Breastmilk or infant formula are

best for the first year of life.

• Hard pieces of raw vegetable or raw fruit—they

can cause choking and be difficult to digest.

• Egg white, whole eggs, shellfish (shrimp, lobster,

crab, oysters, clams, scallops, crawfish), and

chocolate and cocoa. These foods may cause 

allergic reactions in babies.

• Shark, swordfish, king mackerel, or tilefish—these

fish may contain high levels of harmful mercury.

• Citrus (e.g., orange, tangerine, grapefruit), pineapple, or tomato juices or foods before 6 months

of age. These foods may cause allergic reactions

in babies.

• Home-prepared beets, carrots, collard greens,

spinach, and turnips before 6 months of age.

• Peanut butter and other nut and seed butters

(e.g., soy nut, almond, cashew, or sunflower seed

butter) and nuts and seeds. These foods can

cause choking and may cause allergic reactions

in some babies.

• Commercially prepared baby food desserts or

commercial cakes, cookies, candies, and sweet

pastries. These foods tend to be high in sugar

and may contain less of the key nutrients that 

babies need.

• Sugar, maple syrup, corn syrup, molasses, 

glucose, or other syrups added to food or 

beverages.

• Foods, beverages, or powders containing artificial

sweeteners. Babies should not be fed low-calorie

foods or drinks.

• Foods that could cause choking, see page 66.

Never Feed Babies These Foods:

• Honey–Honey and products containing honey, 

including sources used in cooking or baking (such

as in honey graham crackers), should never be

fed to babies. Honey is sometimes contaminated

with Clostridium botulinum spores which may

cause a type of illness called infant botulism.

• Raw milk–Raw cow’s or goat’s milk could be 

contaminated with harmful substances which can

make a baby very sick. Only pasteurized milk

products should be used once milk is introduced

at 12 months of age.

• Raw or undercooked eggs, meat, poultry, or 

fish– These foods when raw or undercooked can

contain harmful bacteria, parasites, and other

harmful substances that can make a baby very

sick.

• Home-canned foods–These 

foods may contain harmful 

bacteria if improperly 

canned.

Figure 6 (continued)

Basic Principles for Feeding Solid Foods
58 Feeding Infants

DO

Burp the baby at natural pauses

during the feeding and at the end

of each feeding.

Put only breastmilk or formula in

the bottle. Do not put cereal, other food, juices, or other drinks in

the bottle.

Give the bottle to the baby at

feeding time, not nap time, and 

do not let the baby go to sleep

with the bottle.

Hold the baby while feeding 

instead of propping the bottle in

the baby’s mouth. Do not let the

baby walk or crawl around with

the bottle.

DO

Wash the baby’s hands before

feeding.

Use a small spoon or let the baby

use his or her fingers.

Place food on the tip of the spoon

and put food on the middle of the

baby’s tongue.

Remove food from the jar before

feeding. Do not feed the baby

food from the jar.

Give only one new food at a time,

and wait at least 1 week before

giving another new food.

Figure 7 

Good Habits Start Early

During a baby’s first year, good nutrition and good eating habits will help the baby to

grow up happy and healthy.

WHY

To reduce spitting up from 

swallowed air.

To prevent overfeeding, choking,

tooth decay, and to allow the

baby to develop good eating

habits.

To prevent choking, ear 

infections, and tooth decay from

the milk which remains on the

teeth.

To prevent choking, to provide

cuddling for the baby, and to 

prevent babies from sharing 

their bottles with others.

WHY

To clean any dirt or germs off

the hands to keep the baby’s

food clean.

To help the baby learn proper

eating habits.

To make it easy for the baby to

swallow.

To prevent the saliva from the

baby’s mouth from spoiling the

remainder of the food in the jar.

To give the baby time to get

used to each new flavor and 

texture, and to see if the baby 

is allergic to the new food.

When You Feed a Baby Solid Foods:

When You Bottle Feed a Baby:
A Guide for Use in the Child Nutrition Programs 59

Figure 8

How the Infant Meal Pattern Corresponds

with Food Textures and Feeding Styles

Age of Birth 1 2 3 4 5 6 7 8 9 10 11 12

Baby by

Month

Age

grouping

in Infant

Meal

Pattern

Sequence

of Introducing

Foods in

Infant

Meal

Pattern

Texture 

of Solid

Food

Feeding

Style

Birth through 3 months 4 months through 7 months 8 months through 11 months

Breastmilk Infant Cereal Meat or Meat Alternates 

or Formula Vegetables and/or Fruit Crackers and/or Bread

Fruit Juice (only in a cup)

Strained/Pureed (thin consistency for cereal) 

Mashed

Ground/Finely Chopped

Chopped

Breastfeeding or Bottle Feeding

Spoon Feeding

Cup Feeding

Self Feeding/Finger Foods
60 Feeding Infants
A Guide for Use in the Child Nutrition Programs 61

abies are usually ready to drink from a cup when they 

can seal their lower lip on the cup and can sit without

support. To help the baby learn to drink from a cup:

• Hold the cup for the young baby;

• Introduce small amounts of breastmilk, infant formula, fruit

juice, or water in a cup; and

• Feed very slowly, i.e., tilting the cup so that a very small

amount of liquid (one mouthful) leaves the cup; then the baby

can swallow without hurry.

Weaning From a Bottle

Weaning a baby from a bottle to a cup is a gradual process 

requiring the baby to learn new skills. Some babies learn to

drink from a cup more easily than others. To make weaning 

easier, a cup can be introduced in place of a bottle at the feeding

of least interest or at mealtimes when other people are drinking

from cups. Generally, a baby will not drink the same quantity of

fluid from a cup as from a bottle at a feeding. Discuss with the

parents that it is recommended to totally wean babies off the 

bottle and onto a cup by 12 to 14 months of age. Children still

feeding from a bottle beyond 12 to 14 months of age may:

• be more likely to develop tooth decay,

• consume so much milk that they don’t eat enough solid foods

to get an adequate amount of nutrients, and

• be delayed in developing appropriate feeding skills.

Breastmilk or Formula From a Cup

Discuss with the parents when they would like you to feed

breastmilk or infant formula from a cup. Babies will consume

less breastmilk or formula from the bottle as their intake of solid

foods and drinking from a cup increases.

Fruit Juice

Only serve fruit juice to babies when they are developmentally

ready to drink from a cup and are at least 6 months of age or

older. If fruit juices are introduced, remember:

• Consult and coordinate with parents about introducing fruit

juice. Introduce new fruit juices one at a time and at least 

1 week apart, and observe the baby for reactions to the juice.

B

8 Drinking From a Cup
62 Feeding Infants

• Choose a 100 percent fruit juice that is pasteurized and 

naturally high in or fortified with vitamin C. Only full-strength

fruit juice is reimbursable for infants ages 8 through 

11 months in the Infant Meal Pattern. Either regular fruit

juice with vitamin C or commercial baby juices can be served. 

• Do not feed babies unpasteurized juices—they may contain

bacteria that could make a baby very sick.

• Only feed fruit juice in a cup. Do not feed fruit juice in a bottle

or let a baby carry around or drink continuously throughout

the day from a bottle or covered (sippy) cup of juice. Do not

give babies juice at naptime.

• When using juice for a snack, measure 2 to 4 ounces of juice.

Limit the total juice given to a baby to no more than 4 ounces

per day. Too much juice can spoil a baby’s appetite for other

nutritious foods and can cause diarrhea, gas, abdominal pain

and bloating, and tooth decay. Fruit juice contains very few

nutrients compared to other nutritious foods.

• Avoid feeding citrus (orange, tangerine, and grapefruit), pineapple, and tomato juices before 6 months of age because they

are more likely to cause an allergic reaction.

• Do not feed babies fruit drinks, fruit punch, soda pop, 

artificially sweetened drinks, and sweetened iced tea. They are

not 100 percent fruit juice and contain added sugar.

Fruit juices cannot be used to meet the fruit and vegetable

components in the Infant Meal Pattern. Juice drinks (which 

contain some full strength fruit juice, water, and possibly other

ingredients), fruit and vegetable juice blends, and vegetable juice

are not reimbursable in the Infant Meal Pattern.

Other Beverages

WATER

Consult with the parent about what the baby’s doctor 

recommends about feeding plain water to the baby. Water fed to

babies as plain water, mixed with formula, or mixed with foods,

should be from a source approved by the local health 

department. As a precaution, sterilize the water fed to babies or

used to prepare formula or foods. If tap water is used, collect

only from the cold water tap which has been allowed to run for 

2 minutes (hot tap water may pick up lead from water pipes).

Sterilize the water by bringing it to a very bubbly boil, boiling for 

1 to 2 minutes, and then letting it cool. Do not boil for a long

time because this concentrates harmful substances that may be

in the water (e.g., lead, nitrates). If there is a flood or disaster in
A Guide for Use in the Child Nutrition Programs 63

the area that contaminates the water supply, consult with the local health department on procedures to disinfect water or obtain

clean water. 

WHOLE COW’S MILK

Whole cow’s milk is not recommended for babies less than 

12 months of age and is not reimbursable as a meal component

in the Infant Meal Pattern unless it is approved by a recognized

medical authority. Whole cow’s milk is a poor source of iron, 

vitamin C, and other nutrients and contains too much protein,

sodium, and other nutrients. Breastmilk and iron-fortified infant

formula contain adequate amounts of the nutrients babies need.

Whole cow’s milk may cause babies to develop iron deficiency

anemia. Parents (or guardians) who are concerned that they 

cannot afford to buy infant formula, for babies who are not

breastfed or are only partially breastfed, can be referred to the 

local Special Supplemental Nutrition Program for Women,

Infants, and Children (WIC Program) for assistance. Contact

your local health department for more information.

Consult with parents about introducing whole cow’s milk. At

12 months of age, whole cow’s milk can gradually be introduced

by mixing part whole cow’s milk and part breastmilk or infant

formula at a particular feeding and, over time, increasing the

amount of whole cow’s milk in the cup. If cow’s milk is served,

only serve whole, pasteurized milk. Raw cow’s milk has not been

pasteurized (heated to kill disease-causing bacteria). Babies

could get very sick from drinking unpasteurized cow’s milk that

has not been heated to kill harmful bacteria.

