Learning Outcome 3 Feed Infants and Toddlers Contents:: Date Developed: December 5, 2018 Document No

LEARNING OUTCOME 3 FEED INFANTS AND TODDLERS
CONTENTS:
 Procedures in feeding
 Hand washing procedures
 Infant diet
 Table etiquette
ASSESSMENT CRITERIA:
1. Cleaned and sterilized the infants and toddlers’ feeding bottles as
needed.
2. Prepared the milk formula as prescribed.
3. Fed and burped the infant according to established procedure.
CONDITIONS:
Students/trainees must be provided with the following:
 A childcare workplace
 Facilities equipment and materials relevant to the unit of competency
ASSESSMENT METHODS:
 Oral and written evaluation
 Practical /Performance Test
Document No.
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CAREGIVING NC December 5,
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Provide care and Developed by:
support to infants Page 103
Mariechu Y. Revision #
and toddlers Manalo ___
LEARNING EXPERIENCES
Learning Outcome 3
Feed infants and toddlers
Learning Activities Special Instructions
Read Information Sheet 1.3-1 on

Procedures in Feeding.
Answer Self-Check 1.3-1. In this learning outcome, you shall

feed infants and toddlers. To be able
Compare answers with Answer Key
to do this, you must analyze and
1.3-1. understand the following:
Perform Task Sheet 1.3-1 on 1. Procedures in feeding

Feeding an Infant. 2. Hand washing procedures
3. Infant diet
4. Table etiquette
Evaluate your output using
Go through the Information Sheets
Performance Criteria Checklist 1.3- and answer the Self-Checks to ensure
1. that knowledge contents of the
standards in Competency-based
Training are acquired. You are
required to get all answers correct. If
not, read the information sheets
Hand Washing Procedures. again to answer all questions
correctly.
You will prepare formula and feed an
infant accurately.
Answer Self-Check 1.3-2.
You will clean feeding equipment
accurately.
1.3-2.
Present your work to your trainer for
evaluation.
Perform Task Sheet 1.3-2 on

Cleaning Baby Bottles After a Feed.
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Evaluate your output using
Performance Criteria Checklist 1.3-
2.

Infant Diet.

1.3-3.

Table Etiquette.

1.3-4.
After doing all the activities of

this LO, you are ready to proceed
to the next LO on Put Infants and
Toddlers to Sleep.
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Information Sheet 1.3-1
Procedures in feeding
Learning Objective:
After reading this information sheet, you must be able to: describe best
practice for feeding infants, including promoting breastfeeding; describe
developmentally appropriate ways to introduce solid food and other fluids;
and identify nutritious foods and appropriate servings for toddlers.
Early Care Food
Importance of nutrition in early care food provides the energy and nutrients needed by
infants and children during this critical period of growth and development. Caregivers
should provide food each day to meet each child’s nutritional needs. Food should be clean,
safe, and developmentally appropriate. Food also should look and taste good! Clean
drinking water should be freely available to children.
Caregivers have the opportunity to observe children’s eating patterns in a relaxed and
pleasant eating environment. They can work with parents to promote development of
healthy eating habits.
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Breast Milk and Breastfeeding
Mothers will be instructed in

breastfeeding techniques before
leaving the hospital with their
newborn. A breastfeeding mother
can pump and store human milk
for bottle-feeding later. As a
Caregiver you should also be
familiar with the proper
procedures of storage regarding
breast milk. Breast milk should be
brought to child care in prepared
bottles. Bottles should be clean
and sanitized.
There are many benefits of breast milk.
 Helps fight infection. Human milk contains antibodies from the mother to help protect
the infant from some illnesses and conditions.
 Promotes digestion. The major ingredients are sugar (lactose), easily digestible protein
(whey and casein), and fat, which are all properly balanced. Human milk also contains
vitamins, minerals, and enzymes that aid digestion and absorption of nutrients.
Commercial formulas are a good imitation of human milk, but do not contain enzymes,
antibodies, and other ingredients.
 Is less expensive and inconvenient. There are no bottles to mix and clean. Human milk is
the perfect temperature, and it is always fresh and available.
 Helps prevent childhood obesity, as indicated by many studies.
 Is bacteria-free. Human milk is free of bacteria. Human milk can be expressed into
sanitized bottles.
 Promotes nurturing and bonding with direct skin-to-skin contact and is soothing for both
infant and mother.
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Storage of Breast Milk
• Check the date on the label.

• Parents may store frozen human milk at home in single use, plastic milk storage bags,
clearly labeled with the infant’s full name and the date the milk was expressed.
• Expressed human milk can be frozen for up to six months in the freezer compartment of
a refrigerator with separate doors and up to 12 months in a stand-alone (chest/upright)
freezer.
• Frozen human milk should be thawed overnight in the home refrigerator and put in a
clean/sanitized bottle the following morning.
• Label the bottle with the child’s full name, the date and time, and “frozen.” NOTE: Once
thawed, human milk should never be refrozen.
• Discard human milk that appears as if it may be contaminated (unsanitary bottle), is
curdled, smells rotten, or has not been properly stored/refrigerated.
• Return all bottles to the parent at the end of each day.
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Infant/ Toddler Formula
A parent may prefer a formula instead of, or in addition to, breast milk. Commercial
formulas are a good imitation of human milk, but do not contain enzymes, antibodies, or
other beneficial ingredients found in human milk.
• An infant may need special formula (e.g., iron fortified, soy-based).

