5101:2-13-41 Infant feeding requirements in licensed type A homes.

 

 

 

5101:2-13-41               Infant formula and foodf feeding requirements in licensed type A homes.

 

 

 

(A)Infant feeding: each infant shall be removed from his or her crib for all feedings. Infants shall be held or fed sitting up for bottle feedings. At no time shall a bottle be propped for an infant.

 

(B)Type A homes shall support parent preferences in infant feeding, including breast feeding and introduction of solid foods as long as developmentally appropriate and not detrimental to the health of the child.

 

(A)Type A home policies and practices shall support parent preferences in  infant feeding, including breastfeeding and shall recognize the center for disease control's determination that handling and storage of breast milk does not require the use of universal precautions and that breast milk is not considered a biohazard. Type A home policies and practices shall also support the introduction of solid foods as long as developmentally appropriate and not detrimental to the health of the child.

 

(B)Each infant shall be removed from his or her crib for all feedings. Infants shall be held or fed sitting up for bottle feedings. At no time shall a bottle be propped for an infant.

 

(C)      Infant food shall be prepared and served in a manner appropriate to the developmental needs of each individual child according to his or her stage of development.

 

(D)   Infants shall be served food in conformity with dated written instructions from the parent or guardian or physician. The instructions shall include amounts of food, type of food, and feeding times, and be updated as needed based upon the child's needs and parent's instructions.

 

(E)   If the parent or guardian does not provide instructions for the serving of food to their child infant, the infant shall be served formula and food in sufficient amounts to meet the meal pattern and quantity of the USDA United States department of agriculture (USDA) child and adult care food program child care component.

 

(F)   Bottles prepared at type A home: when When infant formula is prepared by the home, it shall be prepared according to the manufacturer's instructions or instructions from the child's physician or advance practice nurse. in conformity with written instructions from the parent or guardian, or physician. All powdered or concentrated formula shall be prepared according to the manufacturers' instructions unless written instructions from a physician or an advance practice nurse certified to prescribe medication are on file at the type A home.

 

(G)  The type A home shall clean and disinfect sanitize all counter surfaces and equipment

 

 

 

needed to prepare the just prior to preparing formula, breast milk or food. All equipment, including bottles and nipples, shall be washed in a dishwasher or scrubbed with hot water containing soap, and be thoroughly rinsed and boiled for one minute prior to use or reuse. Equipment not washed in a dishwasher shall be boiled for five minutes or more just prior to filling bottles. Handwashing facilities shall not be used for formula or, breast milk or food preparation or for rinsing or washing dishes and bottles or rinsing for reuse.

(H) For children requiring bottles, but no longer on formula, milk shall be poured from the original container into clean, disinfected, and labeled bottles.

(I)(H) Type A homes that care for infants shall have available the appropriate commercially prepared formula for the infant to be used in the event that the parent or guardian does not provide a quantity of formula sufficient to meet the infant's daily requirement. Formula beyond its expiration date shall not be served.

(J)(I) Safety and storage: the The type A home shall develop and implement a plan for the safe storage of food, formula or breast milk.

(1)    Open containers of ready to feed and concentrated formula shall be covered, dated and refrigerated according to the manufacturer's instructions. Formula Prepared formula and food shall be discarded if not used within twenty-four hours or sent home.

(2) Any formula or food to be stored at the home for any period of time, whether prepared by the parent or guardian or the type A home, shall be labeled with the child's name and date of preparation and shall be used only for the intended child.

(3)(2) Until used, all formula or food shall be labeled with the child's name and date of preparation and refrigerated immediately after preparation or upon arrival if prepared by the parent or guardian, and sent home daily. Formula or food that is commercially prepared may not be required to be refrigerated until after opening and shall be stored and served according to the manufacturer's instructions and the expiration date on the label and labeled with the child's name and date of preparation. Formula and food shall be stored no longer than twenty-four hours.

(4)(3) If breast milk is provided by the parent or guardian, it shall be labeled with the child's name, date expressed and the date of receipt. and immediately refrigerated or frozen. Refrigerated breast milk shall not be stored for more than twenty-four hours. Breast milk shall be kept frozen no more than two weeks. Type A homes shall follow the chart below in regard to storing breast milk:

Breast milk storage guidelines

If the breast milk is stored:	Then keep it as long as:
at room temperature (up to 78 degrees Fahrenheit)	6 to 8 hours
in the refrigerator (39 degrees Fahrenheit or lower)	up to 5 days counted from the day the breast milk was expressed
in a freezer compartment inside a refrigerator (5 degrees Fahrenheit)	2 weeks
in a freezer compartment of a refrigerator with separate doors (0 degrees Fahrenheit)	3 to 6 months
chest or upright deep freezer (-4 degrees Fahrenheit)	6 to 12 months

(5)(4) If formula or fluid breast milk is to be warmed, bottles shall be placed in a container of hot, (not boiling), water or be placed in a commercial bottle warmer. The container of water shall be emptied and cleaned each day. The bottle shall be shaken well, and the formula or breast milk temperature tested before feeding. Frozen breast milk shall be thawed under cold running water or in the refrigerator.

(6)(5) Microwave ovens shall not be used for heating formula, breast milk or other liquids bottles.

(7)(6) Infant bottles, formula, breast milk and food shall be readily available to staff. Staff/child ratios and supervision shall be maintained when staff are obtaining, preparing or warming bottles or food.

(8)(7) The unused portion of formula, breast milk or food remaining in a container from which the infant has been directly fed, shall not be reheated or served again.

(9)(8) Food heated in a microwave oven shall be stirred or shaken to avoid uneven heating.

Effective:                                                     09/01/2007

R.C. 119.032 review dates:                         03/30/2007 and 09/01/2012

CERTIFIED ELECTRONICALLY

Certification

06/18/2007

Date

Promulgated Under:                           119.03

Statutory Authority:                           5104.011

Rule Amplifies:                                  5104.011

Prior Effective Dates:                         9/5/86, 7/1/03