Brown Bear Educare
HEALTH POLICIES & PROCEDURES
We at Brown Bear Educare are committed to the health and welfare of the children in our care. The following procedures and policies are designed to uphold that commitment in cooperation with the Washington State Department of Health.
HOW DO WE PREVENT ILLNESSES?
HAND WASHING, DISINFECTING, MAINTAINING STAFF HEALTH, EXCLUSION OF ILL CHILDREN, REPORTING COMMUNICABLE DISEASES & DEALING WITH BODY FLUIDS
WHAT DOCUMENTS MUST WE MAINTAIN?
HEALTH CARE, IMMUNIZATIONS, ILLNESS, INJURY, ACCIDENTS, INCIDENTS, MEDICATIONS, & ATTENDANCE
HOW DO WE HANDLE MINOR & MAJOR EMERGENCIES?
FIRST AID, MINOR INJURIES, MAJOR MEDICAL EMERGENCIES, & GENERAL DISASTER PLAN
HOW DO WE HANDLE CHILDREN WITH SPECIAL NEEDS?
WHAT SPECIAL REGULATIONS ARE WE REQUIRED FOR INFANT CARE?
AGE REQUIREMENTS, NUTRITION, SLEEPING, DIAPERING PROCEDURES, NURSING CONSULTANT
WHAT ARE THE NUTRITION & FOOD SERVICE REQUIREMENTS?
FOOD & MENUS, MILK, FOOD SERVICE, FOOD SOURCES, SERVING, STORAGE, THAWING, MATERIAL & EQUIPMENT
HOW DO WE PREVENT ILLNESSES?
Hand washing is the single best way to reduce or stop the spread of bacteria (germs) that cause a child to be ill. Our staff wash their hands and teach or help children (if help is needed) to wash their hands.
HAND WASHING
Staff members wash their hands:
Upon arrival at the child care center.
Before handling foods, cooking activities, eating & serving food.
After toileting self, children and diaper changing.
After handling an ill child
After handling or coming in contact with body fluids such as mucus, blood saliva, or urine.
Before & after giving medication
After cleaning up after or handling animals
After smoking
After being outdoors or involved in outdoor play
As needed
Children are directed or assisted in hand washing:
Upon arrival at the child care center.
Before & after meals or cooking activities.
Before & after playing with pets
During the diaper changing process (may use wet wipe)
After toileting or diapering
After outdoor play
After coming in contact with body fluids.
Hand Washing Procedures:
Soap, warm water, and individual towels are available for staff and children.
Turn on water and adjust temperature.
Wet hands and apply a liberal amount of soap.
Rub hands in a wringing motion from wrists to fingertips for period of not less than 10 seconds.
Rinse hand thoroughly.
Dry hands, using an individual towel.
Use hand-drying towel to turn off water faucet(s).
DISINFECTING
Cleaning, disinfecting & laundering: Toys, sleeping mats and other inanimate objects also can spread diseases and parasites (head lice, scabies, etc.). To reduce these risks, we follow a regular cleaning and disinfecting schedule. Our staff members are instructed to add cleaning of toys to their daily cleaning schedule. Sleeping mats and blankets are to be sanitized and laundered on a weekly basis. Our cleaning schedule is posted in the classrooms.
Sanitizing & Disinfecting: We have found the best way to control the spread of illness and reduce infections is for our staff members to:
1. Wash hands properly
2. Disinfect all surfaces that can spread bacteria
We prefer not to use cleaning agents with Phenol or Quaternary Ammonium compounds. These agents require extra time to rinse off surfaces and remove harmful residues. At our center we choose to use only bleach solutions. The solutions are mixed according to the table below. If other cleaning agents are used, our staff members always follow manufacturer’s instructions.
Usage |
Ratio of Bleach to Water |
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General Purpose: tables, chairs, and hard surface toys |
¼ teaspoon bleach to 1 quart water |
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Diapering/Toileting Area: includes diaper changing table and bathroom |
1 tablespoon bleach to 1 quart water or ¼ cup bleach to 1 gallon water |
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Kitchen: dishes, utensils and toys using the 4 step method |
1 teaspoon bleach to one gallon water |
Using Bleach Solutions: When we use bleach our staff members follow the procedures listed below on a daily basis:
Mix and fill all clean spray bottles to be used
Date each bottle
Empty spray bottles at the end of each day
We work very hard to keep our staff members and children healthy. Still, even healthy people can develop illnesses, which can be spread easily in a group care setting.