• An infant may need supplemental formula if the mother does not have sufficient
human milk.
• A mother may choose not to breastfeed or to breastfeed for a limited time. The
convenience and flexibility of bottled formula may be necessary.
Parents should consult their child’s regular doctor about the initial formula choice and
before changing formula or changing brands. There are many different types and brands of
formula. Generic or store brand formulas may be equally nutritious and less expensive.
Formula can meet the basic nutritional needs of most infants, but it may be necessary to
change formulas. Observe infants for signs of a feeding intolerance, such as being very fussy
or gassy, spitting up a lot, having diarrhea, or vomiting. If an infant seems to have a problem
with feeding, alert the child’s parent and recommend consulting with the infant’s regular
doctor. Infants should not have regular cow’s milk until they are one year of age.
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Warming Bottles
Bottles can be served cold or at room temperature. Infants who are normally breastfed may
be more willing to accept a bottle if it is warmed.
To warm refrigerated bottles:
 Place the bottle in a container of warm water (no more

than 1200 F) for 5 minutes or less.
 If an electric slow-cooking device or bottle-warmer is

used to warm bottles, the device should contain water
that does not exceed 1200 F. The device and electrical
cords must be out of children’s reach and positioned
away from children’s areas. The device must be
emptied, cleaned, sanitized, and refilled with fresh
water each day.
 Remove the bottle from the water. Dry thoroughly

with a disposable towel to prevent the risk of hot
water dripping onto the infant.
 Gently swirl or mix (do not shake) the bottle after

heating to evenly distribute the warmed milk and
prevent "hot spots." Check the temperature by shaking
a few drops out onto the back of your hand, which is
more sensitive than your wrist. It should feel cool or
slightly warm. An infant's mouth and skin are very
sensitive. Milk that feels warm to you may be too hot
for the infant.
DO NOT microwave bottles! There are many reported
cases of serious burns to infants due to microwaved
bottles.
 The bottle may seem cool, but the liquid inside may be extremely hot.
 The buildup of steam in the bottle, which is a closed container, could cause it to explode.
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Safety Tips
For both human milk and formula:
 Each bottle should contain human milk or formula for a single feeding. For young
infants, consider using 4 oz. bottles rather than 8 oz. bottles.
 Encourage parents to transport bottles in insulated cooled bags (e.g., with freezer
pack). Upon arrival, bottles should be immediately stored in the refrigerator at a
temperature of 390 F (40 C).
 It is recommended that a separate refrigerator be used for infant bottles, infant food,
and other infant supplies.
 If a refrigerator is also used for other food storage, then place bottles near the back of
the refrigerator on a designated top shelf to avoid contamination by food spillage or
drips.
 A bottle should be in the refrigerator until the infant is fed. Bottles should never be
left at room temperature.
 Complete the infant's feeding within one hour. After that time, harmful bacteria can
grow. Discard unfinished formula and human milk.
 Return all bottles to the parent at the end of the day.
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Preparing Formula
Infants should be fed the same type and brand of formula at home and at child care.
Formula provided by the parents should be brought in prepared, labeled bottles.
If parents use powdered formula, it must be mixed at home and brought in prepared,
labeled bottles. Caregivers should not mix powdered formula due to sanitation and dilution
concerns. Parents may provide ready-to-feed or concentrated formula in the factory-sealed
container, labeled with the child’s full name. The formula should be poured into clean,
sanitized bottles, also labeled with the child’s full name. Water for formula dilution must be
from a source approved by the health department.
To prepare a bottle:
1. Wash your hands.
2. Use clean and sanitized bottles and nipples.
3. Rinse and dry the unopened formula can
4. Fill the bottle(s) with formula for one feeding.
5. Cover and refrigerate the unused portion.
6. Use opened formula within 48 hours.
7. Ready-to-feed: pour amount directly into bottle.
8. Concentrated: mix formula with water at a 1:1 ratio. For every 1 oz. of formula, add 1 oz.
of water. (Follow instructions on can).
9. Powder: Add 1 scoop of formula (scoop provided in formula can) for every 2 oz. (4
tablespoons) of water. Mix directly in bottle; shake thoroughly.
10. Demonstrate measuring utensils. 1 oz. = 2 Tablespoons; scoop (level or heaping); show
ounce markings on bottles.
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Techniques for Bottle Feeding
Bottle feeding techniques should mimic breastfeeding. If possible, have the same caregiver
feed the infant for every feeding.
 Hold the infant during feeding. Caregivers may talk,

sing, or croon to infants during feeding. Respond to
infant vocalizations with eye contact and
vocalizations.
 Make sure the bottle is upright and the nipple is
full of human milk or formula.
 Touch the nipple to the baby’s mouth until he/she
starts sucking. Hold the bottle at a right angle with
her mouth.
 Allow the infant to stop during the feeding. Watch
for signs of fullness.
 Burp infants after every feeding and during feeding
if needed.
 Feeding should be completed within one hour.
After one hour, harmful bacteria can begin to grow
in the human milk or formula. After feeding,
discard unused milk in the bottle.
Caution:
Do not prop a bottle!

Do not allow infants to have bottles in the crib.
Do not allow older infants to carry a bottle while standing or walking around.
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Burp infant after each feeding
When burping an infant, use repeated gentle patting on the infant's back.
Try experimenting with different positions that are comfortable for you and the infant:
A C
B
A. On your chest
1. Hold the baby against your chest so the baby’s chin is resting on your shoulder.
2. Support the baby’s head and shoulders with your hand.
3. Gently rub or pat the baby’s back with your other hand.
B. Sitting on your lap

1. Sit the baby on your lap facing away from you.
2. Use one arm to support the baby’s body, the palm of your hand supporting the
baby’s chest while your fingers gently support the baby’s chin and jaw.
3. Keep your fingers away from the baby’s throat.
4. Lean the baby slightly forwards and gently pat or rub the baby’s back for a while
with your free hand.
C. Face down across your lap

