<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 13A.16.12.06" title_num="13A" subtitle_num="16" chapter_num="12" heading="Infant Feeding.">
  <paragraph num="A.">
    <text>The operator shall ensure that the written feeding schedule for an infant or toddler, as required by COMAR 13A.16.03.02D(1), is:</text>
    <paragraph num="(1)">
      <text>Followed; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Updated as necessary or at least every 3 months while the child is in care.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Infant Self-Feeding.</text>
    <paragraph num="(1)">
      <text>An infant shall be held for each bottle feeding except when the infant or toddler is developmentally able and insistent upon self-feeding.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>When an infant or toddler holds the bottle, the infant or toddler may do so only:</text>
      <paragraph num="(a)">
        <text>When seated; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If the bottle is made of unbreakable material.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Except as specified by §D of this regulation, an operator may serve an infant or toddler only developmentally appropriate:</text>
    <paragraph num="(1)">
      <text>Commercially prebottled formula;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Breast milk, formula, juice, or water which has been prebottled for the child and provided by the child's parent;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Commercially processed baby food that is opened and used the same day;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Commercial infant formula, in concentrate, powder, or ready-to-feed form, if the:</text>
      <paragraph num="(a)">
        <text>Child's parent has provided prior written authorization for the use of the formula; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Formula is prepared directly from a factory-sealed container and in accordance with the manufacturer's instructions; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Other foods supplied by the operator or the parent that are consumed the same day.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Only whole, pasteurized milk will be served to an infant or toddler who is not receiving formula or breast milk, except that skim milk, reconstituted nonfat dry milk, or 1—2 percent milk may be served upon the written prior approval of the child's parent and health care provider.</text>
  </paragraph>
  <paragraph num="E.">
    <text>An operator shall ensure that:</text>
    <paragraph num="(1)">
      <text>All infant foods and bottles are labeled with the infant's name, dated, and refrigerated at 40° F or below if potentially hazardous;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>All nipples on bottles are protected;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Breast milk or formula which has been bottled for the child is:</text>
      <paragraph num="(a)">
        <text>Placed immediately in a refrigerator when brought to the center;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Warmed to the desired temperature immediately before feeding; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Served to the child at a temperature that is safe and conducive to the child's comfortable feeding;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Foods that present a high risk of choking for infants and toddlers are not served to them; and</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Reusable bottles and nipples are:</text>
      <paragraph num="(a)">
        <text>Reused only after they have been washed, rinsed, and sanitized; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If supplied by the child's parent, rinsed after use and returned daily to the parent.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>