Infants need special care in many aspects of development, especially feeding. Consequently, when infants are enrolled in Early Head Start, staff and families need to work together to identify each infant's nutritional needs, particularly if the infant has nutrition-related health problems or disabilities. During the first four to six months, a baby requires only breast milk or iron-fortified infant formula (IFIF). Early Head Start programs are required to provide IFIF, or other nutritional health related support for each infant, if necessary.

Infant Feeding and Development Requirements

The Child and Adult Care Food Program (CACFP) has specific requirements that must be met for an infant meal or snack to be reimbursable. Infants have different CACFP meal component requirements every four months of growth.

• From birth through three months of age, infants need only expressed breast milk or IFIF.
• Infants less than six months old usually do not follow a set feeding schedule.
• Infants should be fed on demand, but not all the food at one sitting.
• Infants must be held when bottle feeding.

Natural Signs of Hunger and Fullness*

Infants have natural signs that show feelings of hunger or fullness. Signs that an infant is hungry include waking and tossing, sucking on a fist, crying or fussing, and looking like he or she is going to cry. Signs of fullness include sealing the lips together, a decrease in sucking, spitting out the nipple, turning the head away from the bottle, and pushing the bottle away.

Feeding Infants Solid Foods (Age 4-7 Months)* **

The CACFP Infant Meal Pattern is very specific as to the kind and quantity of food that must be offered for a reimbursable meal as soon as the infant is developmentally ready. The Infant Meal Pattern Chart (in the TABLE manual) identifies the food and the minimum amount for each four months of development. Early Head Start staff should work with the parents and the health care provider before any infant is offered solid or a new food. Here are some of the key guidelines for feeding solid foods:

• Four months through seven months of age, infants may be ready for iron-fortified infant cereal (IFIC), fruits, and vegetables.
• Infant tastes change. What they did not like at six months, they may like at nine months.
• Fresh prepared food will taste better than baby jar food.
• Only one new food should be introduced at a time.

Feeding the Infant (Age 8-11 Months)

At the age of eight months through eleven months, infants are testing their likes and dislikes, practicing motor skills, eating finger foods — and wanting the foods that they see older toddlers or adults eat. When the infant is developmentally ready for meats/meat alternates, it must be offered. Creditable meat and meat alternates include:

• Meat, poultry, fin fish (not shellfish)
• Cheese and yogurt
• Egg yolk
• Dry cooked beans and peas

Meat and meat alternates infant foods that are not creditable include:*

• Peanut butter
• Other nut or seed butters
• Nuts and seeds
• Tofu
• Soy yogurt
• Commercial fish stick or other breaded fish products
• "Baby food" meat sticks
• Hot dogs, sausage, corn dogs
• Commercially prepared baby food or other foods that come in combination dinners

Feeding the Vegetarian Infant

"According to the American Dietetic Association (ADA), a varied, appropriately planned vegetarian diet can meet all of the growing baby's and toddlers' nutritional needs, as well as those of children and adolescents."** If the parents are vegetarian and decide to raise their infant as a vegetarian the CACFP Infant Meal Pattern may be served for reimbursable CACFP meals.

At eight through eleven months of age, and if the infant is developmentally ready, he or she may have meat alternate foods to meet the CACFP Infant Meal Pattern guidelines. Vegetarian infant meat alternates that may be served in place of meat are iron-fortified infant cereal (IFIC), cheese, egg yolk, soft cooked lentils, garbanzo beans, tahini, and split peas.* **

Sources
* U.S. Department of Agriculture Team Nutrition Food and Nutrition Service. Feeding Infants: A Guide for Use in the Child Nutrition Program
** Bessinger, Jeannette. (2010). Great Expectations Best Food for Your Baby and Toddler, New York, NY: Sterling Publishing