1. Lie the baby’s face down on your leg, at a right angle to your body so the baby’s
lying across your knees.
2. Support the baby’s chin and jaw with one hand.
3. Keep the baby’s head slightly higher than the rest of the body, so blood doesn’t
rush to the head.
4. Rub or pat the baby’s back gently with the other hand.
If an infant seems fussy while feeding, stop the session, burp him, and then resume feeding.
Burp the infant again when the feeding is completed.
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Serving Infant and Toddler Food
Parents may want to prepare infant foods at home and bring them to the child care
program. These foods may be brought in single-serve dishes or in storage containers. If,
however, the child care program provides the infant foods, then the first solid foods offered
to infants should be commercially prepared infant foods (without added sugar, fat or salt).
Caregivers should not prepare infant foods, such as pureed fruits or vegetables, on site.
Regardless of whether the food is brought from home or commercially prepared, the food
should be served to the infant using a feeding dish and spoon.
 Wash the infant food container with soap and water before opening.
 After opening, check the rim of a glass container for chips or cracks.
 Do not feed from the container.
 Use a clean spoon to place a portion of the infant food on a clean dish. Examine food for
glass pieces or foreign objects.
 Immediately cover and refrigerate unused portion. Discard unused portions after 24
hours. Feed only one infant at a time. Use a small, soft-tipped spoon that fits the infant's
mouth and serve tiny amounts. Allow the cereal or other food to flow off the spoon into
the mouth. This is a new experience for infants; they may spit out the first few bites.
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Feeding Infants and Toddlers
A. Meal and Snack Patterns

1. Children should be offered nutritious meals and snacks each day, based on the
length of time they are in child care each day. o If 8 hours or less, serve at least one
meal and two snacks, or two meals and one snack. o If over 8 hours, serve at least
two meals and two snacks, or one meal and three snacks.
2. If breakfast is not served by the child care program, then communicate with parents
to be sure every child is offered breakfast.
3. Toddlers need frequent small servings of foods (meals and snacks) to provide their
total daily nutritional intake. They need to eat every three to four hours. The USDA
requires 2 ½ hours between meals (e.g., breakfast and lunch), and 1 ½ hours
between meals and snacks (e.g., lunch and afternoon snack).
B. Allow Sufficient Time for Each Child to Eat
1. Allow sufficient time (e.g., 20-30 minutes) for each child to eat. If a child does not
complete his meal, he will probably be hungry and will eat when the next meal or
snack is provided.
2. Discuss what to do if a child is a very slow or a very fast eater.
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3. Slow eater: Gently remind the child that “You have five more minutes” or give other
reminder of time. After the 30 minutes, take the food away and involve the child in
other classroom activities.
4. Fast eater: Encourage all children to chew, taste, and enjoy the foods. Involve
children in pleasant mealtime conversation. If a child has completed his meal, it is
not necessary for him to remain at the table.
C. Choose Lower Fat, Sugar, and Sodium
1. Infants and toddlers need some fat in their diet. Fat is essential for development,
including brain development.
2. Do not add salt when cooking. Remove the salt shaker from the table.
3. Limit foods that are high in salt and low in nutrients.
4. Limit high sugar and low nutrient foods such as cookies, candy, and cake. Limit
sweetened beverages; offer water, milk, or juice.
D. Healthy Eating
There are basic premises for healthy eating. Portion

control, enjoying your food, but eat less and eat a
variety of foods. Varied foods will differ in the following
ways:
 Food group (i.e., dairy, protein, fruit, vegetable,

grains).
 Color (e.g., red apples, green pears, red
tomatoes, yellow squash).
 Texture (e.g., wheat bread, cooked and raw
vegetables, soft banana, crisp celery).
 Shape (e.g., long zucchini, round biscuit, sliced
bread, grated carrot).
 Method of preparation (e.g., steamed, grilled,
fried, baked, raw).
 Temperature (e.g., cold milk, warm bread).
 Size (e.g., compare size of a strawberry, a kiwi, and a banana).
 Choose healthy and nutrient-dense foods.
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 Healthy foods are those that supply a significant amount of nutrients (vitamins and
minerals as well as energy) in amounts appropriate to meet children's growth and
development.
 Make half the plate colorful fruits and vegetables.
 Make half the plate grains and proteins. Whole grains and lean protein are
recommended.
 Choose reduced fat milk.
 Choose foods lower in salt (sodium).
 Drink water instead of sweetened drinks.
E. Self-Feeding Skills
Young toddlers are beginning to develop self-feeding skills. At first, toddlers may sit in high
chairs as the caregiver helps them learn to feed themselves. Caregivers should be seated
within arm’s reach of each child.
As toddlers develop gross motor control, they will be more able to sit and eat at a table with
other children.
 Child-size table and chairs should be provided.

 If children seem to slip in chairs, it may help to place rubber matting in the chair seat.
 Rubber matting may also help keep plates and bowls from slipping on the table.
 Start with finger foods and foods that “stick” to the spoon. Help children learn to use
eating utensils.
 Use appropriate utensils including a child-size spoon (short handle with a shallow bowl
like a soup spoon) and a child-size fork (short, blunt tines and broad handle similar to a
salad fork).
Mealtime will be messy as toddlers develop self-feeding skills! Encourage children through
positive verbal and non-verbal cues—smile!
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SELF-CHECK 1.3-1
I. ENUMERATION: Give at least five (5) benefits of breastfeeding.
II. TRUE OR FALSE: Write TRUE if the statement is correct and FALSE if
it’s not.
1. “Feed on Demand, Not on Schedule”