REDUCED-FAT AND FAT-FREE (SKIM) COW’S MILK

Do not serve fat–free (skim) milk, reconstituted nonfat dry milk,

or reduced-fat milk to babies or young children less than 2 years

old. These milks contain too little fat and too much protein for

very young children. Babies and young children need fat for

proper growth and for development of the brain and nervous 

system. Fat is found in the right amounts in breastmilk, infant

formula, and whole cow’s milk (for 1 to 2 year olds).

OTHER MILKS

For babies who are not breastfed or are partially breastfed,

iron-fortified infant formula is the formula of choice and is 

reimbursable as a meal component in the Infant Meal Pattern.

See page 24 for more information on the milks that are not 

recommended for babies less than 12 months of age.

8 D RINKING FROM A CUP
64 Feeding Infants
A Guide for Use in the Child Nutrition Programs 65

abies are at risk of choking on food due to their poor 

chewing and swallowing abilities. It is therefore very 

important to be careful about how a baby is fed. Serve

foods that are the appropriate texture for a baby and avoid feeding certain foods that can cause choking. Following the 

general guidelines below will reduce the risk of choking in babies

in your care.

Preventing Choking When Serving Foods

When serving food to babies, keep in mind the following:

• Keep mealtimes calm by avoiding too much excitement or 

disruption during eating. Feed the baby in a quiet area away

from noise and distractions such as a TV set.

• Sit with the baby and supervise mealtimes and snacks. Do not

leave babies alone when they are eating. 

• Have babies sit in an upright position during meals and snacks.

• Make sure that biscuits, toast, and crackers are eaten only

when the baby is in an upright position. A baby who eats

these foods while lying down could choke on crumbs.

• Hold babies while giving them a bottle.

• Make sure the hole in the nipple of the baby’s bottle is not too

large (if the bottle is held upside down, the falling drops should

follow each other closely and not make a stream).

• Serve foods that are the appropriate texture for the baby’s 

development. Prepare food so that it is soft and doesn’t require

much chewing.

• Avoid using teething pain relief medicine before mealtime since

it may interfere with chewing.

• Feed small portions.

• Encourage babies to eat slowly.

Feeding and Eating Behaviors to Avoid

Certain feeding and eating behaviors increase a baby’s risk of

choking on food and must be avoided. These include:

• Propping a bottle in the baby’s mouth,

• Giving the baby a bottle with a nipple with too large a hole,

• Feeding solid foods to a baby before the baby is 

developmentally ready,

9 Choking Prevention

B
66 Feeding Infants

• Feeding a baby solid foods in a bottle,

• Feeding the baby too quickly,

• Feeding while the baby is lying down, walking, talking, crying,

laughing, running, riding in a vehicle, or playing,

• Serving difficult-to-chew foods to babies with poor chewing and

swallowing abilities,

• Feeding a baby without close supervision, 

• Feeding foods that may cause choking (see list below).

Acceptable Finger Foods

Examples of finger foods that are safer and present a lower risk

of choking include:

• Small pieces of ripe soft peeled banana, peach or pear,

• Small strips of toast or bread, 

• Cooked macaroni,

• Thin slices of mild cheese,

• Soft cooked chopped vegetables such as string beans or 

potatoes,

• Teething biscuits, and

• Soft moist finely chopped meats.

Foods to Avoid That Can Cause Choking

Some foods are hard to control in the mouth, and they can slip

into the airway before being chewed properly. Do not feed babies

or young children foods or pieces of food that are the size or

shape of a marble. Foods this size can be swallowed whole and

could become lodged in a child’s throat and cause choking. The

following foods are not recommended for babies and young 

children because they can cause choking:

• tough meat or large chunks of meat,

• peanuts or other nuts and seeds (such as pumpkin or 

sunflower),

• peanut butter or other nut or seed butters,

• candy (e.g., hard candy, jelly beans, caramels, chewing gum),

• popcorn,

• hot dogs, sausages, or toddler hot dogs (even when cut into

round slices),

• potato and corn chips and similar snack foods,

• pretzels,

• chunks of cheese,
A Guide for Use in the Child Nutrition Programs 67

9 CHOKING PREVENTION

• cooked or raw whole kernel corn,

• plain wheat germ,

• fish with bones,

• marshmallows,

• whole uncut grapes, berries, cherries, melon balls, or cherry or

grape tomatoes,

• raisins and other dried fruit,

• whole beans,

• hard pieces of raw fruit,

• whole grain kernels,

• raw vegetable pieces (e.g., carrots, green peas, string beans,

celery, etc.) or hard pieces of partially cooked vegetables,

• whole pieces of canned fruit (cut them up instead).

See above for a list of acceptable finger foods.

Food Preparation Techniques to Lower

Choking Risk

You can lower a baby’s risk of choking on food by taking the

proper precautions. When preparing food for babies, make sure

it is in a form that does not require much chewing. The following

preventive preparation techniques are recommended:

• Cook foods until soft enough to easily pierce with a fork.

• Cut soft foods into small pieces (cubes of food no larger than

1/4 inch) or thin slices that can easily be chewed.

• Cut soft round foods, such as soft cooked carrots, into short

strips rather than round pieces.

• Substitute foods that may cause choking with a safe 

substitute, such as thinly sliced meat or hamburger instead 

of hot dogs.

• Remove all bones from poultry and meat and especially from

fish.
68 Feeding Infants

• Cut grapes in quarters.

• Remove pits and seeds from very ripe fruit and cut the fruit

into small pieces.

• Grind or mash and moisten food for young babies.

• Cook and finely grind or mash whole grain kernels of wheat,

barley, rice, etc. before feeding to a baby. Do not feed babies

raw or cooked whole grain kernels in the whole form. 

Remember, choking can occur anywhere and anytime there is

food. Avoid those foods known to be a risk or modify them to

make them safer. Closely supervise mealtimes and encourage 

babies to eat their meals sitting quietly. Meals can continue to 

be both a happy time and a safe time.

For more Information:

For more information, see Figure 9, “You Can Help Prevent

Choking,” page 69.

Contact your local chapter of the American Red Cross (national

web site: http://www.redcross.org), American Heart Association

(national web site: http://www.americanheart.org), or American

Lung Association (national web site: http://www.lungusa.org) for

pamphlets, posters, and classes in emergency techniques for 

preventing choking, cardiopulmonary resuscitation (CPR), and

first aid. Also, a pamphlet on first aid, choking, and CPR can be

ordered from the American Academy of Pediatrics (national web

site: http://www.aap.org) or may be available from a 

pediatrician’s office.
A Guide for Use in the Child Nutrition Programs 69

Figure 9

You Can Help Prevent Choking

Watch Babies and Children During Meals

and Snacks to Make Sure They:

• Sit quietly for all feedings.

• Eat slowly.

• Chew food well before swallowing.

• Eat small portions and only one bite at a time.

Fix Table Foods So They Are Easy to

Chew:

• Grind up tough foods.

• Cut soft food into small pieces or thin slices.

• Cut soft round foods, like cooked carrots, into

short strips rather than round pieces.

• Remove all bones from fish, chicken, and

meat before cooking.

• Cook food until it is soft.

• Remove seeds and pits from fruit.

Foods That Can Cause Choking and

Should Not be Fed to Babies and Young

Children:

Firm, smooth, or slippery foods that slide down

the throat before chewing, such as:

• hot dogs, sausages, or toddler hot dogs (even

when cut in round slices)

• peanuts and other nuts

• hard candy, jelly beans

• whole beans

• whole grapes, berries, cherries, melon balls,

or cherry and grape tomatoes

• whole pieces of canned fruit

Small, dry, or hard foods that are difficult to chew

and easy to swallow whole, such as:

• popcorn

• peanuts, nuts and seeds (like sunflower or

pumpkin seeds)

• plain wheat germ 

• whole grain kernels (like rice, wheat berries)

• small pieces of raw carrots or other raw or

partially cooked hard vegetables or fruits

• pretzels

• cooked or raw whole kernel corn

• potato and corn chips

Sticky or tough foods that do not break apart easily and are hard to remove from the airway, such

as:

• peanut butter or other nut or seed butters

• raisins and other dried fruit

• tough meat or large chunks of meat

• marshmallows 

• chewing gum

• caramels or other chewy candy.

Babies and young children are at the highest

risk of choking on food and remain at high

risk until they can chew better. Choking kills

more young children than any other home

accident. How can you make eating safer for

young children?
70 Feeding Infants
A Guide for Use in the Child Nutrition Programs 71

abies are more susceptible to bacteria than older children,

and unsanitary food conditions can cause serious 

infections. General cleanliness, proper food selection, 

and sanitary food preparation and storage are key to preventing

illnesses related to food contamination in babies. Take extra care

when handling babies’ food, bottles, and utensils to make sure

they are safe and clean. State and local guidelines may vary 

regarding requirements for sanitary food preparation in child 

care facilities and other institutions. Contact your local health

department to obtain the local regulations and standards for food

safety and sanitation and to ask about a local food handler

course in your area. See Chapter 11, Commercially Prepared

Baby Food, for guidelines on purchasing, serving, and storage of

commercially prepared baby foods. See Chapter 12, HomePrepared Baby Food, for information on home-prepared baby

food, including information on cleanliness, equipment to use,

preparation guidelines for specific types of foods, food safety, and

storage of foods.

Hand Washing

Proper hand washing can help prevent the spread of illness in

child care settings. Make sure to wash your hands thoroughly

by following these steps:

• Wet your hands with warm running water.

• Add soap.

• Wash all surfaces on hands. Rub vigorously for at least 

20 seconds. Wash carefully between fingers, around the tops

and palms of hands, over wrists, and under nails using a clean

nail brush.

• Rinse your hands well under warm running water, leave the

water running while drying hands.

• Dry your hands with a clean, disposable paper towel. 

• Turn off the faucet, using the disposable paper towel, instead

of your clean bare hands.

When should the hands be washed?

Wash your hands thoroughly before you:

• bottle feed a baby,

• handle, prepare, serve, or touch food or bottles,

B

10 Sanitary Food Preparation

& Safe Food Handling 
72 Feeding Infants

• handle food utensils and set the table,

• touch raw meat, poultry, or fish,

• eat, drink, or feed food to babies or children,

• put away clean dishes,

• give medication.

