DATE:

DAILY INFANT MENU PRODUCTION RECORD FOR 6 – 11 MONTH OLD INFANTS

1) Record date (month/day/year).

2) Record the name & birthdate of each infant.

3) Specify the name of the formula and serving size (Document the brand of formula for each meal/snack when different from the formula listed for the infant).

4) Record if the infant is receiving formula or breastmilk. Optional: if receiving expressed breastmilk mark “EB”, or is breastfed on-site mark “BF” for each meal/snack. Record the serving size offered for infants receiving formula or expressed breastmilk.

5) If solid foods are offered record actual food offered and serving size for each meal/snack (examples: peaches, green beans, rice cereal, Cheerios).

6) Designate food and/or formula supplied by parent/guardian for each meal/snack as parent supplied, “PS”. Example: “PS, peaches”. Note: parent/guardian may only supply one component of each meal/snack, when the infant is developmentally ready for solid foods.

NAME OF INFANT

Birthdate
Brand of Formula /

BREAKFAST

/

LUNCH OR SUPPER

/

AM or PM SNACK

Breast milk or Formula 6-8 oz. / Infant
Cereal
0-4 Tbsp. / Meat or Meat Alt.
0-4 Tbsp. / Veg. and/or Fruit
0-2
Tbsp. / Complete Breakfast Served / Breast milk or Formula 6-8 oz. / Infant
Cereal
0-4 Tbsp. / Meat or Meat Alt.
0-4 Tbsp. / Veg. and/or Fruit
0-2 Tbsp. / Complete Lunch or Supper Served / Breast milk or Formula 2 - 4 oz. / Bread
0-1/2 slice or 0-2
Crackers
or 0-4 Tbsp. cereal / Veg. and/or Fruit
0-2 Tbsp. / Complete Snack Served
Birthdate:
Formula: / AM
PM
Birthdate:
Formula: / AM
PM
Birthdate:
Formula: / AM
PM
Birthdate:
Formula: / AM
PM
Reimbursable Meals
/
Breakfast
/
Lunch or Supper
/ Snacks

Daily Infant Menu Record Page 1 of 1