To help prevent the spread of illness our staff members follow the procedures listed below:
Sanitizing Toys: Staff members are to sanitize toys on a daily basis. Plastic toys are washed in soap and water, rinsed and dipped in a disinfectant solution for a minimum of 1 minute and allowed to air dry.
Sanitizing Equipment: Tables and chairs are washed and disinfected before and after each meal or activity. High chairs, cribs, swings, playpens and infant seats are washed and disinfected daily, or after use by each child.
Laundering: Laundry such as bedding, mat covers, clothing items, cleaning rags and cloth toys are washed once a week or as needed in the washing machine at a water temperature of 150 degrees F, or an appropriate disinfectant is used at least once a week or more often if soiled. All items are machine dried.
Sanitizing Toilets & Sinks: Toilets and hand washing sinks will be washed and disinfected daily. Potty-chairs are washed and disinfected after each use. Toilet training equipment is kept and used in/or adjacent to toilet room and only on a moisture-impervious floor covering.
Maintaining Floors & Furniture: Vinyl or tiled floors are washed and disinfected daily or more frequently as needed. Furniture, rugs and carpeting are vacuumed on a daily basis. Steam cleaning is scheduled monthly in the infant area and quarterly in all other areas or as needed. Walls and doorknobs are cleaned on a weekly basis.
Avoiding Harmful Chemicals: We avoid using powders or chemical cleaners, which can be harmful to children with allergies, asthma, etc. Carpets will be steam-cleaned following the use of any chemical spot cleaner.
The health of our employees, who care for your children, is very important to us. If a child care provider is not feeling well, it is more difficult for them to interact positively with your child.
The director of Brown Bear Educare makes a daily visual and verbal assessment of all staff and volunteers for signs of illness. Mental health is as important as physical health.
To assure persons taking care of your child are healthy we:
TB test: Require all our child care staff members to be tested for Tuberculosis prior to being employed, unless they are advised otherwise by their health care provider.
No contact: Require all staff members with a reportable communicable disease to avoid contact with a child unless approved, in writing, by a health care provider.
Immunizations: Recommended proof of immunizations for persons working directly with children.
Training: Staff members are required to take training courses.
Ill children as described below may not attend childcare for the following reasons: They are unable to be an active part of our daily program, they expose other children and staff members to illnesses and they are at risk for being exposed to other diseases when their resistance is low. Staff members are required to screen children for illnesses upon their arrival.
Parents whose children display the symptoms listed below are notified to pick up their child and given an illness report:
If staff members or the director has concerns about a child’s ability to safely return to care, Brown Bear Educare reserves the right to request a note from the child’s health provider.
REPORTING COMMUNICABLE DISEASES
Communicable diseases are illnesses. Illnesses are spread by direct contact with infectious agents (germs or bacteria). Parents are to notify the staff at Brown Bear Educare if their child has acquired a communicable disease so that we may notify other parents of the potential hazard. We are required to notify parents that children may have been exposed to a communicable disease or parasites.
Illness can be spread by:
Direct contact with body excretions or discharges from open sores,
Indirect contact with inanimate objects (drinking glasses, toys, bedding, etc.)
Flies, mosquitoes or other insects (vectors) capable of spreading a disease.
If a child or staff member has one of the following illnesses, we will contact the King County Health Department at 206-296-4774. All the parents of Brown Bear Educare of such an outbreak shall be notified in writing upon request of the King County Health Department.
Acquired Immune Deficiency Syndrome (AIDS)
Campylobacteriosis (Campy)
Diphtheria
E. Coli 0157: H7
Giardiasis
Hemophilus Influenza Type B (HIB)
Hepatitis
Kawasaki Syndrome
Listeriosis
Meningitis
Meningoccal Disease
Mumps
Pertussis (Whooping Cough)
Poliomyelitis (Polio)
Reyes Syndrome
Rheumatic Fever
Rubella (German or 3 day measles)
Rubeola (10 day measles)
Salmonellosis
Shigellosis
Tetanus
Tuberculosis (TB)
Typhoid Fever
Yersioniosis
Body fluids include blood, urine, stools (feces), drool (saliva), vomit, drainage from sores/rashes (pus), etc.
