Appendix A - Breast Milk Storage
(A)What are the requirements for infant
daily care?
(1)The in-home aide (IHA) is to:
(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 on a daily basis. The record is
to 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 is to be removed from his or
her crib or playpen for all feedings. Infants are to be held or fed sitting up
for bottled feedings. A bottle is not to be propped for an infant at any time.
(B)What are the requirements for infant
bottle and food preparation?
The IHA is to:
(1)Prepare and serve infant food in a
manner appropriate to the developmental needs of each child. The IHA is to
introduce new foods only after consultation with the parent. The IHA is to
comply with written feeding instructions from the infant's parent, physician,
physician's assistant or certified nurse practitioner (CNP), which is to
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)Ensure the parent updates 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 are to 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 is to be kept out of reach of children and is to be emptied
and cleaned each day. The bottle is to be shaken well, and the formula or
breast milk temperature tested before feeding.
(b)Frozen breast milk is to 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 is not to be reheated or served again.
(6)If the IHA prepares infant formula it is
to be prepared according to the manufacturer’s instructions or instructions
from the infant's physician, physician assistant or CNP.
(7)Ensure that open containers of
ready-to-feed and concentrated formula are to be covered, dated and
refrigerated according to the manufacturer's instructions.
(8)Label all bottles or prepared food with
the infant's name and date of preparation. All formula is to be refrigerated
immediately after preparation or if the formula is prepared by the parent. All
commercially prepared food is be stored according to manufacturer's
instructions and not served after the expiration date.
(9)Ensure that if breast milk is provided
by the parent, it is to be labeled with the infant's name, the date pumped, and
the date the bottle was prepared. The IHA is to follow the chart in appendix A
to this rule for storing breast milk.
(C)What are the requirements for diapering?
(1)The IHA is to change a child's diaper
immediately when wet or soiled.
(2)Clothing is to be changed immediately
when wet or soiled.
(3)When changing diapers the IHA is to
comply with the following:
(a)The IHA is to 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 IHA place a disposable separation material between
the child and the changing surface. A different separation material is to be
used for each diaper change.
(c)If a diapering product is used on more
than one child:
(i)The container is not to touch the child
to avoid cross contamination.
(ii)The product is to be administered to
avoid cross contamination.
(d)No child is to be left unattended on the
diaper changing table.
(4)The IHA is to store and launder soiled
diapers or clothing as follows:
(a)The IHA is to store soiled diapers and
diapering washcloths, which are to be laundered in the child's home, in a
covered container with sanitizing solution.
(b)If soiled diapers are to be commercially
laundered, a parent is to make the arrangements.
(c)The IHA is to 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.
(d)If the IHA is laundering diapers, the
IHA is to follow the manufacturer's guidelines.
(D)Toilet training is to occur based on a
child's readiness and consultation with the parent regarding practices in the
child's home. The IHA is to ensure that toilet training is never forced.
Replaces: Part of 5101:2-14-04
Effective: 11/12/2023
Five Year Review (FYR) Dates: 11/12/2028
Certification: CERTIFIED ELECTRONICALLY
Date: 11/02/2023
Promulgated Under: 119.03
Statutory Authority: 5104.019
Rule Amplifies: 5104.019
Prior Effective Dates: 04/01/1982, 05/20/1983, 09/01/1986,
02/15/1988, 05/01/1989, 10/15/1996, 10/01/1997 (Emer.), 12/30/1997, 04/01/2003,
08/14/2008, 12/01/2009, 07/01/2011, 01/01/2014, 12/31/2016, 10/29/2017