Infant Feeding Plan and Bottle Labeling Log

Captures each infant's individualized feeding schedule, formula and breastmilk instructions, and bottle labeling details to help prevent misadministration in childcare settings.

Infant and Guardian Information

• Infant's Full Name
• Date of Birth
• Room or Group
• Parent or Guardian Name
• Parent or Guardian Contact Number
• Plan Effective Date

Feeding Plan

• Primary Feeding Type
• Feeding Schedule
  List typical feeding times, amounts, and any cues or routines staff should follow.
• Usual Amount per Feeding (oz or mL)
• Feeding Method
• Special Feeding Instructions
  Include pacing, burping, positioning, temperature preferences, or other care instructions.

Formula, Breastmilk, and Storage Instructions

• Formula Brand and Type
• Formula Mixing Instructions
• Breastmilk Handling Instructions
  Include thawing, warming, and any parent-provided handling requirements.
• Storage Requirements
• Allergy or Intolerance Notes
  Document only relevant allergy or intolerance information needed for safe feeding.

Bottle Labeling Log

• Required Label Format
  Specify exactly what must appear on each bottle label, such as infant name, date, time prepared, milk type, and initials.
• Label Must Include
• Bottle Preparation and Feeding Log

Consent, Review, and Audit Trail

• Parent or Guardian Acknowledgment
  I confirm the feeding instructions above are accurate and may be followed by childcare staff.
• Consent to Store Feeding Instructions
  I consent to the childcare provider storing these feeding instructions for care and safety purposes.
• Staff Reviewed By
• Review Date
• Additional Notes
  Use for brief updates, incidents, or changes to the feeding plan. Do not include unnecessary PII.