There are many diseases that can be spread through direct contact with body fluids. To protect children and staff members the guidelines below are followed when anyone is at risk for being or has been in contact with body fluids:
Training: We provide training for all our staff members on the transmission of and prevention of diseases, including illnesses associated with body fluids.
Considerations: All blood and body fluids are considered by staff members to be capable of causing illness.
Storing Toothbrushes: Each child’s toothbrush is stored in a manner to prevent contamination. We use a toothbrush holder to keep toothbrushes separated, which allows for air-drying and from touching other toothbrushes. The holders are kept on a high shelf.
Hand Washing: Hands are always washed after handling body fluids, soiled laundry & equipment.
Covering: Staff members are required to wear latex or vinyl gloves when dealing with blood and other body fluids. Cuts or sores on children or staff members are kept covered. Depending on the type of wound a covering may be a bandage or clothing.
Washing: Whenever a child or staff member comes into contact with any body fluids, the area is washed immediately with soap and warm water and dried with paper towels.
Disinfecting: All surfaces in contact with body fluids are cleaned immediately and the area is disinfected with a proper disinfecting agent (e.g. ¼ cup bleach to a gallon of water). Any brushes, brooms, dustpans, mops, or etc. used to clean up body fluids are soaked in disinfecting solution, and rinsed thoroughly. Cloth items or mops, after soaking, are washed with hot water in a washing machine. All items are hung off the floor or ground to dry. Equipment used for cleaning is stored safely out of children’s reach.
Disposing: Cleaning material used to wipe up body fluids are put in a plastic bag (secured with a tie) and placed in a covered waste container.
Soiled Clothing: All clothing soiled with body fluids changed in a timely manner. Children’s clothes soiled with body fluids are put into a plastic bag and sent home with the child’s parent. A change of clothing should be available for children in care. All soiled laundry is kept safely out of reach of children.
Protective Clothing: Staff members in regular contact with body fluids (ex. Changing diapers) are provided an apron (to protect street clothing). Staff members working with infants or toddlers are advised to have a fresh change of clothes at the center.
Certain information about each child is required by state childcare regulations (WAC 388-150). We update forms with new information on a quarterly basis for children less than one year of age, semi-annually basis for children 1-2 years of age, and yearly bases for children over two years of age.
We ask for that information in our registration packet, which includes:
Our staff members are required to provide the following:
1. Show proof of a negative Tuberculosis (TB) skin test using the Mantoux Method. Should a test be positive, the staff member should provide a note from the doctor’s office stating that the staff member does not have TB.
2. HIV/AIDS and Blood Born Pathogens Training Certificate
3. CPR & First Aid Training Certificate– must include infants
4. Food Handler’s permit
IMMUNIZATION RECORDS
To protect all children in our care and our staff members, and to meet state health requirements we only accept children full immunized, for their age. We keep on file the certificate of immunization status to show the department of health that we are in compliance with licensing standards.
1. Diphtheria
2. Hemophilus Influenza Type B (HIB)
3. Hepatitis B
4. Measles (Rubella)
5. Measles (Rubeola)
6. Mumps (MMR)
7. Pertussis (Whooping Cough) (DTP)
8. Polio (OPV or IPV)
9. Tetanus
A child can be accepted into care without immunizations when the parents provide a sign statement stating:
Religious: They oppose their child being immunized due to religious, philosophical or personal grounds or
Medical Condition: Immunizations are medically unsafe or unnecessary for their child. In this instance, the child health care provider must describe the medical reason why it is not safe and to sign a statement advising against immunization.
Outbreaks: Children who are not immunized will not be accepted for care during a disease outbreak for diseases, which can be prevented by immunization. This is for the un-immunized child’s protection and to reduce the spread of disease.
When a child is excluded from attending our childcare, a center staff member will complete an Illness Report. The parent signs and receives the white copy and the yellow copy is filed in the child’s file after it has been logged. When a report is given to a parent, the symptom must be logged on the Incident Log Sheet.
