Appendix A - Breast Milk Storage
(A)What are the
requirements for infant daily care?
(1)The licensed
family child care provider shall:
(a)Allow infants
to safely and comfortably sit, crawl, toddle, walk and play according to the
infant's stage of development.
(b)Remove each
infant from the crib, swing, infant seat, exercise seat or other equipment
throughout the day for individual attention.
(c)Provide each
non-crawling infant the opportunity for tummy time,
outside of their crib or playpen, each day.
(d)Maintain a
daily written record for each infant that is provided to the infant's parent or
person picking up the infant on a daily basis. The record shall include the
following information:
(i)Food intake.
(ii)Sleeping
patterns.
(iii)Times and
results of diaper changes.
(iv)Information
about daily activities.
(2)Each infant
shall be removed from his or her crib or playpen for all feedings. Infants
shall be held or fed sitting up for bottled feedings. At no time shall a bottle
be propped for an infant.
(B)What are the
requirements for infant bottle and food preparation?
The family child care provider shall:
(1)Prepare and
serve infant food in a manner appropriate to the developmental needs of each
child. The family child care provider shall introduce new foods only after
consultation with the parent. The provider shall comply with written feeding
instructions from the infant's parent, physician, physician's assistant or
certified nurse practitioner (CNP), which shall include the following:
(a)Type of food
and/or formula/breast milk.
(b)Amount of food
and/or formula/breast milk.
(c)Feeding times
or frequency of feedings.
(2)Require the
parent to update the written feeding instructions as needed.
(3)Not feed any
foods, other than formula or breast milk, to infants under four months of age,
unless there is written documentation on file from a physician, physician's
assistant or CNP.
(4)Ensure that
formula, breast milk, or other liquids in a bottle are not heated in a
microwave oven.
(a)If formula or
breast milk is to be warmed, bottles shall be placed in a container of water
not hotter than one hundred twenty degrees or be placed in a commercial bottle
warmer. The container of water shall be kept out of reach of children and shall
be emptied and cleaned each day. The bottle shall be shaken well, and the
formula or breast milk temperature tested before feeding.
(b)Frozen breast
milk shall be thawed under cold running water or in the refrigerator.
(5)Ensure that 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.
(6)Store, prepare and serve food, formula
and breast milk in a safe and clean manner.
(7)(6) If the provider prepares infant formula they
shall do so according to the manufacturer’s instructions or instructions from
the infant's physician, physician assistant or CNP.
(8)(7) Ensure that open containers of ready-to-feed
and concentrated formula shall be covered, dated and refrigerated according to
the manufacturer's instructions. Prepared formula and food shall be discarded
or sent home daily if not used.
(9)(8) Label all bottles or prepared food with the
infant's name and date of preparation. All formula shall be refrigerated
immediately after preparation or upon arrival if the formula is prepared by the
parent. All commercially prepared food shall be stored according to
manufacturer's instructions and not served after the expiration date.
(10)(9)Ensure that if breast milk is
provided by the parent, it shall be labeled with the infant's name, the date
pumped, and the date the bottle was prepared. Providers shall follow the chart
in appendix A to this rule for storing breast milk.
(C)What are the
requirements for diapering?
(1)The family
child care provider shall change a child's diaper immediately when wet or
soiled.
(2)Clothing shall
be changed immediately when wet or soiled.
(3)When changing
diapers the provider shallis
to comply with the following:
(a)The provider
shall wash all soiled areas of the child's body with either a wash cloth which
is then appropriately sanitized, or a disposable wipe.
(b)If a
diaper-changing surface is used to change more than one child, the provider
shall place a disposable separation material between the child and the changing
surface. A different separation material shall be used for each diaper change.
(c)If an infant's diapers are to be
changed in a crib, there shall be a separation material between the infant and
the crib sheet. If the bedding becomes wet or soiled during the diaper change,
it shall be replaced with clean bedding.
(d)(c) If a diapering product is used on more than
one child:
(i)The container
shall not touch the child to avoid cross contamination.
(ii)The product
shall be administered to avoid cross contamination.
(e)(d) No child shall be left unattended on the
diaper changing table.
(e)If using gloves while diapering, the
provider is to use non-latex gloves.
(4)The family
child care provider shall store and launder soiled diapers or clothing as
follows:
(a)If soiled
diapers or clothing are to be sent home with a parent, the provider shall store
the diapers or clothing for no longer than one day in an individual covered
container or plastic bag away from the child's belongings and out of the reach
of children.
(b)The provider
shall store soiled diapers and diapering washcloths, which are to be laundered
in the provider's home, in a covered container with sanitizing solution.
(c)If soiled
diapers are to be commercially laundered, the provider shall hold them for
laundering pickup for no longer than seven days.
(d)The provider
shall store soiled disposable diapers in a plastic-lined covered container that
prevents hand contamination and is not easily accessible to children and
discard diapers daily or more frequently as needed to eliminate odor.
(e)If the provider
is laundering diapers, the provider shall follow the manufacturer's guidelines.
(5)Toilet training
shall occur based on a child's readiness and consultation with the parent
regarding practices in the child's home. The provider shall ensure that toilet
training is never forced.
Effective: 10/29/2021
Five Year Review (FYR) Dates: 7/28/2021 and 10/29/2026
Certification: CERTIFIED ELECTRONICALLY
Date: 10/05/2021
Promulgated Under: 119.03
Statutory Authority: 5104.017, 5104.018
Rule Amplifies: 5104.017, 5104.018
Prior Effective Dates: 04/01/1982, 05/20/1983, 09/01/1986,
09/05/1986, 02/15/1988, 05/01/1989, 10/01/1997 (Emer.), 12/30/1997, 04/01/2003,
07/01/2003, 09/01/2007, 08/14/2008, 01/01/2014, 12/31/2016, 10/29/2017