2. Always wash your hands when handling baby food.
3. There’s no need to check the date on the label when storing breast milk.
4. After opening a toddler’s food container, check the rim of a glass container for chips or
cracks.
5. Toddlers can use adult tables and chairs when self-feeding.
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ANSWER KEY 1.3-1
I. ENUMERATION: Give at least five (5) benefits of breastfeeding.
- Helps fight infection

- Promotes digestion
- Less expensive and inconvenient
- Promotes nurturing and bonding
- Bacteria-free
II. TRUE OR FALSE: Write TRUE if the statement is correct and FALSE if
it’s not.
1. TRUE
2. TRUE
3. FALSE
4. TRUE
5. FALSE
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TASK SHEET 1.3-1
TITLE: Feeding an Infant
Performance Objective: After reading the information sheet on “Procedures

in Feeding”, the students must be able to perform the steps on how to
prepare formula and feed an infant.
Supplies/Materials :
 Record form
 Ball- point pen: blue (1) black (1) red (1)
Equipment :
 Bottles, with caps and discs
 Formula powder
 Knife (not a sharp one) Used to level off the formula powder. Plastic or
metal
 Muslin cloth or Towel
 Sterilized water
 Teats
 Electric Kettle
SITUATION: The trainees will do a return demonstration of preparing

formula and feeding infant.
Objective : The trainees must be able to prepare formula and feed an

infant accurately.
Steps/Procedure:
1. The trainees are given 5 minutes to review and practice the procedure.
2. The trainees will prepare the necessary materials and equipment needed
for the return demonstration.
3. The trainees will be performing the procedure individually and will be
graded accordingly.
Assessment Method: Practical/ Performance Test
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Performance Criteria Checklist
Task Sheet 1.3-1
Feeding an Infant
Trainees’ Name:
Date:
PROCEDURE DONE NOT DONE

I. Making Formula
1. Assumed hand washing.
2. Filled the Electric kettle with fresh tap water.
3. Let it boil and cool down until it is lukewarm, or around
room temperature
4. Poured the right amount of cooled, boiled water into
the bottle.
5. Added the right number of scoops to the water.
6. Used a clean knife to level off the powder on each scoop
(turn the knife upside down and use the flat edge).
7. Put the cap and disc on the top of the bottle.
8. Shook the bottle well to mix the powder.
9. Held the bottle upside down when it’s filled with liquid
at room temperature. (The liquid should drip steadily
but not pour out.)
II. Feeding
1. Positioned baby in an inclined angle facing oneself.
2. Touched the teat gently on the baby’s lips.
3. Gently removed the bottle and see whether the baby
wants to burp.
4. Gently removed the bottle when the baby stops sucking
strongly.
III. Burping
1. Placed muslin square or an old towel over oneself.
A. On your chest
2. Held the baby against your chest so the baby’s chin is
resting on your shoulder.
3. Supported the baby’s head and shoulders with your
hand.
4. Gently rub or pat baby’s back with your other hand.
B. Sitting on your lap
1. Sat the baby on your lap facing away from you.
2. Used one arm to support the baby's body, the palm of
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your hand supporting the baby’s chest while your
fingers gently support the baby’s chin and jaw.
3. Kept your fingers away from the baby’s throat.
4. Leaned the baby slightly forwards and gently pat or rub
the baby’s back for a while with your free hand.
C. Face down across your lap
1. Lied the baby’s face down on your legs, at a right angle
to your body so the baby's lying across your knees.
2. Support the baby's chin and jaw with one hand.
3. Keep the baby's head slightly higher than the rest of the
body, so blood doesn't rush to the head.
4. Rub or pat the baby's back gently with the other hand.
TOTAL SCORE:
EVALUATED BY: DATE:
Comments/Suggestions:
Trainer: Date:
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Performance Assessment
Task Sheet 1.3-1

Feeding an Infant
Trainees’ Name:
Date:
SKILLS TECHNIQUE SAFETY COMMUNICATION TOTAL AVERAGE
PERFORMANCE ASSESSMENT SCALE

CRITERIA 4 3 2 1
Consistently Demonstrates ability Inconsistently Inconsistently
demonstrates ability to perform skills demonstrates ability to demonstrates ability to
to perform skills previously learned. perform skills previously perform skills previously
SKILLS previously learned Requires moderate learned. Requires learned. Has
with minimal or no instructor maximum instructor demonstrated unsafe
instructor assistance assistance or assistance or cueing. patient care.
or cueing. cueing.
Consistently Demonstrates Inconsistently Inconsistently
demonstrates knowledge of demonstrates knowledge demonstrates knowledge
knowledge of principles of of technique. Not able to of technique. Has no
principles of technique. Able to verbalize and perform recollection of technique
technique. Able to verbalize and technique. Requires or procedure. Has
TECHNIQUE
verbalize and perform perform technique maximum instructor demonstrated unsafe
technique with with moderate cueing or feedback. patient care. Below level
minimal or no instructor cueing or of safety.
instructor cueing or feedback.
feedback.
demonstrates knowledge of safety. demonstrates knowledge demonstrates knowledge
knowledge of safety. Keeps the patient of safety. Requires of safety. Has no
Keeps the patient safety in the maximum instructor recollection of patient
SAFETY safety in the forefront forefront of patient reminders or cueing. safety. Has
of patient care with care with moderate demonstrated unsafe
minimal or no instructor reminders patient care. Below level
instructor reminders or cueing. of safety.
or cueing.
knowledge of therapeutic of therapeutic of therapeutic
therapeutic communication communication communication
COMMUNICATION
communication techniques with techniques. Requires techniques. Has
techniques with moderate instructor maximum instructor demonstrated unsafe
minimal or no cueing. involvement and cueing. patient care. Below level
instructor cueing. of safety.
Trainee’s signature:____________________ Trainer’s signature:____________________
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Cleaning baby bottles
Learning Objective:
After reading this information sheet, you must be able to learn the proper
ways of cleaning baby bottles.
Bottle Washing Procedure
Washing baby bottles can seem like an endless chore, so it may become tempting to skip
proper cleaning. However, the proper cleaning of baby bottles is extremely important, as
babies' immune systems have not fully developed, making them much more susceptible to
getting sick from bacteria in dirty bottles
1. Rinse the baby bottles directly after use. As soon as