Reporting Illnesses: An Illness Report is to be completed when a child is inflicted by the following conditions:
Allergies
Cold
Conjunctivitis
Coughing
Diarrhea
Ear Infection
Fever
Flu
Head Lice
Rash
Sinus Infection
Sore Throat
Stomach Ache
Vomiting
All reports are logged and placed in each child’s file. Public Health Officials, our Health Nurse or our Licensor may review these records to help us detect patterns of incidents so that we may improve our environment.
Single child injury/incident: only one child involved. If a child has an injury on the premises, the teacher who witnessed the event must complete and Accident/Incident Report. The report should be as detailed as possible. When the form has been completed, the teacher, director and the parent or guardian of the child who was injured, must sign it. The parent receives the yellow copy. The white copy is to be placed in the child’s classroom medical book and recorded on the Incident log sheet.
Example: Billy was running on the cement area after being reminded to use his “walking feet.” He tripped and skinned his right knee on the cement. Be as detailed as possible.
Multiple child injury/incident: more than one child involve two forms must be completed. When more than one child is involved in an injury/incident, it is important that ONLY the injured child’s name is written on the Accident Report. The parent of the child who caused the incident must receive and INCIDENT REPORT. When the forms are completed, then the above procedures are to be followed.
Example: Billy and another child were struggling over a toy when the other child bit him. Or, Billy was pulling another child’s hair when the other child bit him. Be as accurate as possible.
Incident Report: Should a child inflict injury to another child or teacher with the purpose of hurting that child or teacher, or purposely damage school equipment, the incident is to be recorded on an Incident Report. Incident reports are located in the hallway of both buildings.
Incident Log Sheet: It is important to keep an accurate log so that we can detect patterns of children’s behavior and make changes in the children’s environment to prevent incidents from reoccurring. The Incident Log sheet is to be kept confidential and not shared with anyone other than the employees of our center or a health official. All incidents are documented on the Incident Log Sheet under the circumstances below:
Injury: When a child is injured, the incident must be logged on the Incident Log Sheet.
Injury/Incident: When a child injures another child with the intent of hurting that child, then the incident must be logged on the Incident Log Sheet.
Incident: When a child causes physical damage to property, then the incident must be logged on the Incident Log Sheet.
Restraining a Child: If a teacher should have to restrain a child to prevent damage to others and equipment, the incident must be logged on the Incident Log Sheet.
Illness: When we have to send a child home for an illness.
Medication will only be given with prior written consent of the child’s parent/legal guardian.
When parents request that staff members administer any medications to their child, certain procedures are to be followed:
Medication Release Form: The Parent/Guardian must complete the medication release form located in the hallway of each building. The parent completes the form and hands the medication to a staff member. The staff member is responsible for making sure the form is filled out completely and accurately. Parents are to be informed if they must have a health care provider’s permission to use the medication. The parent’s written consent must include:
Child’s first & last name
Name of medication
Reason for giving medication
How to give the medication
How often to give the medication
Start & stop dates
Expected side effects
How to store the medication consistent with directions on the medication label.
Prescription Medication: All prescription medication must be in its original container and properly labeled with:
Child’s full name
Name of medication
Date prescription was filled or medication’s expiration date
Dosage amount
Frequency
Length of time
Non-prescription medication: The following classifications can be given with written parental consent only as to the dose, duration, and method of administration specified on manufacturer’s label for the age or weight of the child needing medication. A physician’s authorization is required if the instructions on the label indicate to consult a physician for that child’s age and weight group. Authorizations may be faxed at 425-671-0221. The following is a list of acceptable non-prescription medication:
Non-aspirin fever reducers/pain relievers
Non-narcotic cough suppressants
Decongestants
Anti-itching ointments or lotions, intended specifically to relieve itching
Diaper ointments intended specifically for the use in the diaper area of the child
Sun screen (not used on infants under the age of 6 months)
Unlisted non-prescription medication: A physician’s authorization is needed for non-prescription medication that is not included in the above list, or if it is to be taken differently than indicated on the label or lacks labeled instructions. In general, all oral medications for children under the age of 2 years require legally authorized health care practitioner notations specifying name, dose and period of time. In addition, we must have written authorization from a health care provider for:
Vitamins
Herbal supplements
Fluoride
Bulk Medications: Brown Bear Educare may provide bulk containers of diaper ointments and nontalc type powders intended for use in the diaper area and sunscreen provided we:
Obtain written consent prior to use
Use for no longer than 6 months
Notify parents of the:
Name of the product
Active ingredients in the product
Sun Protective Factor (SPF) in sun screen
Storage of medications:
Internal medications are store separate from external medications
All medications are stored at the proper temperature (refrigerated or non-refrigerated)
Internal medications not needing refrigeration are stored in a container in that child’s classroom that is inaccessible to children.
