1. A. The provider shall ensure that the written feeding schedule for each infant and toddler, as required by COMAR 13A.18.03.02C, is:

   1. (1) Followed; and
   2. (2) Updated as necessary or at least every 3 months while the child is in care.

2. B. Self-Feeding by Children Younger than 18 Months Old.

   1. (1) The child shall be held for each bottle feeding except when developmentally able and insistent upon self-feeding.

   2. (2) The child may hold the bottle only:

      1. (a) When seated; and
      2. (b) If the bottle is made of unbreakable material.

3. C. Except as specified by §D of this regulation, a provider may serve a child younger than 18 months old only developmentally appropriate:

   1. (1) Commercially prebottled formula;
   2. (2) Breast milk, formula, juice, or water which has been prebottled for the child and provided by the child's parent;
   3. (3) Commercially processed baby food that is opened and used the same day;

   4. (4) Commercial infant formula, in concentrate, powder, or ready-to-feed form, if the:

      1. (a) Child's parent has provided prior written authorization for the use of the formula; and
      2. (b) Formula is prepared directly from a factory-sealed container and in accordance with the manufacturer's instructions; and
   5. (5) Other foods supplied by the provider or the parent that are consumed the same day.
4. D. Only whole, pasteurized milk will be served to a child younger than 2 years old who is not receiving formula or breast milk, except that skim milk, reconstituted nonfat dry milk, or 1 or 2 percent milk may be served upon the written prior approval of the child’s parent and health care provider.

5. E. A provider shall ensure that:

   1. (1) All food and bottles intended for consumption or use by a child younger than 18 months old are labeled with the child’s name, dated, and refrigerated at 40°F or below if potentially hazardous;
   2. (2) All nipples on bottles are protected;

   3. (3) Breast milk or formula which has been bottled for the child is:

      1. (a) Placed immediately in a refrigerator when brought to the child care home;
      2. (b) Warmed to the desired temperature immediately before feeding; and
      3. (c) Served to the child at a temperature that is safe and conducive to the child's comfortable feeding;
   4. (4) Foods that present a high risk of choking for children younger than 2 years old are not served to them; and

   5. (5) Reusable bottles and nipples are:

      1. (a) Reused only after they have been washed, rinsed, and sanitized; or
      2. (b) If supplied by the child's parent, rinsed after use and returned daily to the parent.

Authority: Education Article, §§9.5-301—9.5-308, 9.5-310—9.5-312, 9.5-320, and 9.5-321; General Provisions Article, §4-333; Human Services Article, §1-202; Annotated Code of Maryland
Agency Note: Federal Statutory Reference — Americans with Disabilities Act of 1990 (42 U.S.C. §12101 et seq.);
Pro-Children Act of 1994 (20 U.S.C. §6081 et seq.);
Child Care Development Block Grant (45 CFR Parts 98 and 99 and 42 U.S.C. 9858 et seq.);
Social Security Act §418 (42 U.S.C. 618)

Effective date: February 6, 2012 (39:2 Md. R. 142)

Regulation .01 repealed and new Regulation .01 adopted effective July 20, 2015 (42:14 Md. R. 884)

Regulation .01B amended effective January 13, 2020 (47:1 Md. R. 17)

Regulation .06D amended effective January 13, 2020 (47:1 Md. R. 17)