Wash your hands thoroughly after you:

• arrive at the site for the day,

• handle raw meat, poultry, fish, or eggs,

• change a baby’s or child’s diaper and/or clothing, 

• use the bathroom or assist a child in the bathroom,

• handle a baby or child who is ill or give medication,

• come in contact with any bodily fluids (e.g., soiled diapers,

urine, blood, feces, vomit, mucus, spit, breastmilk),

• sneeze or cough into tissues or hands,

• get your hands dirty, or have been cleaning, or working outside,

• wipe noses, mouths, bottoms, sores or cuts,

• handle pets, or other animals, or garbage.

Make sure to wash a baby’s or child’s hands before and after

eating meals and snacks, and after changing a diaper (many 

babies place their hands in the diaper area during changing).

See pages 97-99 for resources on food safety (which include 

materials on hand washing).

If a Caregiver Has an Illness or Infected Injury

People who are ill and handle food can easily spread their 

illness to others, including babies and children. Therefore, the

following caregivers should not handle food for babies:

• those who have signs or symptoms of illness (including 

vomiting, diarrhea, and infectious skin sores that cannot be

covered); and

• those who may be infected with bacteria or viruses that can be

carried in food.

Food Preparation Areas Are Not for Diaper

Changing

Do not use food preparation and dining areas or surfaces for

changing diapers. Staff and caregivers should make sure to 

follow the hand washing guidelines above.
A Guide for Use in the Child Nutrition Programs 73

SANITARY FOOD PREPARATION & SAFE FOOD HANDLING 10

Cleaning and Sanitizing Food Preparation Areas,

Equipment, Feeding Dishes and Utensils, and

Dining Areas

Clean and sanitize all food preparation, food service, and 

dining areas (including countertops, tables, and high chairs) 

before and after each meal. Clean and sanitize all food preparation equipment, dishes and utensils for serving and feeding after

each use and store them in a clean and sanitary manner.

Before and after preparing and serving food, the following

should be washed with soap and hot water and then rinsed 

thoroughly with hot water:

• all surfaces used to prepare food, including countertops and

tables,

• food preparation equipment and utensils (including food 

warmers),

• food service and dining areas (including highchairs).

After washing, sanitize all of the above according to applicable

Federal, State, and local food service rules and regulations for

centers, small and large family child care homes, and other 

public institutions serving food to infants and children. Follow

applicable Federal, State, and local guidelines if a dishwashing

machine is used for sanitization. 

Note: Do not use styrofoam cups and plates and breakable 

disposable plastic utensils. Swallowed styrofoam pieces or

broken plastic utensil pieces can cause choking or other 

injuries.

Refer to the latest edition of the following publication, for 

additional guidelines regarding cleaning and sanitizing serving

and feeding dishes and utensils and equipment in child care 

facilities: American Public Health Association and the American

Academy of Pediatrics. Caring For Our Children: National Health

and Safety Performance Standards: Guidelines for Out-of-Home

Child Care Programs. Ask your State agency for information on

obtaining this publication. It is also available from the National

Resource Center for Health and Safety in Child Care, toll-free

phone 1-800-598-KIDS, web site: http://nrc.uchsc.edu
74 Feeding Infants

Clothing of Caregiver Involved in Food

Preparation or Handling

Providers and staff should wear clean clothing and aprons

when working with breastmilk, infant formula, or food. Consult

with your State agency about requirements for wearing rubber or

latex gloves or other types of protective clothing.

Refrigerator and Freezer Temperature

The refrigerator in the facility should be set at a temperature of

40° Fahrenheit or below and should be checked regularly with an

appliance thermometer. The temperature in a freezer should be

0° Fahrenheit or below and should be checked regularly with an

appliance thermometer. Have the appliances checked immediately by a qualified repairperson if the temperatures are above those

levels.

Reducing Lead Exposure from Food

To reduce the chances that a baby will be exposed to lead from

food:

• Store foods or beverages in covered plastic or regular glass food

storage containers. After opening canned foods or beverages,

store the leftover food or beverage in such containers. Do not

store food or beverages in their opened cans, except infant 

formula.

• Do not feed babies any canned imported foods or beverages—

these cans may have lead seams (lead in seams can leak into

the food).

• Do not use decorative or ornamental ceramic ware or pottery,

especially if imported from another country, for cooking, 

storing, or serving food or beverages. Imported dishware may

release toxic levels of lead into food.

• Do not cook, store, or serve foods or beverages using:

— Leaded crystal (glass) bowls, pitchers, or other containers, or

— Antique ceramic or pewter vessels, dishes, or utensils.

These items can release toxic amounts of lead into food.

If using canned foods to make baby food, only use food 

manufactured in the United States, where can seams cannot 

contain lead by law.

000

000

000

000
A Guide for Use in the Child Nutrition Programs 75

Wash each baby’s and child’s hands with soap and water

before feeding to wash away dirt and dust that could contain

lead. Dust and dirt containing lead can come from outside 

or inside a house or apartment. For this same reason, it is

important to regularly wash toys and wash the hands of 

babies and children in your care. See page 25 on lead in 

water.

SANITARY FOOD PREPARATION & SAFE FOOD HANDLING 10
76 Feeding Infants

Wash Your Hands Often!

Proper and regular hand washing by adults and children can keep children, caregivers and their families

healthier and can help prevent the spread of illness

in child care settings. Hand washing is the easiest,

least expensive, and most effective way to stop the

spread of germs that cause illness. Our hands pick 

up germs from objects, other children and adults,

food, surfaces, and our own bodies. Once germs

are on our hands, they can easily enter our bodies or

those we care for and cause illness. Make sure to

wash your hands thoroughly by following these

steps:

Wet your hands with 

warm running water.

Add soap.

Wash all surfaces on hands.

Rub vigorously for at least 20

seconds. Wash carefully 

between fingers, around 

the tops and palms of hands, 

over wrists, and under nails 

using a clean nail brush.

Rinse your hands well 

under warm running water, 

leave the water running 

while drying hands.

Dry your hands with 

a clean, disposable 

paper towel.

Turn off the faucet, 

using the disposable 

paper towel, instead 

of your clean bare hands.

WHEN SHOULD THE HANDS BE WASHED?

Wash your hands thoroughly before you:

• bottle feed a baby,

• handle, prepare, serve, or touch food or 

bottles,

• handle food utensils and set the table,

• touch raw meat, poultry, or fish,

• eat, drink, or feed food to babies or children,

• put away clean dishes,

• give medication.

Wash your hands thoroughly after you:

• arrive at the site for the day,

• handle raw meat, poultry, fish, or eggs,

• change a baby’s or child’s diaper and/or 

clothing, 

• use the bathroom or assist a child in the

bathroom,

• handle a baby, child, or person who is ill,

• come in contact with any bodily fluids (e.g.,

soiled diapers, urine, blood, feces, vomit, mucus, spit, breastmilk),

• wipe noses, mouths, bottoms, sores or cuts,

• get your hands dirty or have been cleaning a

child, a room, potty chairs, toys, or other objects,

• sneeze or cough into tissues or your hands,

• give medication,

• handle pets, or other animals, or garbage,

• have been playing or working outside.

1

2

3

5

4

Figure 10

Hand Washing Tips
A Guide for Use in the Child Nutrition Programs 77
78 Feeding Infants

Applesauce

INGREDIENTS: APPLES, WATER,

ASCORBIC ACID (VITAMIN C) 

Nutrition Facts

Serving Size 1 jar (140 g)

Amount Per Serving

Calories 80

Total Fat 0 g

Sodium 0 mg

Total Carbohydrate 20 g

Dietary Fiber 2 g

Sugars 12 g

Protein 0 g

% Daily Value

Protein 0% Vitamin A 4%

Vitamin C 45% Calcium 0%

Iron 2%

*Note that manufacturers may include information on the content of

additional nutrients (e.g., zinc, potassium, B-complex vitamins) on

the nutrition label of foods for children under 2 years of age.

Information about other essential vitamins and minerals is mandatory

only when they are added to enrich or fortify a food, or when a claim

is made about them on the label.

Definitions:

% Daily Value shows how a food fits into the overall daily diet of the

child. It shows what percent of the nutrient is provided from one

serving of the food to meet the daily dietary needs of the child.

Serving Size is the basis on which manufacturers declare the nutrient amounts and % Daily Values on the label. It is the amount of

food customarily eaten at one time.

Sample Nutrition Label and Ingredient List 

for Commercial Jarred Baby Food*
A Guide for Use in the Child Nutrition Programs 79

ommercially prepared baby foods are safe, sanitary, and

nutritious. Below, and in Figure 11, are guidelines on 

purchasing, serving, and storing commercially prepared

baby foods.

Purchasing Baby Food

• Look at the “use-by” dates for purchase and use of unopened

baby food jars or other commercial baby food. If the date has

passed, do not purchase or use the food. 

• Buy baby food jars that are clean on the outside and do not

have a broken vacuum seal. The seal is broken if the button in

the center of the top is popped out. Do not purchase or use

sticky or stained jars, jars with rusty lids, or cracked jars (the

food in such jars would contain germs and may contain glass

chips). Do not purchase or use any jar with the vacuum seal

already broken.

• Choose single-ingredient baby foods and ones containing a 

small number of simple ingredients. Some combination foods

or dinners with many different types of ingredients may have

less nutritional value by weight than single-ingredient foods

mixed together. Plain meat and plain vegetables can be mixed

together if the baby likes the taste. Plain fruits can be served

instead of baby food desserts.

• Read the ingredient list and the nutrition label on the food

package. See the sample food label on page 78. Avoid baby

foods containing added salt and sugar. 

• Avoid desserts such as baby puddings, custards, and cobblers

because they are high in sugar. Babies do not need added 

sugar and should have the opportunity to have naturally sweet

foods such as fruit.

• For babies 6 to 12 months of age, choose baby foods that

progress in texture and thickness to challenge the baby to

learn new mouth skills.

• Do not feed commercial baby food dinners, vegetables, or other

products containing milk, yogurt, cheese, whole milk solids, or

nonfat dry milk to babies who cannot consume milk products

because of milk allergies, lactose intolerance, or galactosemia. 

Serving Baby Food

• Look at the “use-by” date on the baby food jar. If the date 

has passed, do not use the food. 

