Infant Feeding Statement

Our center participates in the Child and Adult Care Food Program (CACFP) and receives USDA reimbursement for servicing nutritious meal to infants according to program requirements.

  • We are required to provide meals to all children in attendance. Our center will be providing all infant meal components which include formula for our infants.
  • Our facility has chosen Member’s Mark brand formula.
  • You have the option to accept or decline the formula supplied by our center.
  • Please mark your selection below.

Parents (or guardians) complete the following table(s) as appropriate:
Today's Date:(Required)
Birth – 3 months4 – 7 months8 – 11 Months
I will bring breast milk for my infant.
I want the center to provide the infant formula if offers for my infant.
I will bring the infant formula for my infant. Please list the kind of infant formula you will provide.

According to CACFP requirements, in order to claim meals for reimbursement, the center must provide infant cereal and other foods when your infant is developmentally ready to accept them.

Today's Date:(Required)
4 – 7 months8 – 11 Months
My child is developmentally ready for solid foods. I want the center to provide the infant cereal and other foods for my infant.
My child is developmentally ready for solids. I will bring the infant cereal and/or other foods for my infant.
My child is NOT developmentally ready for solid foods. I will inform the provider when and designate the solid food(s) to be introduced to my infant at that time.
Date:(Required)

1. This form must be kept on file for each infant enrolled for childcare.
2. This form must be kept current and accurate for each infant enrolled for childcare until the infant reaches 1 year of age.
3. If the parent (of guardian) provides expressed breast milk and the childcare provider feeds it to the child, the meal may be claimed for reimbursement.
4. If the parent (or guardian) declines the formula and the childcare provider provides meal and/or snack components, the meal may be claimed for reimbursement.
5. If the parent (or guardian) declines infant meals/snack, meals and snacks may NOT be claimed for reimbursement.