you have finished feeding your baby, give the bottle a
quick rinse out in the sink.
You can wash the bottle more thoroughly later on when

you have time, but this will prevent any old milk or dirt
from accumulating in the bottle.
Try to use hot water when rinsing out the bottle, as this
will clean more effectively.
2. Gather the right cleaning materials. When cleaning

out baby bottles, it helps to use the right materials.
Make sure you have:
A bottle brush to help you clean the bottom and sides of

the bottle and a nipple brush to clean out the rubber
nipple, which is prone to accumulating bacteria.
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Dishwashing liquid designed specifically for baby bottles. This is very gentle and non-toxic
and will not leave a soapy residue on the bottles.
If you are using plastic baby bottles, make sure that they are free from BPA (bisphenol A), an
estrogen-mimicking chemical that was banned by the FDA in 2012.
3. Rinse out the sink and fill with hot soapy

water. Before you wash your bottles, it's a
good idea to clean the sink you intend to use
first, to remove any potential bacteria or
chemicals.
Use a sponge or scouring pad to scrub down

the bottom and sides of the sink and around
the plug using hot water. You can use a little
baking soda as a natural disinfectant if
necessary.
Once the sink is clean and rinsed, fill it with hot water (as hot as your hands can comfortably
handle) and dish soap.
4. Dismantle the bottle and wash each part

separately. When cleaning baby bottles, it's
necessary to take them apart and wash each part
-- the bottle, the ring and the nipple -- separately.
This is important as a lot of old milk can build up

between the ring and the nipple, leading to the
growth of bacteria.
Place all of the bottle parts into the hot, soapy

water and wash separately. Use the bottle brush
for the bottles and the nipple brush for the plastic
nipples and rings.
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5. Alternatively, wash the bottles in the dishwasher. If your bottles are labeled dishwasher
safe, you can go ahead and wash them in the dishwasher.
Stack the bottles upside-down on the top rack of the dishwasher, away from the heating
element. You can buy special dishwasher-safe baskets for the nipples and rings in baby
supply stores.
6. Allow the bottles to dry thoroughly. After

washing, rinse the bottle parts thoroughly in hot
running water to remove any bubbles or soap
residue.
Place the parts on a bottle drying rack (available at

baby supply stores in a range of cute designs).
Make sure the bottles are left to drain in a well-

ventilated location to ensure that they dry
thoroughly. Bottles that remain damp for too long
can grow mold or fungus.
7. Wash your hands before bottle feeding your

baby. Once the bottles are dry, remember to wash your
hands thoroughly with soap and warm water before
handling the bottles or feeding your baby.
The Importance of sterilizing bottles
1. Understand that it's not necessary to sterilize

bottles after each use. Although parents were once
advised to sterilize bottles after every use, this is no
longer deemed necessary.
According to The American Academy of Pediatrics,
washing your bottle with hot, soapy water is enough to
effectively clean it -- as long as the water is safe to
drink.
However, it is still necessary to sterilize new bottles before their first use and to sterilize
bottles that have been washed with well water after each use.
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2. Use a bottle sterilizer. When you need to
sterilize your bottles, you can do so using an
electric steam sterilizer or a microwave steam
sterilizer.
With both types of sterilizer, the bottles are

immersed in steam at a temperature of 212
degrees F (or 100 degrees C), which kills off any
bacteria.
With the electric sterilizer, you add water, stack
the bottles, rings and nipples (spaced well
apart), cover with a lid, plug in and turn on. The
sterilization process takes approximately 10 minutes.
With the microwave sterilizer, the process is essentially the same. Once the bottles are in
the sterilizer, place it in the microwave and heat on full power for 4 to 8 minutes, depending
on the wattage of your microwave.
3. Sterilize bottles in boiling water. The old fashioned

way of sterilizing bottles simply involved boiling them
in a pot of water.
Bring a large pot of water to the boil, then add the

bottle parts, cover with a lid and boil for at least three
minutes.
This method is best for sterilizing glass baby bottles,

but will work on plastic ones too (provided they don't
contain BPA).
Document No.
Date Developed:
II 2018 Issued by:
SELF-CHECK 1.3-2
I. MULTIPLE CHOICES: Choose the best answer to the following questions.
1. Why should you rinse your bottles immediately after using them?
A. To prevent milk from accumulating in the bottle
B. To remove bacteria
C. To wash off your baby's saliva
2. How long do you need to sterilize bottles in the microwave?

A. 1 to 3 minutes
B. 4 to 8 minutes
C. 10 to 13 minutes
3. With both types of sterilizer, the bottles are immersed in steam at a temperature
of______________, which kills off any bacteria.
A. 212 degrees F
B. 212 degrees C
C. 100 degrees F
4. Try to use ______ when rinsing out the bottle, as this will clean more effectively.
A. cold water
B. hot water
C. salt
5. After washing, rinse the bottle parts thoroughly in _______ to remove any bubbles or
soap residue.
A. Hot running water
B. Cold running water
C. Shampoo
Document No.
Date Developed:
II 2018 Issued by:
ANSWER KEY 1.3-2
I. MULTIPLE CHOICES: Choose the best answer to the following questions.
1. ANSWER A- You want to give your bottles a quick rinse after using them so that milk
doesn't build up in the bottle, especially in hard-to-reach places. This can leave an odor
or make the bottle harder to clean later.
2. ANSWER B- Place your bottles in the sterilizer, and then set your microwave on full
power for 4 to 8 minutes, depending on the wattage of your microwave. The higher the
wattage, the less time you will need to sterilize your bottles.
3. Answer A
4. Answer B
5. Answer A
Document No.
Date Developed:
II 2018 Issued by:
TASK SHEET 1.3-2
TITLE: Cleaning baby bottles after a feed
Performance Objective: After reading the information sheet on “Hand