11 Commercially Prepared 

Baby Food

C
80 Feeding Infants

• Wash the jar and lid of baby food before opening it.

• Be sure the vacuum seal has not been broken before using.

You should hear a pop when you open the lid of the jar.

• Do not tap the jar lid with a utensil or other object or bang

it against a hard surface—this could break glass chips into

the food. If a grating sound is heard when opening the jar lid,

check if there are any glass chips under the lid. Always look at

the food for any abnormal pieces when removing it from the jar.

• Since babies usually do not finish a small jar of baby food at

one feeding, remove enough food from the jar for one feeding

and put it in a dish for serving. Do not use the baby food jar

as a serving dish. If the spoon used for feeding is put back

into the jar, the baby’s saliva will contaminate and spoil the

remainder of the food. If more food is needed from the jar,

use a clean spoon to remove it.

• Do not leave baby food in jars to heat in a microwave

oven—this may heat food unevenly and then the food

could burn the baby’s mouth. Instead, remove the food

from the jar and heat it only until warm on a stove, in a food

warmer, or in a microwave oven. Then, stir it, and test its

temperature before feeding. If a microwave oven is used to

heat food removed from a jar, let the food sit for a few minutes, stir thoroughly, and test its temperature.

• Throw away any leftover food in the dish. Do not put it back

into the jar because it could make the food in the jar spoil.

• The desired amounts of plain meats and plain vegetables can

be mixed together. Some infants will accept meat better

when it is mixed in this manner.

Storing Baby Food

• Observe “use-by” dates for pantry storage of unopened baby

food jars. If the date has passed, throw out the food. Rotate

the inventory of baby food. Store the unopened jars in a cool

dry indoor place—not in a refrigerator or in a vehicle, a

garage, or outdoors.

• Once a jar is opened and some food is removed, label and

date the jar, store any remaining food immediately in the 

refrigerator, and use it within 2 days. However, baby food

meats and egg yolks should be used within 24 hours. Throw

out food not used within those time periods. Keep masking

tape and a marker in the kitchen to use in marking food with

the date and time opened.

• Regularly check to make sure the refrigerator is cold enough,

40° F or below, to keep food safe (see page 74).
A Guide for Use in the Child Nutrition Programs 81

When you buy baby foods:

• Look at the “use-by” date on baby food jars. If the date has passed, do not

buy or use the food.

• Buy baby food jars that are clean on the outside and do not have a broken

vacuum seal. The seal is broken if the button on the center of the top is

popped out.

• Single-ingredient baby foods, like single vegetables, fruits, and meats provide

more nutrition ounce for ounce than baby food combination dinners and baby

food desserts. Plain meats and plain vegetables or fruit can be mixed together

if the baby likes the taste. Fruit can be served instead of a baby food dessert.

• Read the ingredient list on the baby food label. This way you can tell if foods

contain vegetable, fruit, or meat as the first ingredient and if they have added

salt, butter, oil or cream, sugar, corn syrup, or other ingredients.

When you serve baby food in jars:

• Look at the “use-by” date on the baby food jar. If the date has passed, do not

use the food.

• Wash the lid and jar of baby food before opening.

• Make sure the jar lid is sealed and has not been broken before opening it. If

the seal has not been broken, you should hear a “pop” noise when you open

the lid of the jar.

• Do not tap the jar lid or bang it to open it—this could break glass chips into the

food.

• Remove enough food from the jar for one feeding. Look closely at the food to

make sure there are no abnormal pieces in it. Place the food in a dish for

feeding. This way the baby’s saliva on the spoon will not spoil the leftover

food in the jar. If additional food is needed, use a clean spoon.

• If needed, warm the baby food on a stove or in a food warmer. Stir the

food and test its temperature before feeding. Do not leave baby food in

jars to heat in a microwave—the food can get very hot and could burn

the baby’s mouth.

• Throw away any leftover food in the dish. Do not put it back in the jar.

When you store baby food in jars:

• After opening a jar, replace the lid and place it in the refrigerator. Label the jar

with the child’s name and the date and time that it was opened. Use the food

within 2 days, except for baby food meats and egg yolks which should be

used within 24 hours. Throw out foods not used within those times.

• Regularly check to make sure that your refrigerator temperature is cold

enough (40° Fahrenheit or lower) to keep the food safe.

• Look at the “use-by” date on the jar when storing unopened jars. If the date

has passed, throw out the food and recycle the jar.

• Store unopened jars in a cool dry place like a kitchen cabinet or pantry (not in

the refrigerator, car, garage, or outdoors).

• Rotate the stored jars so that you use the food previously purchased prior to

newly purchased food.

Keep the baby’s food clean to keep it safe. Remember to wash your hands before 

handling any food (See Figure 10 on Hand Washing Tips).

Figure 11

Using Commercially Prepared Baby Food
82 Feeding Infants
A Guide for Use in the Child Nutrition Programs 83

ome-prepared baby foods can be equally nutritious and

more economical than commercially prepared baby foods.

With home-prepared baby foods, the parent or caregiver

has more control over the variety and texture of food than with

commercial baby foods. Babies 8 months and older who are on

commercial baby foods can be shifted to home-prepared baby

foods with a thicker texture. When preparing food for the older

baby, some similar foods can be used as those prepared for children over 1 year of age as long as the texture is modified for the

baby’s stage of development. However, some foods for children

are not appropriate for babies, such as mixed foods like

casseroles, pizza, etc. These mixed foods contain ingredients that

a baby may not have tried before, may be allergic to, and could

possibly choke on. See Figure 12 on using home-prepared baby

foods.

When preparing baby food at home, care must be taken to 

ensure that the food is:

• prepared and stored safely;

• appropriate in texture;

• cooked using methods that conserve nutrients; and

• prepared without adding unnecessary ingredients such as sugar

and salt.

Take extra care when handling a baby’s food, bottles, and

utensils. To better assure that baby food is safe and sanitary, 

it is critical to follow handwashing guidelines and to wash and

sanitize all equipment used to prepare and serve food before and

after food preparation. See Figure 10 on handwashing guidelines. See page 73 on washing and sanitizing all equipment and 

appliances, dishes and utensils, and food preparation and 

serving surfaces.

Equipment for Preparing Baby Food

Common kitchen equipment is all that is needed for cooking

food. A simple metal steamer, found in supermarkets, can be

used to cook vegetables and fruit and will reduce the loss of 

vitamins in cooking.

Equipment for making food into appropriate textures for babies

include:

• Blender or food processor (purees foods, including meats, 

vegetables, and fruit, to a very smooth texture);

H

12 Home-Prepared Baby Food
84 Feeding Infants

• Fine mesh strainer (use to puree soft cooked or very

ripe fruits and some vegetables—push the food through the

strainer with the back of a spoon); 

• Baby food grinder or food mill (purees most foods to a smooth

texture and purees meats to a coarser texture); or 

• A kitchen fork and/or knife (for older infants, foods can be

mashed with a fork or chopped finely with a knife—cubes of

food should be no larger than 1/4 inch to reduce the chances

of choking).

Wash the above equipment with soap and hot water, rinse 

thoroughly with hot water, and sanitize. Allow to air dry. Use

separate cutting boards for animal foods (i.e., meat, poultry, fish)

and non-animal foods (i.e., vegetables, fruits, breads). Do not

use boards with crevices and cuts. Wash and sanitize boards 

after each use. Non-porous plastic or glass cutting boards are

best as they are easiest to clean.

Preparing Food

Some general tips to remember when making baby food include

these:

• Begin with good quality food. Use fresh food. Ideally, prepare

foods for a baby immediately before use and avoid using 

leftover food. 

• Cook foods until soft and tender.

• After pureeing food, liquid (cooking liquid, water, or fruit juice)

can be added for a thinner texture. As a baby gets older and

develops better eating skills, the texture of foods can be

changed.

• It is not necessary to add sugar, syrups, salt, seasonings, oil,

butter, lard, cream, gravy, sauces, or fat drippings to the

baby’s food. When cooking foods for a group of children, 

separate out the baby’s portion before adding those 

ingredients. 

• Never add honey to a baby’s foods because of the risk of 

getting a very serious illness, called infant botulism.

• Do not use:

— home-canned food (if canned improperly, harmful bacteria 

could be in the food),

— outdated cans (if dated),

— food from dented, rusted, bulging, or leaking cans or jars, or 

— food from cans or jars without labels.
A Guide for Use in the Child Nutrition Programs 85

12 H O ME-PREPARED BABY FOOD

Some tips to remember when preparing, using, and storing 

different foods include these:

VEGETABLES AND FRUITS 

• Do not feed home-prepared spinach, beets, turnips, carrots, or

collard greens to babies under 6 months old. These types of

home-prepared vegetables may contain large amounts of nitrates

or nitrites which could make babies under 6 months of age sick.

• Select high quality fresh vegetables and fruits or plain frozen

vegetables and fruits (without added salt or sauces). Canned

fruits without added sugar or canned vegetables without added

salt can be used. If frozen or canned foods are used, make

sure to check the ingredient list.

• Wash fresh vegetables and fruits very well with clean cold 

running water to remove dirt. Remove pits, seeds, skins, and

inedible peels from fruits and some vegetables. Edible skins

and peels can be removed either before or after cooking. 

• When cooking is needed to soften a food’s texture, cook the

vegetables or fruits either by boiling in a covered saucepan

with a small amount of water or steaming in a saucepan until

just tender enough to be pureed or mashed or eaten as a finger

food. A microwave oven can be used to cook vegetables until

soft.

• After cooking, puree or mash food with liquid until it reaches

the desired smoothness. Vegetables puree easier in large

quantities in a blender or food processor.

• Keep produce separate from meat, poultry, and fish in both

your shopping cart and your refrigerator. The meat, poultry,

and fish could drip juices and contaminate the other foods.

When shopping, ask the cashier to bag meat, poultry, and fish

separately from other foods.

MEATS, POULTRY, FISH, AND MILK PRODUCTS 

Food Purchasing

• Obtain all food from an approved source, such as a grocery

store or food wholesaler. Check with your State agency for 

approved sources.

• Purchase only USDA government-inspected meats.

• Select cheese made from pasteurized milk. Never feed babies

dairy products made from raw, unpasteurized milk.