Internal medications needing refrigeration are stored in a locked box in a refrigerator.
External medications are stored in the child’s classroom on a in a locked box for preschoolers or on a high shelf in the diaper changing area for toddlers.
All medications are inaccessible to children.
Unused medication: will be returned to the parent or properly disposed.
Administration of medications: The child’s teacher is responsible for following the directions on the Medical Release Form and administering the medications at the appropriate times.
Documentation of Medications: Anytime a staff person administers medication to a child, he/she must log the treatment located on the back of the Medication Release Form. The child’s teacher is responsible for documenting medications administered to children including the amount, date and time the medication was used.
Medical Log Sheet: When the treatment is discontinued, the treatment should be logged in the on the Log Sheet located in the registration notebook and placed in the child’s file
Staff members are to record when children arrival and departure times from the center. If a child is not in attendance, the reason why should be written in their time slot. These sheets are distributed weekly to staff and kept on classroom clipboards. At the end of the week, the attendance sheet should be filed. We are to keep attendance record for 5 years.
Example:
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Class: Toddler |
Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
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Billy S. |
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Chicken Pox |
Chicken Pox |
Chicken Pox |
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Kelly P. |
Vacation |
Vacation |
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Antonio S. |
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The parent or other person authorized by the parent to take the child to or from the center must in the child on arrival and sign out the child at departure, using their full legal signature and writing the time of arrival and departure. These forms are kept on a clipboard in front of each child’s assigned classroom.
All staff members of Brown Bear Educare are required to maintain an age-appropriate Cardio-Pulmonary Resuscitation (CPR) and First Aid training certificate and are always available in case of an emergency
Location: Our First Aid Kits are located in the bathroom of the Infant Toddler Center and in the Kitchen of the Preschool. Both schools have additional kits located outside as well.
Field Trips: When we go on field trips the lead staff member is responsible for taking the portable First Aid Kit.
Stocking: The Assistant Director is responsible for assuring our first aid kits are fully stocked.
Our kits contain: One-way CPR barrier mask
First Aid Guide
Adhesive Tape
Band-Aids (different sizes)
Cotton Balls
Gloves
Large Triangular Bandage
Roller Bandages
Sterile gauze pads
Small scissors
Syrup of Ipecac (only used after calling poison control)
Tweezers
It is inevitable that children will incur minor injuries. When a child does injure himself, we follow the procedures below:
Provide First Aid: One staff member will stay with the child and, if necessary, provide first aid according to the recommendations of the American Red Cross or American Academy of Pediatrics. However, most minor injuries include nose bleeds, scrapes and bruises. The staff person assisting the child must:
Contact Parents/Guardians: The lead staff member will contact the parent or legal guardian by phone if the injury
Contact Licensor and Child Protective Services: If it should be necessary for a child to be seen by a doctor, the assigned licensor for Brown Bear Educare, Marie Garrison, and the local Child Protective Services shall be contacted by phone and sent a copy of the Injury or Illness report.
Documentation: The person who witnessed the accident will complete an injury/accident report form as soon after the incident as possible. The parent will sign the incident/accident report form. The white copy will be given to the parent. The accident will be logged in the registration notebook before filing the white copy in the injured child’s file.
In the event of a life-threatening emergency to a child in our care, we will take the following actions:
Provide First Aid: One staff member will stay with the child and, if necessary, provide first aid according to the recommendations of the American Red Cross or American Academy of Pediatrics.
Call 911: The child’s teacher or designated staff member will contact the Emergency Medical System (911) and will…
Describe the situation
State the physical location of the emergency
Give phone number, and stay on the line until told to hang up
Contact Parents/Guardians: The lead staff member will contact the parent or, if the parent can not be reached, the child’s alternate emergency contact person
Transportation: Emergency transportation for any necessary medical care will be determined by the emergency response team and/or parent. A staff member will go with and remain with the child until parents arrive.
