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Infants
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4
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Routine use of feeding practices that may result in impaired nutrient status, disease, or health problems.
411.1 Routinely Using a Substitute for Breast Milk or FDA-approved Iron-fortified Formula as the Primary Nutrient Source during the First Year of Life
Examples of substitutes include:
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Low-iron formula without iron supplementation
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Cows milk, goats milk, or sheep's milk (whole, reduced fat, low-fat, skim), canned evaporated or sweetened condensed milk
AND
411.2 Routinely Using Nursing Bottles or Cups Improperly
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Using a bottle to feed fruit juice
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Feeding any sugar-containing fluids, such as soda/soft drinks, gelatin water, corn syrup solutions, sweetened tea
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Allowing the infant to fall asleep or be put to bed with a bottle at naps or bedtime
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Allowing the infant to use the bottle without restriction (e.g., walking around with a bottle) or as a pacifier
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Propping the bottle when feeding
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Allowing an infant to carry around and drink throughout the day from a covered or training cup
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Adding any food (cereal or other solid foods) to the infants bottle
411.3 Routinely Offering Complementary Foods or Other Substances that Are Inappropriate in Type or Timing
Examples of inappropriate complementary foods:
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Adding sweet agents such as sugar, honey, or syrups to any beverage (including water) or prepared food, or used on a pacifier
AND
411.4 Routinely Using Feeding Practices that Disregard the Developmental Needs or Stages of the Infant
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Inability to recognize, insensitivity to, or disregarding the infant's cues for hunger and satiety (e.g., forcing an infant to eat a certain type and/or amount of food or beverage or ignoring an infants hunger cues).
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Feeding foods of inappropriate consistency, size, or shape that put infants at risk of choking
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Not supporting an infant's need for growing independence with self-feeding (e.g., solely spoon-feeding an infant who is able and ready to finger-feed and/or try self-feeding with appropriate utensils).
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Feeding an infant food with inappropriate texture based on his/her developmental stage (e.g., feeding primarily pureed or liquid food when the infant is ready and capable of eating mashed, chopped, or appropriate finger foods).
411.5 Feeding Foods to a Infant that Could Be Contaminated with Harmful Microorganisms or Toxins
Examples of potentially harmful foods:
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Unpasteurized fruit or vegetable juice
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Unpasteurized dairy products or soft cheeses such as feta, Brie, Camembert, blue-veined, and Mexican-style cheese
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Honey (added to liquids or solid foods, used in cooking, as part of processed foods, on a pacifier, etc.)
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Raw or under-cooked meat, fish, poultry, or eggs
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Raw vegetable sprouts (alfalfa, clover, bean, and radish)
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Undercooked or raw tofu
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Deli meats, hot dogs processed meats (avoid unless heated until steaming hot)
AND
411.6 Routinely Feeding Inappropriately Diluted Formula
411.7 Routinely Limiting the Frequency of Nursing of the Exclusively Breastfed Infant when Breast Milk is the Sole Source of Nutrients
Examples of inappropriate frequency of nursing include:
Examples of inappropriate frequency of nursing:
AND
411.8 Routinely Feeding a Diet Very Low in Calories or Essential Nutrients
Examples:
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Vegan diet
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Macrobiotic diet
AND
411.9 Routinely Using Inappropriate Sanitation in Preparation, Handling, and Storage of Expressed Breast Milk or Formula
Examples of inappropriate sanitation:
Limited or no access to a:
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Safe water supply (documented by appropriate officials e.g., municipal or health department authorities)
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Heat source for sterilization
AND/OR
Failure to prepare, handle, and store bottles, storage containers or breast pumps properly; examples include:
Human Milk
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Thawing/heating in a microwave
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Refreezing
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Adding freshly expressed unrefrigerated human milk to frozen human milk
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Adding freshly pumped chilled human milk to frozen human milk in an amount that is greater than the amount of frozen human milk
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Feeding thawed refrigerated human milk more than 24 hours after it was thawed
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Saving human milk from a used bottled for another feeding
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Failure to clean breast pump per manufacturer’s instruction
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Donor human milk acquired directly from individuals or the Internet
Formula
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Failure to prepare and/or store formula per manufacturer’s or physician instructions
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Storing at room temperature for more than 1 hour
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Using formula in a bottle one hour after the start of a feeding
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Saving formula from a used bottle for another feeding
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Failure to clean baby bottle properly
411.10 Feeding Dietary Supplements with Potentially Harmful Consequences
Examples of dietary supplements, which when fed in excess of recommended dosage, may be toxic or have harmful consequences:
AND
411.11 Routinely Not Providing Dietary Supplements Recognized as Essential by National Public Health Policy when a Infant's Diet Alone Cannot Meet Nutrient Requirements
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Infants who are 6 months of age or older who are ingesting less than 0.25 mg of fluoride daily when the water supply contains less than 0.3 ppm fluoride
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Breastfed infants who are ingesting less than 500 mL (16.9 ounces) per day of vitamin D-fortified formula and not taking a supplement of 200 IU of vitamin D
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Non-breastfed infants who are ingesting less than 500 mL (16.9 ounces) per day of vitamin D-fortified formula and not taking a supplement of 200 IU of vitamin D
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CPA Assigned Only
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