Unpasteurized milk products may contain harmful bacteria

that can cause serious illnesses.

• If fish is purchased, only purchase finfish (e.g., flounder, 

haddock, cod, salmon) not shellfish.
86 Feeding Infants

Food Storage

• Immediately after purchasing meats, poultry, finfish, and dairy

products such as cheese, store them in a refrigerator (not in

the door section) and remove them right before use. Make sure

these foods are wrapped securely so that any juices do not drip

and contaminate other foods. Do not allow these foods to sit

out at room temperature. 

• Store these uncooked foods in the coldest part of the refrigerator, on a bottom shelf or drawer, and prepare them quickly

(within 1 day for fish, and 1 to 2 days for meat and poultry).

Thawing Foods

• Thaw frozen foods either in a refrigerator, during cooking, or 

in a microwave oven set at the defrost setting. If thawed in a

microwave oven, cook immediately since parts of the food will

be warm.

• Do not thaw frozen meat, poultry, or fish on a kitchen counter

or in standing water at room temperature. Germs grow rapidly

as food thaws at room temperature.

Avoid Spreading Harmful Bacteria to Other Foods

• To avoid spreading harmful bacteria to other foods, do not 

allow raw or partially cooked meat, poultry, fish, or their juices,

to touch other foods or the surfaces, serving plates, or utensils

used to serve or prepare other foods. For example, do not use

a fork to test a piece of meat, poultry, or fish while cooking and

then use the same fork to mix a cold vegetable dish.

• Use separate utensils and cutting boards for meat, poultry, fish

and non-animal foods (i.e., vegetables, fruits, breads). Do not

use boards with crevices and cuts. Wash and sanitize utensils

and boards after each use. Non-porous plastic or glass cutting

boards are best as they are easiest to clean.

• In the refrigerator, store raw or cooked meat, poultry, and fish

below cooked or ready-to-eat foods so that no juices from those

foods drip on other foods.

Preparation Before and After Cooking

• Remove all fat, gristle, skin, and bones from meat, poultry, 

and fish before cooking. Take care in removing all the bones,

including small ones, from fish and poultry. Heat from cooking

destroys any bacteria that may be added to food when bones

are removed. 

• After cooking, remove tough parts and visible fat. 

000

000

000

000
A Guide for Use in the Child Nutrition Programs 87

Cooking Guidelines

• Always use a meat thermometer when cooking meat, poultry,

or fish to ensure that the foods are safely cooked. Brochures

on how to use kitchen and meat thermometers are available

from USDA’s Food Safety and Inspection Service, toll-free

phone 1-800-535-4555, or web site: http://www.fsis.usda.gov.

• Cook meat, poultry, and fish thoroughly to kill any bacteria

that might be present in the food:

— Cook all red meats to an internal temperature of at least

160° Fahrenheit. Check the temperature with a meat 

thermometer. 

— Cook white meat poultry to an internal temperature of at

least 170° Fahrenheit and dark meat poultry to an internal

temperature of at least 180° Fahrenheit for doneness. Check

the temperature with a meat thermometer. 

— Cook fish to an internal temperature of 160° Fahrenheit.

Check the temperature with a meat thermometer. 

• Try these cooking methods: broiling, baking or roasting, pan

broiling, braising, pot roasting, stewing, or poaching (for fish).

• Do not cook food in an oven set at a temperature below 325°

Fahrenheit because low temperatures may not heat the food

hot enough to kill bacteria.

Never Feed Partially Cooked or Raw Meat, Poultry, Fish, or Eggs

• Never feed infants partially cooked or raw meat, poultry, fish,

or eggs. Uncooked meat, poultry, fish, and eggs can contain

harmful bacteria, parasites, or viruses that could cause very

serious food poisoning.

Preparation After Cooking

• After cooking, separate any remaining bone, skin, and visible

fat. Cut the meat, poultry, or fish into small pieces and puree,

using some sterile water or cooked broth if needed for moisture, to the desired texture. Warm meat is easier to blend than

cold meat; chicken, turkey, lamb, and fish are the easiest to

puree. Also, meats are easier to puree in a blender or food

processor in small quantities. 

• As a baby’s feeding skills mature, meats, poultry, and fish can

be served ground or finely chopped instead of pureed.

Storage After Cooking

• After cooking, immediately serve these foods or store them in

the refrigerator (for no longer than 24 hours) or freezer (use

within 1 month). If stored, label the container with the date

12 H O ME-PREPARED BABY FOOD
88 Feeding Infants

and time the food was prepared. Cool foods immediately in the

refrigerator after cooking.

• Throw out cooked meat, poultry, or fish if kept at room temperature out of the refrigerator for more than 2 hours, including

serving time.

Home-Prepared Eggs

• Buy grade AA or A eggs with clean, uncracked shells. Do not

buy unrefrigerated eggs.

• As soon as possible after purchasing, refrigerate eggs in the

original carton, in the main section of the refrigerator which is

colder than refrigerator door sections.

• Cook eggs well—boil them until the yolk and white are firm

and not runny, and then separate the yolk from the white. Do

not serve soft, runny eggs—these are undercooked and might

contain bacteria that can make a baby sick.

• Only feed babies the yolk of the egg—the white is not 

recommended for babies less than 1 year of age. The hard

yolk can be mashed with some liquid, such as sterile water or

infant formula, to the desired texture. 

• Refrigerate eggs immediately after cooking or keep them hot.

Throw out eggs if kept at room temperature out of the 

refrigerator for more than 2 hours, including serving time.

• Do not feed babies raw or partially cooked eggs or foods that

contain them, such as homemade ice cream, mayonnaise, or

eggnog (do not feed commercial foods containing eggs to babies

either because they would contain egg whites).

• Before using commercially prepared foods, check the list of 

ingredients to check if they contain whole eggs.

• Wash hands, utensils, equipment, and work areas with warm

soapy water before and after contact with eggs and dishes 

containing eggs.

• Serve cooked eggs and dishes containing eggs immediately after

cooking or place in shallow containers for quick cooling and 

refrigerate immediately.

Dry Beans or Dry Peas

• To cook dry beans or dry peas, follow cooking instructions

found on the package label or in many basic cookbooks. It is

not necessary to add seasonings, salt, or fat to the beans or

peas. Make sure to cook the beans or peas until soft enough

to puree or mash easily.

• If canned beans are used, drain the salty water and rinse the

beans with clean water before pureeing or mashing.
A Guide for Use in the Child Nutrition Programs 89

Grain Products

• Cook noodles, macaroni, and spaghetti until soft, then mash or

finely chop, depending on the baby’s development.

• Cook rice, barley, or other grain kernels until very soft and

then puree or finely mash before serving to a baby. Babies can

choke on cooked grain kernels that are not mashed or ground.

Serving, Storing, and Reheating 

Home-Prepared Baby Foods 

Recommended guidelines for serving and storing homeprepared baby foods after cooking and pureeing include:

If Serving Immediately:

• Serve freshly cooked food to a baby shortly after preparation is

completed. Allow the food to cool for a short period (10-15

minutes) so that it does not burn the baby’s mouth. Test the

temperature of the food, using a clean spoon, before feeding it

to the baby.

• Do not allow freshly cooked foods to stand at room 

temperature or between 40° and 140° Fahrenheit for more than 

2 hours. Between those temperatures, bacteria can grow that

can cause a baby to become ill.

If Refrigerating Foods:

• Keep the refrigerator maintained in a clean and sanitary 

condition. See page 74 on maintaining the proper temperature

in a refrigerator.

• Refrigerate or freeze home-prepared foods, which will not be

eaten, immediately after cooking. All foods to be stored should

be covered, wrapped, or otherwise protected and labeled with

the date and time they were prepared.

• Refrigerate hot foods in shallow containers with the food less

than 3 inches deep and cover the container only after the food

is cold. 

• Store raw or partially cooked foods below cooked or ready-toeat foods so that the raw juices cannot drip onto the other

foods.

• Use freshly prepared refrigerated foods within 2 days (except

meats, poultry, fish, and egg yolks which should be used within 24 hours).

• Throw out any foods if left unrefrigerated for more than 

2 hours. It is not wise to taste the food to see if it is safe 

because a food can contain harmful bacteria but still taste 

normal.

12 H O ME-PREPARED BABY FOOD
90 Feeding Infants

If Freezing Foods:

• Keep the freezer clean and sanitary.

• Try these methods of freezing baby food in serving-size 

quantities:

— Ice cube tray method—Pour cooked pureed food into sections

of a clean ice cube tray; cover with plastic wrap, a lid, or 

aluminum foil; and place into the freezer. When frozen solid,

the cubes can be stored in a freezer container or plastic freezer

bags in the freezer.

— Cookie sheet method—Place 1-2 tablespoons of cooked

pureed food in separate spots on a clean cookie sheet, cover

with plastic wrap or aluminum foil, and place into the freezer. When frozen solid, the frozen food pieces can be stored

in a freezer container or plastic freezer bags in the freezer.

• Label and date the bags or containers of frozen food and use

them within 1 month. When ready to use the frozen baby food,

remove the desired number of cubes or pieces from the bag or

container with clean hands and thoroughly reheat them. 

• See page 74 on checking the temperature of the freezer. 

When Reheating Foods:

• Thoroughly reheat refrigerated or frozen home-prepared baby

foods to 165° F before feeding them to a baby. Reheating kills

bacteria which can grow slowly while a food is in the refrigerator or during thawing. Stir the food and test its temperature

before feeding it to the baby.

• Defrost frozen foods in the refrigerator, under cold running 

water, or as part of the reheating process. Never defrost baby

foods by leaving them at room temperature or in standing 

water, as in a pan or bowl.

• Throw out any uneaten leftover food in the baby’s dish or the

serving dish. 

Do not refreeze baby food that has been removed from the

freezer and allowed to thaw in the refrigerator. Use thawed food

within 48 hours from the time it was removed from the freezer

(label the food with the date and time you removed it). Throw it

out if it has been stored longer than 48 hours. Meats, poultry, or

fish should be thrown out if stored longer than 24 hours.
A Guide for Use in the Child Nutrition Programs 91

Before preparing food:

• Wash all bowls, utensils, pots and pans, equipment

(such as a blender, food mill, food processor, baby

food grinder, cutting board), the sink, and counters in

hot, soapy water, rinse, and sanitize. Allow to air dry.