washing procedure”, the students must be able to perform the steps on how
to clean feeding equipment.
Supplies/Materials :
 Record form
 Ball- point pen: blue (1) black (1) red (1)
Equipment :
 Bottle brush
 Bottle sterilizer
 Bottles with teats, caps and discs
 Large sauce pan
 Sterilized water
SITUATION: The trainees will do a return demonstration of cleaning feeding

equipment.
Objective : The trainees must be able to clean feeding equipment

accurately.
Steps/Procedure:
1. The trainees are given 5 minutes to review and practice the procedure.
2. The trainees will prepare the necessary materials and equipment needed
for the return demonstration.
3. The trainees will be performing the procedure individually and will be
graded accordingly.
Assessment Method: Practical/ Performance Test
Document No.
Date Developed:
II 2018 Issued by:
Performance Criteria Checklist
Task Sheet 1.3-2

Cleaning baby bottles after a feed
Trainees’ Name:
Date:
PROCEDURE DONE NOT DONE

I. Cleaning and sterilizing bottles and equipment
A. Cleaning after a feed
1. Assumed hand washing.
2. Rinsed the bottle and teat with cold water from the tap
straight after feeding.
3. Washed the bottle and teat well with hot water and
detergent.
4. Used a bottle brush to clean all the bits of milk off the
inside of the bottle.
5. Turned the teat inside out to clean off bits of milk, and
squirted water through the holes.
6. Rinsed the bottle and teat well in clean water (no
detergent).
B. Sterilizing
1. Boiling
1. Put bottles, teats and other equipment into a large
saucepan.
2. Covered with cold tap water.
3. Made sure the equipment is completely covered with
water and there are no air bubbles.
4. Put a lid on the pan, brought it to the boil, and boiled for
5 minutes.
5. Let the water cool before taking the equipment out.
6. Shook off excess water, put the lids on the bottles, and
stored everything in a clean, dry place.
1. Steam Sterilizer
1. Put bottles, teats and other equipment into the
sterilizer.
2. Covered the bottle sterilizer.
3. Plugged in the bottle sterilizer.
4. Followed the settings on the bottle sterilizer.
5. Let the feeding equipment dry.
Document No.
Date Developed:
II 2018 Issued by:
6. Put the lids on the bottles, and store everything in a
clean, dry place when finished.
7. Clean out the unit as per the instructions.
TOTAL SCORE:
EVALUATED BY: DATE:
Comments/Suggestions:
Trainer: Date:
Document No.
Date Developed:
II 2018 Issued by:
Performance Assessment
Task Sheet 1.3-2

Cleaning baby bottles after a feed
Trainees’ Name:
Date:
SKILLS TECHNIQUE SAFETY COMMUNICATION TOTAL AVERAGE
PERFORMANCE ASSESSMENT SCALE

CRITERIA 4 3 2 1
Consistently Demonstrates ability Inconsistently Inconsistently
demonstrates ability to perform skills demonstrates ability to demonstrates ability to
to perform skills previously learned. perform skills previously perform skills previously
SKILLS previously learned Requires moderate learned. Requires learned. Has
with minimal or no instructor maximum instructor demonstrated unsafe
instructor assistance assistance or assistance or cueing. patient care.
or cueing. cueing.
knowledge of principles of of technique. Not able to of technique. Has no
principles of technique. Able to verbalize and perform recollection of technique
technique. Able to verbalize and technique. Requires or procedure. Has
TECHNIQUE
verbalize and perform perform technique maximum instructor demonstrated unsafe
technique with with moderate cueing or feedback. patient care. Below level
minimal or no instructor cueing or of safety.
instructor cueing or feedback.
feedback.
demonstrates knowledge of safety. demonstrates knowledge demonstrates knowledge
knowledge of safety. Keeps the patient of safety. Requires of safety. Has no
Keeps the patient safety in the maximum instructor recollection of patient
SAFETY safety in the forefront forefront of patient reminders or cueing. safety. Has
of patient care with care with moderate demonstrated unsafe
minimal or no instructor reminders patient care. Below level
instructor reminders or cueing. of safety.
or cueing.
knowledge of therapeutic of therapeutic of therapeutic
therapeutic communication communication communication
COMMUNICATION
communication techniques with techniques. Requires techniques. Has
techniques with moderate instructor maximum instructor demonstrated unsafe
minimal or no cueing. involvement and cueing. patient care. Below level
instructor cueing. of safety.
Trainee’s signature:____________________ Trainer’s signature:____________________
Document No.
Date Developed:
II 2018 Issued by:
Infant Diet
Learning Objective:
After reading this information sheet, you must be able to learn the best
practices in feeding infant
Infant diet
Age-by-age guide to feeding your baby
The American Academy of Pediatrics recommends the introduction of solid foods at 4 to 6

months of age, exclusive breastfeeding for the first 4 to 6 months of age, continued
breastfeeding to the first birthday and beyond if possible, and the use of infant formula for
the first year of life for those infants who are not breastfed.
The Academy cautions against the feeding of hard, small particulate foods during the first 2
to 3 years of life and recommends introducing single-ingredient complementary foods one
at a time for a several day trial. The guidelines suggest that fruit juice is not a necessary part
of an infant's diet and that, in any event, fruit juice intake be limited to 8 ounces per day
after its initial introduction at 6 months of age.
Document No.
Date Developed:
II 2018 Issued by:
Age: Birth 0 to 4 months
Feeding behavior
 Rooting reflex helps your baby turn toward a nipple to find nourishment.
What to feed
 Breast milk or formula ONLY
Age: 4 to 6 months
Signs of readiness for solid food
The following are some guidelines from the American Academy of Pediatrics. Your child is
likely ready to try solids when he:
 Can hold head up and sit upright in highchair

