<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 13A.18.12.06" title_num="13A" subtitle_num="18" chapter_num="12" heading="Feeding Infants and Toddlers.">
  <paragraph num="A.">
    <text>The provider shall ensure that the written feeding schedule for each infant and toddler, as required by COMAR 13A.18.03.02C, 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>Self-Feeding by Children Younger than 18 Months Old.</text>
    <paragraph num="(1)">
      <text>The child shall be held for each bottle feeding except when developmentally able and insistent upon self-feeding.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The child may hold the bottle 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, a provider may serve a child younger than 18 months old 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 provider or the parent that are consumed the same day.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Only whole, pasteurized milk will be served to a child younger than 2 years old who is not receiving formula or breast milk, except that skim milk, reconstituted nonfat dry milk, or 1 or 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>A provider shall ensure that:</text>
    <paragraph num="(1)">
      <text>All food and bottles intended for consumption or use by a child younger than 18 months old are labeled with the child’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 child care home;</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 children younger than 2 years old 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>