When you prepare baby food:

• Begin with good quality food. Use fresh food if

possible. Check ingredients on the ingredient label

of commercially canned or frozen foods. Prepare

foods for a baby immediately before use and avoid

using leftover food.

• Wash fruits and vegetables well and remove parts

not to be eaten (peels, seeds, pits) before cooking.

• Do not feed home-prepared spinach, beets,

turnips, carrots, or collard greens to babies under 6 months old.

• Remove bones, fat, and gristle from meats, 

poultry, and fish. Meats, poultry, fish, dried beans

or peas, and egg yolks should be well cooked.

Baking, boiling, broiling, poaching, and steaming

are good cooking methods. Call USDA’s Meat and

Poultry Hotline at 1-800-535-4555 for information

on safe food handling, including what temperatures to bring meat, poultry, and fish to during

cooking.

• Cook foods until they are soft and tender. Food

can be pureed to the right texture using a blender

or food processor, a fine mesh strainer, baby food

grinder, or food mill. For older babies, foods can

be mashed with a fork or chopped finely. Water

can be added to give pureed food a thinner 

consistency.

• Do not add salt, butter, margarine, lard, oil, cream,

sugar, syrups, gravy, sauces, or fat drippings to the

baby’s food. Never add honey to the baby’s

food.

• Do not use home-canned food, food from 

dented, rusted, bulging or leaking cans or jars,

or from cans or jars without labels.

When you store home-prepared baby food:

• Immediately after cooking, refrigerate or freeze

freshly cooked food to be stored. Label the food

with the date and time it was prepared. Do not let

the food sit at room temperature—harmful germs

can grow in the food at that temperature. Throw

out foods left at room temperature for 2 hours or

more including serving time.

• Make sure to place foods to be stored in the refrigerator in a clean container with a tightly fitting lid.

Regularly check to make sure that the refrigerator

temperature is cold enough (40o

Fahrenheit or 

below) to keep food safe.

• Use refrigerated foods within 2 days (except for

meats, poultry, fish, and egg yolks—use them

within 24 hours). Throw out foods not used within

those times.

• To freeze baby food, either pour cooked food into

sections of a clean ice cube tray or place 1 to 2 

tablespoons of pureed food in spots on a clean

cookie sheet. Cover the food with plastic wrap or

foil. When frozen, place the food pieces into a

covered freezer container or tightly closed plastic

bag in the freezer. Label and date the containers

or bags. Use frozen foods within 1 month.

• Regularly check to make sure that the freezer 

temperature is cold enough (0o

Fahrenheit or 

below) to keep food safe.

When you serve home-prepared baby food:

• Serve freshly cooked food to a baby right after

preparing it. Allow the food to cool to lukewarm. Stir

the food and test its temperature before feeding.

• Throw away any leftover food in the baby’s dish.

Do not put it back in the refrigerator or freezer.

When you reheat home-prepared baby

food:

• Completely reheat refrigerated or frozen homeprepared baby food to at least 165o

Fahrenheit 

before feeding. Allow food to cool to lukewarm.

Stir the food and test its temperature to make sure

it is not too hot or cold before serving to baby.

• Thaw frozen foods in the refrigerator, under cold

running water, or when reheating the food. Never

defrost baby foods by setting them out at room

temperature or in a bowl of standing water. Germs

can grow in food sitting at room temperature.

• Throw out leftover food remaining in the dish that

the baby does not eat.

• Do not refreeze baby food that has thawed. Label

food with the date and time it was removed from

the freezer. Store thawed food in the refrigerator

and use it within 2 days or throw it out (except for

meats, poultry, or fish which should be thrown out

after 24 hours).

Keep the baby’s food clean to keep it safe. Remember to wash your hands before handling

any food (See Figure 10 on Hand Washing Tips).

Figure 12

Using Home-Prepared Baby Foods
92 Feeding Infants
A Guide for Use in the Child Nutrition Programs 93

American Public Health Association and

American Academy of Pediatrics. Caring for

Our Children: National Health and Safety

Performance Standards: Guidance for Out-OfHome Child Care Programs. Arlington, VA:

National Center for Education in Maternal and

Child Health, 1992.

American Dietetic Association. Manual of

Clinical Dietetics. 4th ed., Chicago, IL: The

American Dietetic Association, 1992.

Baker, S. and Henry, R.R. Parents’ Guide to

Nutrition. Reading, MA: Addison-Wesley

Publishing Company, Inc., 1987.

Berman, C. and Fromer, J. Meals Without

Squeals. Palo Alto, CA: Bull Publishing Co.,

1991.

Brazelton, T.B. Why children and parents must

play while they eat: An interview with T. Berry

Brazelton, MD. J Am Diet Assoc 93: 1385-

1387, 1993.

Centers for Disease Control and Prevention,

U.S. Public Health Service. The ABCs of Safe

and Healthy Child Care: A Handbook for Child

Care Providers. Washington, DC: U.S.

Department of Health and Human Services.

1996.

Committee on Accident and Poison Prevention,

American Academy of Pediatrics. Revised first

aid for the choking child. Pediatrics 78:177-

178, 1986.

Committee on Nutrition, American Academy of

Pediatrics. On the feeding of supplemental foods

to infants. Pediatrics 65:1178-1181, 1980.

Committee on Nutrition, American Academy of

Pediatrics. Iron fortification of infant formulas.

Pediatrics 104(1): 119-123, 1999.

Committee on Nutrition, American Academy of

Pediatrics. The use of whole cow’s milk in infancy. Pediatrics 89: 1105-1109, 1992.

Committee on Nutrition, American Academy of

Pediatrics. Pediatric Nutrition Handbook. 3rd

and 4th editions, Elk Grove Village, IL:

American Academy of Pediatrics, 1993 and

1998.

Committee on Nutrition, American Academy of

Pediatrics. The Use and Misuse of Fruit Juice

in Pediatrics. Pediatrics 107:1210-1213, 2001.

Dana, N., and Price, A. The Working Woman’s

Guide to Breastfeeding. Deephaven, MN:

Meadowbrook, Inc., 1987.

DHHS (U.S. Department of Health and Human

Services). Infant Care. Washington, DC: U.S.

Government Printing Office, 1989.

DHHS (U.S. Department of Health and Human

Services). The Surgeon General’s Report on

Nutrition and Health. Washington, DC: U.S.

Government Printing Office, 1988.

Edelstein, S. Nutrition and Meal Planning in

Child-Care Programs: A Practical Guide.

Chicago, IL: American Dietetic Association,

1992.

Eiger, M.S., and Olds, S.W. The Complete

Book of Breastfeeding. New York: Bantam

Books, 1987.

Eisenberg, A. What to Expect The First Year.

New York: Workman Publishing Co., Inc., 1988.

Ekvall, S. Pediatric Nutrition in Chronic

Diseases and Developmental Disorders:

Prevention, Assessment, and Treatment. New

York: Oxford University Press, 1993.

Fomon, S.J. Nutrition of Normal Infants. St.

Louis, MO: Mosby, 1993.

Food and Nutrition Service, U.S. Department of

Agriculture. Breastfed Babies Welcome Here!

A Mother’s Guide, A Guide for Child Care

Providers, and a poster. Washington, DC: U.S.

Department of Agriculture. 1993.

REFERENCE ARTICLES AND BOOKS ON NUTRITION FOR INFANTS

B ibliography
94 Feeding Infants

Food and Nutrition Service, U.S. Department of

Agriculture. Includes Child and Adult Care

Food Program: Nutrition Guidance For Child

Care Centers. Washington, DC: U.S.

Department of Agriculture. 1995.

Food and Nutrition Service, U.S. Department of

Agriculture. Child and Adult Care Food

Program: Nutrition Guidance For Child Care

Homes. Washington, DC: U.S. Department of

Agriculture. 1995.

Food Safety and Inspection Service, U.S.

Department of Agriculture. Keeping Kids Safe:

A Guide for Safe Food Handling & Sanitation

for Child Care Providers. Washington, DC:

U.S. Department of Agriculture, 1996.

Grams, M. Breastfeeding Source Book: Where

to Get What You Need to Breastfeed

Successfully. Sheridan, WY: Achievement

Press, 1988.

Graves D.E., Suitor, C.W., Holt, K.A., eds.

Making Food Healthy and Safe for Children:

How to Meet National Health and Safety

Performance Standards—Guidelines for Outof-Home Child Care Programs. Arlington, VA:

National Center for Education in Maternal and

Child Health, 1997.

Huggins, K. The Nursing Mothers’ Companion.

Boston, MA: The Harvard Common Press,

1991.

Is Baby Food Good Enough for Baby?

Consumer Reports 51:593-599, 1986.

Kitzinger, S. Breastfeeding Your Baby. New York:

Alfred A. Knopf, 1989.

La Leche League. The Womanly Art of

Breastfeeding. Franklin Park, IL: La Leche

International, 1991.

Lansky, V. Feed Me! I’m Yours. New York, NY:

Bantam Books, 1981.

Lawrence, R. Breastfeeding: A Guide for the

Profession. 4th ed. St. Louis, MO: Mosby, 1994.

Mohrbacher, N. and Stock, J. The

Breastfeeding Answer Book. Franklin Park, IL:

La Leche League International, 1991.

Missouri Department of Health. Breastfed

Infants and You, A Manual for Child Care

Providers. Jefferson City, MO: Missouri

Department of Health, 1992. (Other pamphlets

are available from Missouri Department of

Health on subjects such as breastfeeding and

feeding infants.)

*Morris, S.E. and Klein, M.D. Pre-Feeding

Skills: A Comprehensive Resource for

Feeding Development. Tucson, AZ: Therapy

Skill Builders, 1987.

National Association for the Education of Young

Children (NAEYC). Healthy Young Children: A

Manual for Programs. Washington, DC: NAEYC, 1991.

Pennington, J.A.T. Bowes and Church’s Food

Values of Portions Commonly Used. 16th ed.

Philadelphia, PA: Lippincott, 1992. 

*Pipes, P.L. and Trahms, C.M. Nutrition in

Infancy and Childhood. 5th ed. St. Louis, MO:

Mosby, 1993.