 Shows significant weight gain (doubled birth weight) and weighs at least 13 pounds
 Can close mouth around a spoon
 Can move food from front to back of mouth
What to feed
 Breast milk or formula, PLUS
 Pureed vegetables (sweet potatoes, squash)
 Pureed fruit (apples, bananas, peaches)
 Pureed meat (chicken, pork, beef)
 Semi-liquid, iron-fortified cereal
 Small amounts of unsweetened yogurt (no cow's milk until age 1)
How much per day

 Begin with about 1 teaspoon pureed food or cereal. Mix cereal with 4 to 5 teaspoons
breast milk or formula. (It will be very runny.)
 Increase to 1 tablespoon of pureed food, or 1 tablespoon of cereal mixed with breast
milk or formula, twice a day. If you're giving cereal, gradually thicken the consistency
by using less liquid.
Feeding tips
 If your baby won't eat what you offer the first time, try again in a few days.
 Introduce new foods one at a time. Wait two or three days, if possible, before
offering another new food. (Wait three days if your baby or family has a history of
allergies.) It's also a good idea to write down the foods your baby samples. If he has
an adverse reaction, a food log will make it easier to pinpoint the cause.
 The order in which you introduce new foods doesn't usually matter. Your child's
doctor can advise you.
Document No.
Date Developed:
II 2018 Issued by:
Age: 6 to 8 months
Signs of readiness for solid food

 Same as 4 to 6 months
What to feed
 Pureed or strained fruits (banana, pears, applesauce, peaches, avocado)
 Pureed or strained vegetables (well-cooked carrots, squash, sweet potato)
 Pureed meat (chicken, pork, beef)
 Pureed tofu
 Small amounts of unsweetened yogurt (no cow's milk until age 1)
 Pureed legumes (black beans, chickpeas, edamame, fava beans, black-eyed peas,
lentils, kidney beans)
 Iron-fortified cereal (oats, barley)
How much per day

 1 teaspoon fruit, gradually increased to 2 or 3 tablespoons in four feedings
 1 teaspoon vegetables, gradually increased to 2 or 3 tablespoons in four feedings
 3 to 9 tablespoons cereal in 2 or 3 feedings
Feeding tips
allergies.) It's also a good idea to write down the foods your baby samples. If she has
 The order in which you introduce new foods doesn't usually matter. Your child's
doctor can advise you.
Age: 8 to 10 months
Signs of readiness for solid and finger foods

 Same as 6 to 8 months, PLUS
 Picks up objects with thumb and forefinger (pincer grasp)
 Can transfer items from one hand to the other
 Puts everything in his mouth
 Moves jaw in a chewing motion
Document No.
Date Developed:
II 2018 Issued by:
What to feed
 Small amounts of soft pasteurized cheese, cottage cheese, and unsweetened yogurt
 Mashed vegetables (cooked carrots, squash, potatoes, sweet potatoes)
 Mashed fruits (bananas, peaches, pears, avocados)
 Finger foods (O-shaped cereal, small bits of scrambled eggs, well-cooked pieces of
potato, well-cooked spiral pasta, teething crackers, small pieces of bagel)
 Protein (small bits of meat, poultry, boneless fish, tofu, and well-cooked beans, like
lentils, split peas, pintos, or black beans)
 Iron-fortified cereal (barley, wheat, oats, mixed cereals)
How much per day

 1/4 to 1/3 cup dairy (or 1/2 ounce cheese)
 1/4 to 1/2 cup iron-fortified cereal
 3/4 to 1 cup fruit
 3/4 to 1 cup vegetables
 3 to 4 tablespoons protein-rich food
Feeding tip
allergies.) It's also a good idea to write down the foods your baby samples. If he has
Age: 10 to 12 months
Signs of readiness for other solid foods
 Same as 8 to 10 months, PLUS
 Swallows food more easily
 Has more teeth
 No longer pushes food out of mouth with tongue
 Tries to use a spoon
What to feed
 Breast milk or formula PLUS
 Soft pasteurized cheese, yogurt, cottage cheese (no cow's milk until age 1)
 Fruit mashed or cut into cubes or strips
 Bite-size, soft-cooked vegetables (peas, carrots)
 Combo foods (macaroni and cheese, casseroles)
 Protein (small bits of meat, poultry, boneless fish, tofu, and well-cooked beans)
 Finger foods (O-shaped cereal, small bits of scrambled eggs, well-cooked pieces of
potato, well-cooked spiral pasta, teething crackers, small pieces of bagel)
 Iron-fortified cereals (barley, wheat, oats, mixed cereals)
Document No.
Date Developed:
II 2018 Issued by:
How much per day
 1/3 cup dairy (or 1/2 ounce cheese)
 1/4 to 1/2 cup iron-fortified cereal
 3/4 to 1 cup fruit
 3/4 to 1 cup vegetables
 1/8 to 1/4 cup combo foods
 3 to 4 tablespoons protein-rich food
Feeding tip
allergies.) It's also a good idea to write down the foods your baby samples. If she has
Document No.
Date Developed:
II 2018 Issued by:
Document No.
Date Developed:
II 2018 Issued by:
SELF-CHECK 1.3-3
I. ENUMERATION: For two (2) points each, give at least four (4) signs that a
baby at 4-6 months is ready for solid food?
Document No.
Date Developed:
II 2018 Issued by:
ANSWER KEY 1.3-3
I. ENUMERATION: For two (2) points each, give at least four (4) signs that a
baby at 4-6 months is ready for solid food?
 Can hold head up and sit upright in highchair

 Shows significant weight gain (doubled birth weight) and weighs at least 13 pounds
 Can close mouth around a spoon
 Can move food from front to back of mouth
Document No.
Date Developed:
II 2018 Issued by:
Table Etiquette
Learning Objective:
After reading this information sheet, you must be able to learn table
etiquette for toddlers and the correct position for burping.
Mealtime Manners for Infants and Toddlers
Toddlers can make quite a mess when they eat.