Documentation: The person who witnessed the accident will complete an injury/accident report form as soon after the incident as possible. The parent will sign the incident report form. The yellow copy will be given to the parent. The accident will be logged in the Classroom Health Care Policy Notebook before filing the white copy in the injured child’s file.
Contact Licensor and Child Protective Services: The assigned licensor for Brown Bear Educare, Marie Garrison, and the local Child Protective Services shall be contacted by phone and sent a copy of the Injury/Accident report.
DISASTER PLAN
Generally, if we should experience a disaster such as a fire or earthquake, the children will be evacuated to the playground and attendance will be taken. Staff members will call parents to pick up their children. Should we be required to leave the premises, we will evacuate to Small Wonder’s Child Care located on block north at:
Small Wonders
11511 NE 21st St.
Bellevue, WA 98004
425-450-0444
Whenever we experience a disaster in which we must evacuate the facility, the director is required to make a report of the incident and send a copy to the department of licensing.
For more details, we may review our disaster plan for details on responding to disasters on our website. BBECARE.COM
HOW DO WE HANDLE CHILDREN WITH SPECIAL NEEDS?
Brown Bear Educare has experience in working with children with many different types of special needs. Asthma, Diabetes, developmental delays, physical problems, and behavior issues are the most common. We follow the guidelines listed below:
Accepted: Children with special needs will be accepted into our program under the guidelines of the Americans with Disabilities Act (ADA).
Plan: A written plan of care will be developed by the director, parent/guardian and teacher for each child with special needs.
Confidentiality: is assured with all families and staff in our program.
Dignity: all families will be treated with dignity and with respect for their individual needs and or differences.
Full Participation: Children with special needs will be given the opportunity to participate in the program to the fullest extent possible. This may be supported by consulting with outside agencies/organizations.
Staff Training: All staff will receive general training on working with children with special needs and updated training on specific special needs that are encountered in the classroom.
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WHAT SPECIAL REGULATIONS ARE WE REQUIRED FOR INFANT CARE?
Age: Infants must be at least 1 month old
Nutrition: We work with our clients to develop a plan for the infant's feedings that is acceptable to the parent and incorporates the following guidelines:
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Developmental Stage/Age of |
Infant Type of Feeding |
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(a) Under 4 months of age |
Serve only formula or breast milk unless we have a written order from the child's health care provider. |
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(b) When baby can: (at about 4-6 months of age) Sit with support Hold head steady Close lips over the spoon Keep food in mouth and swallow it.
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Serve only formula or breast milk unless we have a written order from the child's health care provider. Begin iron fortified baby cereal and plain pureed fruits and vegetables upon consultation with parents.
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(c) When baby can: (at about 6-8 months) Sit without support Begin to chew Sip from a cup with help Grasp and hold onto things
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Serve only formula or breast milk unless we have a written order from the child's health care provider. Start small amounts of juice, or water in a cup. Let baby begin to feed self. Start semi-solid foods such as cottage cheese, mashed tofu, mashed soft vegetables or fruits.
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(d) When baby can: (at about 8-10 months) Take a bite of food Pick up finger foods and get them into the mouth Begin to hold a cup while sipping from it
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Serve only formula or breast milk unless we have a written order from the child's health care provider. Small pieces of cheese, tofu, chicken, turkey, fish or ground meat. Small pieces of soft cooked vegetables, peeled soft fruits. Toasted bread squares, unsalted crackers or pieces of soft tortilla. Cooked plain rice or noodles. Only formula, breast milk, juice or water in the cup.
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(e) When a baby can: (10-12 months) Finger Feed Chew and swallow soft, mashed and chopped foods Start to hold and use a spoon Drink from a cup
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Serve only formula or breast milk unless we have a written order from the child's health care provider. Begin offering small sized, cooked foods. Variety of whole grain cereals, bread and crackers, tortillas. Cooked soft meats, mashed legumes (lentils, pinto beans, kidney beans, etc.), cooked egg yolks, soft casseroles.
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(f) When a baby can eat a variety of foods from all food groups without signs of an
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