Queen, P.M. and Lang, C.E. Handbook of

Pediatric Nutrition. Gaithersburg, MD: Aspen

Publishers, Inc., 1993.

Renfrew, M., Fisher, C., and Arms, S.

Bestfeeding: Getting Breastfeeding Right For

You. Berkeley, CA: Celestial Arts, 1990.

Rice, S. Assessment of oral feeding skills. WIC

Currents 12:23-28, 1986.

Riordan, J. and Auerbach, K.G. Breastfeeding

and Human Lactation. Boston, MA: Jones and

Bartlett Publishers, 1993.

*Satter, E. Child of Mine: Feeding with Love

and Good Sense. Palo Alto, CA: Bull

Publishing Co., 1986.

*Satter, E. How to Get Your Kid to Eat—But

Not Too Much. Palo Alto, CA: Bull Publishing

Co., 1987.
A Guide for Use in the Child Nutrition Programs 95

*Satter, E. Feeding guidelines: Developmental

guidelines for feeding infants and young children. Food and Nutrition News 56: 21-26,

1984.

Saunders, S., Carroll, J.M., and Johnson, C.E.

Breastfeeding: A Problem-Solving Manual. 2nd

ed. Amityville, NY: Essential Medical

Information Systems, Inc., 1988.

Simko, M.D., Cowell, C., and Hreha, M.S.

Practical Nutrition: A Quick Reference for the

Health Care Practitioner. Rockville, MD: Aspen

Publishers, Inc., 1989.

Suskind, R.M. and Lewinter-Suskind, L.

Textbook of Pediatric Nutrition. 2nd ed. New

York: Raven Press, 1993.

Tinanoff, N., and Palmer, C.A. Dietary

Determinants of Dental Caries and Dietary

Recommendations for Preschool Children. J

Public Health Dent 60(3):197-206, 2000.

USDA (U.S. Department of Agriculture). Food

Safety Facts for Child and Adult Care Food

Programs. Washington, DC: Food Safety and

Inspection Service and Food and Nutrition

Service. 1994.

* These are also the references for Figure 1,

page 12.

B IBLIOGRAPHY
96 Feeding Infants
Resources Available and Contact Information

Administers USDA’s child nutrition programs and

provides resource materials on child nutrition programs.

Phone: (703) 305-2590

Web site: http://www.fns.usda.gov

Provides training and resource materials to USDA

funded child care providers.

Phone: (601) 232-7658

Toll-free phone: 1-800-321-3054

Web site: http://www.nfsmi.org

Protects consumers by ensuring that meat, poultry, and egg products are safe, wholesome, and accurately labeled. Provides resource materials on

food safety. Operates the USDA Meat and Poultry

Hotline Toll-free phone: 1-800-535-4555

TTY: 1-800-256-7072

Web site: http://www.fsis.usda.gov

Resource publication: Keeping Kids Safe: A Guide

for Safe Food Handling & Sanitation for Child Care

Providers (1996) 

Publishes “The Food Safety Educator,” a free quarterly newsletter on new food safety educational

programs and materials, and emerging science

concerning food safety risks. To subscribe: provide

your full name, organization name & mailing address to:

• USDA/FSIS/Food Safety Education, Room 2944

South Building, 1400 Independence Ave., SW,

Washington, DC 20250-3700, or 

• fax your request to: (202) 720-9063, or

• e-mail your request to: fsis.outreach@usda.gov

Administers Federal child care programs to states,

territories, and tribes for low-income children and

families.

Phone: (202) 690-6782

Web site: http://www.acf.dhhs.gov/programs/ccb

Sponsors the National Child Care Information

Center, 243 Church Street, N.W., 2nd Floor,

Vienna, VA 22180

This center is a national resource that links information and people to complement, enhance, and

promote the child care delivery system. 

Toll-free phone: 1-800-616-2242

TTY: 1-800-516-2242

Web site: http://nccic.org 

Develops and applies disease prevention and control, environmental health, and health promotion

and education activities.

Toll-free phone: 1-800-311-3435

Web site: http://www.cdc.gov

Related publication: The ABCs of Safe and

Healthy Child Care: A Handbook for Child Care

Providers (1996) (To order, call 1-800-553-NTIS;

the order number is: PB97-104723)

Agency or Organization and Address

Child Nutrition Division

Food and Nutrition Service

U.S. Department of Agriculture

3101 Park Center Drive

Alexandria, VA 22302

National Food Service Management Institute

The University of Mississippi

P.O. Drawer 188

University, MS 38677-3054

Food Safety and Inspection Service

U.S. Department of Agriculture

Washington, DC 20250

Child Care Bureau

Administration for Children and Families

Department of Health and Human Services

400 Sixth Street, S.W.

Washington, DC 20013

Centers for Disease Control and Prevention

Department of Health and Human Services

1600 Clifton Rd.

Atlanta, GA 30333

A Guide for Use in the Child Nutrition Programs 97

R esources on Infant Nutrition, 

Food Safety, and Related Topics
98 Feeding Infants

Food and Drug Administration

Center for Food Safety and Applied Nutrition 

Department of Health and Human Services

200 C Street, S.W.

Washington, DC 20204

National Agriculture Library (NAL)

U.S. Department of Agriculture

10301 Baltimore Blvd., Room 304

Beltsville, MD 20705-2351

National Resource Center for Health & Safety

in Child Care

National Center for Education in Maternal & Child

Health

Georgetown University

2000 15th Street, North, Suite 701

Arlington, VA 22201-2617

National Maternal and Child Health

Clearinghouse

2070 Chain Bridge Road, Suite 450

Vienna, VA 22182

U.S. Consumer Product Safety Commission

(CPSC)

Washington, DC 20207

Promotes and protects the public’s health by ensuring that the Nation’s food supply is safe, sanitary, wholesome, and honestly labeled, and that

cosmetic products are safe and properly labeled.

Operates a toll-free public information line, 1-888-

SAFEFOOD that provides accurate and meaningful

information about food safety.

Web sites: http//www.cfsan.fda.gov 

This is a gateway web site that provides links to

selected government food safety-related information: http//www.foodsafety.gov

Provides resource materials on infant nutrition

and food safety. NAL sponsors:

—Food and Nutrition Information Center

(FNIC)—collects and disseminates information

about food and nutrition.

Phone: (301) 504-5414

Web site: http//www.nal.usda.gov/fnic

—USDA/FDA Foodborne Illness Education

Information Center—provides information

about foodborne illness prevention to those developing education and training materials for

food workers and consumers. 

Web site: http//www.nal.usda.gov/foodborne

—Child Care Nutrition Resource System—

provides recipes, resources, and information on

food safety and preparing nutritious meals.

Web site: http//www.nal.usda.gov/childcare

—WIC Works Resource System—provides information on infant nutrition and breastfeeding.

Web site: http://www.nal.usda.gov/wicworks

Provides publications, resources, and references

on infant nutrition and health and safety in child

care.

Toll free phone: 1-800-598-KIDS

Phone: (703) 524-7802

Web site: http://nrc.uchsc.edu 

Publishes the National Health and Safety

Performance Standards: Guidelines for Out-OfHome Child Care Programs.

Serves as a clearinghouse of maternal and child

health publications including those on infant nutrition subjects.

Toll-free phone: 1-888-434-4MCH

Phone: (703) 821-8955

Web site: http://www.nmchc.org

CPSC protects the public from unreasonable risks

of injury or death from many types of consumer

products including baby and children’s products.

Toll-free phone hotline: 1-800-638-2772

TTY Hotline: 1-800-638-8270 

Web site: http://www.cpsc.gov 

Free copies of CPSC’s “Sleep Safe/Play Safe” campaign brochures and posters, in English and

Spanish, are available through the web site or by

writing to CPSC, Washington, DC 20207. To obtain

information about product safety or report a dangerous product or a product-related injury, call

CPSC’s above hotline or visit CPSC’s web site.
A Guide for Use in the Child Nutrition Programs 99

NUTRITION.GOV (Web site)

Federal Consumer Information Center (FCIC)

Pueblo, CO 81002

U.S. Government Bookstore

Norwest Banks Building

201 W. 8th St.

Pueblo, CO 81003

American Dietetic Association (ADA)

216 W. Jackson Blvd.

Suite 800

Chicago, IL 60606

The American Academy of Pediatrics 

141 Northwest Point Boulevard

Elk Grove Village, IL 60007-1098

American Red Cross

Partnership for Food Safety Education

800 Connecticut Avenue, N.W., Suite 500

Washington, DC 20006-2701

National Network for Child Care (NNCC)

NNCC Special Products

Communication Systems - Distribution Center

119 Printing and Publications Building

Ames, IA 50011-3171

Serves as a web-based guide to nutrition and

health information on Federal Government Web

sites. This national resource enables easy access

to government information on nutrition, healthy

eating, physical activity, and food safety, and 

specialized nutrition information for infants and

children.

Web site: http://www.nutrition.gov

Provides free and low cost publications, including

those on health and nutrition topics, through the

Consumer Information Catalog. FCIC also sponsors the National Contact Center that answers

questions about Federal agencies, programs, and

services.

Toll-free phone for the Catalog: 1-888-8

PUEBLO (1-888-878-3256).

Toll-free phone for the National Contact Center:

1-800-688-9889 

TTY: 1-800-326-2996 

Web site: http://www.pueblo.gsa.gov 

Offers for sale official Government books, periodicals, posters, pamphlets, forms, and subscription

services in many subject categories, including nutrition, childhood, health care, and safety.

Phone: (719) 544-3142

Fax: (719) 544-6719

E-mail: pueblobks@gpo.gov

Web site:

http://bookstore.gpo.gov/locations/pueblo.html

Provides materials and information on infant nutrition, food safety, and other nutrition topics.

ADA’s National Center for Nutrition and Dietetics

(NCND) Information Line offers the public direct

access to objective, credible food and nutrition information from registered dietitians.

Toll-free phone: 1-800-366-1655

Web site: http://www.eatright.org/ncnd.html

Provides materials on infant nutrition, child safety,

first aid, and choking prevention.

Phone: (847) 434-4000

Web site: http://www.aap.org

Provides health and safety training to the public

and emergency social services to U.S. military

members and their families. Your local chapter

provides pamphlets, posters, and classes in emergency techniques for first aid, preventing choking,

and cardiopulmonary resuscitation (CPR).

National Red Cross web site: http://www.

redcross.org. This web site can help you find your

local chapter of the American Red Cross.

Sponsors “Fight BAC!” Campaign and is a source

of information on food safety.

Phone: (202) 429-8273

Web site: http://www.fightbac.org

Shares land grant university information about

children and child care, through Cooperative

Extension, with parents, professionals, practitioners, and the general public.

Phone: (515) 294-5247 

Web site: http://www.nncc.org

R 

ESOURCES ON INFANT NUTRITION, FOOD SAFETY, AND RELATED TOPICS
100 Feeding Infants
A Guide for Use in the Child Nutrition Programs 101

Outside Reviewers

Kathryn Camp, M.S., R.D., L.D.

Director of Nutrition for Clinical Services

Georgetown University Child

Development Center

Washington, DC

Catherine Cowell, Ph.D, R.D.

Clinical Professor of Public Health 

Columbia University

New York, NY

M.T. DiFerrante, M.P.H., R.D., L.D.

Chief of Nutrition Services

Houston Health and Human Services

Houston, TX

Carlos A. Flores, MD

Associate Professor of Pediatrics

University of Arizona

Tucson, AZ

Reviewers from Federal Agencies

Bessie Berry 

Marianne Gravely

Food Safety and Inspection Service

U.S. Department of Agriculture (USDA)

Washington, DC

Dennis M. Bier, M.D.

Corinne Montandon, Dr.P.H.

Janice E. Stuff, M.S., R.D., L.D.

Judy Hopkinson, Ph.D.

Children’s Nutrition Research Center

Baylor College of Medicine

USDA/ARS

Houston, Texas

Carole Davis, M.S., R.D.

Director of Nutrition Promotion

Center for Nutrition Policy and

Promotion/USDA

Alexandria, VA

Sandy Facinoli, Coordinator

Food and Nutrition Information Center

National Agricultural Library/USDA

Beltsville, MD

Nancy Gaston, M.A., R.D.

Nutrition Education Coordinator

NIH, OD/Division of Nutrition

Coordination

Bethesda, MD

Myrtle Hogbin, R.D.

Nutritionist

Center for Nutrition Policy and

Promotion/USDA

Alexandria, VA

Carol E. Lang

Food and Drug Administration

U.S. Department of Health and Human

Services (DHHS)

Washington, DC

Barbara Z. Park, R.D.H., M.P.H.

Health Education Specialist

Division of Oral Health

Centers for Disease Control and

Prevention/DHHS

Atlanta, GA

Natalie Partridge, Nutritionist

Food and Nutrition Information Center

National Agricultural Library/USDA

Beltsville, MD

Dr. Kit Shaddix

Division of Oral Health

National Center for Prevention

Centers for Disease Control and

Prevention/DHHS

Atlanta, GA

Denise Sofka, M.P.H.

Nutrition Consultant

Maternal and Child Health Bureau

DHHS/HRSA

Rockville, MD

Wells Willis, M.S., R.D.

National Program Leader

EFNEP, Extension Service, USDA

Washington, DC

Staff from the Food and Nutrition

Service, USDA: Rayane AbuSabha, Cheryl

Anderson, Donna Bailey, Deborah Bell, Liz

Bell, Heidi Bishop, Michele Bouchard,

Mandy Briggs, Mavis Buchholz, Jo Ellen

Collins, Lorie Conneen, Patricia Daniels,

Ann DeGroat, Doris Dvorsak, Alberta Frost,

Jim Gatley, Joi Hatch, Marion Hinners,

Gerry Howell, Louise Lapeze, Brenda Lisi,

Rebecca Lucero, Jane Mandell, Vee Ann

Miller, Stella Nash, Nuala O’Toole, Susan

Ponemon, Nancy Ranieri, Maureen Rankin,

Melissa Rothstein, Lucy Mao Sigmund, Joan

Turetsky, Judy Wilson

Reviewers from State agencies and local programs

Sharlet L. Anderson, R.D.

Nutrition Coordinator

Missouri Department of Health

Bureau of Food Programs and Nutrition

Education

Jefferson City, MO

Patricia Bolton

President, Colorado Association of Family

Child Care

Westminster, CO

Karen Brazille

Child Nutrition Consultant

Child Care Food Program

California Dept. of Education

Sacramento, CA

Tami Campasano 

Child Care Director

Scottsdale, AZ

Mary Ann Carr

Rhode Island Dept. of Human Services

Providence, RI

Donna M. Blum-Kemelor, M.S., R.D., L.D., Nutrition Services Staff, Office of Analysis, Nutrition and Evaluation, revised

this publication from the first 1988 edition entitled,“Feeding Infants: A Guide for Use in the Child Care Food

Program.” The 1988 edition of this guide was prepared by Anne Jacobs Molofsky, M.S., R.D., Nutrition and Technical

Services Division.

We would also like to express our appreciation to Dr. Norman Tinanoff for providing the photographs on page 40.

We would like to acknowledge and express our appreciation to the following individuals who reviewed this publication and provided valuable comments:

A cknowledgments
102 Feeding Infants

Alice Carroll

NET Program 

Department of Education

Baton Rouge, LA

Adelaide Cline

Program Development Specialist

Minnesota Department of Education

St. Paul, MN

Kym Coffey 

Rhode Island Department of Human

Services

Providence, RI

Judy Dare, M.S.

Nutrition Consultant for Child Care

Programs

Arizona Department of Health Services

Phoenix, AZ

Ramona DeBoer

Nutritionist

CACFP, Tennessee Dept. of Human

Services

Nashville, TN

Brenda Dobson

WIC Nutrition Services Coordinator

Iowa Dept. of Public Health

Des Moines, IA

Renée Donaldson

Child Care Provider

Baton Rouge, LA

J. Ennist, R.D.

Public Health Nutritionist

Child and Adult Care Food Program

Division of Nutrition

Albany, NY

Jeanne Foster

CACFP Specialist

Child Nutrition Programs

Arizona Department of Education

Phoenix, AZ

Bunny Foxhoven, R.D.

Child Care Sponsor

Littleton, CO

Cleo Gillespie

Christian Children‘s Center

Phoenix, AZ

Kathy Hearon

Christian Children‘s Center

Phoenix, AZ

Sallye R. Henderson, M.S., R.D.

NET Specialist

State Dept. of Education-Child Nutrition

Programs

Montgomery, AL 

Ginny Huntington

Consultant, CACFP

Department of Education 

Des Moines, IA

Helene Kent, R.D., M.P.H.

CACFP Nutrition Coordinator

Colorado Dept. of Public Health and

Environment

Denver, CO

Editha J. Kern

President/Administrator

West Tennessee Special Services, Inc.

SaveTrust Federal Savings Bank

Newbern, TN

Melanie LaPorte

NET Program 

Department of Education

Baton Rouge, LA

Carol Loomis

Nutrition Education and Training Specialist

Nutrition and Transportation Services

Maryland Department of Education

Baltimore, MD

Libby Johnson, M.S., R.D., L.D.N.

Nutrition Coordinator

C.H.I.L.D. Inc.

Warwick, RI

Ann McCormack, R.D.

Nutrition Resource Coordinator

Missouri Department of Health

Bureau of Food Programs and Nutrition

Education

Jefferson City, MO

Linda Miller, M.S., R.D.

Chief, Program Assistance and Monitoring

Section

Nutrition and Transportation Services

Maryland Department of Education

Baltimore, MD 

Debra L. Moore, R.D., M.P.H.

USDA Coordinator

Places and Programs for Children

Tidewater Child Care Association

Portsmouth, VA 

Joanne Norman

Nutrition Education Coordinator

Provider’s Choice, Inc.

Bloomington, MN

Katie O’Neill, M.P.H., R.D.

Nutritionist

BJ Enterprises

Scottsdale, AZ

Suzanne Secor Parker, CHE

Consultant, CACFP

Department of Education 

Des Moines, IA

Paula Peirce, R.D., Ph.D

Director of Field Operations

Wildwood CACFP, Inc.

Englewood, CO

Mali Pistiner

CACFP Specialist

Child Nutrition Programs

Arizona Department of Education

Phoenix, AZ

Janet Pletcher

Program Assistant

Eastminster Food Program

East Lansing, MI

Joni Ralph

CACFP Specialist

Child Nutrition Programs

Arizona Department of Education

Phoenix, AZ

Sandra J. Rhoades, R.D., M.P.H.

Director of Nutrition Education and

Training

Child and Adult Care Food Program

Division of Nutrition

Albany, NY

Lori Rittel, M.S., R.D.

Public Health Nutritionist

CACFP

Health Services Division

Helena, MN
A Guide for Use in the Child Nutrition Programs 103

Les Rosenzweig, R.D.

Child and Adult Care Food Program

Division of Nutrition

Albany, NY

SeAnne Safaii, M.S., R.D.

Consultant

Idaho Department of Education

Child Nutrition Programs

Boise, ID

Joanne Static, R.D., M.S.

CACFP

New York State Dept. of Health

Buffalo, NY

Rosemary Suardini

Consultant

Michigan Child and Adult Care Food

Program

Michigan Department of Education

Lansing, MI 

Deanne Tolzman, M.S., R.D., L.D.

Specialist

Minnesota Department of Education

St. Paul, MN

Kathy Voorhies

FDC Specialist

State Department of Education

Columbus, OH

Luan York, R.D.

Consultant

Idaho Department of Education

Child Nutrition Programs

Boise, ID

Elaine M. Zabor

CACFP Administrator

Ohio Hunger Task Force

Columbus, OH 

The U.S. Department of Agriculture/Food

and Nutrition Service does not endorse

commercial products, materials, and/or

foods.

In accordance with Federal law and U.S.

Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national

origin, sex, age, or disability. To file a

complaint of discrimination write USDA,

Director, Office of Civil Rights, Room 326-

W,Whitten Building, 1400 Independence

Avenue, S.W., Washington, DC 20250-

9410 or call (202) 720-5964 (voice or

TDD). “USDA is an equal opportunity

provider and employer.”

Revised December 2001

A CKNOWLEDGMENTS
104 Feeding Infants

Notes