They sometimes spit, throw or squash foods, talk
with their mouths full and fidget.
Research indicates that children can understand

good manners by the time they are around five
years of age, but this doesn’t necessarily mean
they will eat as you would like them to all the time.
The behavior of children at mealtimes rates as a
common source of stress for Australian parents.
Toddlers sitting down to eat

Toddlers are curious and energetic, which
makes them run around and want to
explore. Sitting down for any length of time
is an effort for a young child. Some toddlers
do most of their eating on the run, refusing
to sit down at the table at all.
Apart from being antisocial, eating while

running around increases the risk of choking.
Suggestions to get your child to sit down at
mealtimes include:
 Accept that behavior changes take time and effort. Be patient and calm.
Document No.
Date Developed:
II 2018 Issued by:
 Discuss your plan of action with your partner and other carers so that your
approaches are consistent.
 Be a good role model. Don’t let your child see you walking around the house while
eating.
 Establish a predictable mealtime routine to help your child remember that they are
required to sit down at an appropriate table without distractions such as TV.
 Turn the television off.
 Don’t fight over the issue of sitting down at mealtimes. Concentrate on making
mealtimes fun and enjoyable so that your child is more likely to want to stay at the
table. For example, involve your child in family discussions.
 Talk about it with your child in a calm and reasonable way, explaining why it is best
to sit down when eating. You may need to have this conversation many, many times.
 Tell your child that their meal is over when they leave the table. Take away their
plate. If they are hungry later, offer them a healthy snack.
 Be consistent. Insist that snacks are also eaten while sitting down.
 Compliment your child whenever they show the desired behavior.
 Be realistic about the timing of meals – for example, don’t schedule mealtimes for
when your child is overtired.
Making a mess at mealtime

It takes time to develop the fine motor skills required to eat neatly with a knife and fork.
Don’t assume that your child is deliberately being messy when they eat, since guiding food
to the mouth without any spills is tricky for a toddler. Suggestions include:
 Find out about the stages of child development, so that you don’t expect too much
of your child.
 Plan for the mess by putting a plastic sheet under the highchair.
 Present the foods in easy-to-eat ways, such as cut into strips or fingers.
 Allow your child to eat with their hands rather than a knife and fork.
 Say something like ‘food is for eating’ or ‘are you finished?’ if your child throws food.
 Do not pay attention to the food on the floor – pick it up when the meal is finished.
Toddlers and food wastage

Toddlers tend to play with their food. For example, your child may like to squash foods in
their hands, throw food onto the floor, deliberately spit and dribble with their mouths full,
or leave the majority of food uneaten on their plate. This can be stressful to parents for
three reasons, being that food costs money, meals take time and effort to prepare, and
parents may be concerned their child isn’t eating enough.
You may find yourself getting angry with your child for wasting food or worrying about
whether they are getting enough to eat. Toddlers are good at picking up on your anxiety.
They are also good at recognizing their own hunger and fullness signals and, short of illness,
will never voluntarily starve themselves.
Document No.
Date Developed:
II 2018 Issued by:
Suggestions include:
 Don’t spend too much time over meal preparation for your toddler.
 Aim to make mealtimes relaxed and enjoyable for everyone in the family.
 Avoid battles with toddlers about food and eating. Remember that a healthy toddler
will know when they are full. Check their growth and height charts over a few
months for reassurance.
 Your toddler’s tummy is much smaller than yours. Offer a variety of small portions
on their plate. You are less likely to worry if a couple of banana slices hit the floor
rather than the whole fruit. You can always give them more.
 Try using special plates for toddlers, made of non-breakable material, to help
prevent food being tipped off easily.
 Don’t force your child to finish everything on their plate. It is better to waste a few
leftovers than battle with your child or force them to eat when they’ve had enough.
 Try putting dishes of food centrally on the dinner table and allow your child to serve
themselves.
 Have consequences if food is deliberately wasted by older children, such as taking
away their plate. Offer them a healthy snack later on if they are hungry.
 Don’t try to persuade your child to eat by talking about ‘hungry’ children in other
countries. Your child will not be able to understand.
Toddlers and good table manners

Suggestions include:
 Involve your child in setting the table.
 Lead by example and show good table manners yourself.
 Your child may feel more inclined to copy your behavior if you promote them to a ‘big’
chair rather than their highchair. Give them the same kind of place setting as yours
but don’t give them sharp cutlery.
 Explain why table manners are important, including the difference between eating a
casual meal at home and being at a formal restaurant or grandma’s house.
 Point out the advantages of good table manners. For example, it is difficult for your
child to make themselves understood if they are talking with their mouth full.
 Remind your child gently when their manners slip, but don’t make an issue out of it.
Reward systems for toddlers

Simple rewards may help to reinforce your child’s behavior. Suggestions include:
 Compliment your child whenever they show good table manners.
 Offer stickers or hand stamps for sitting nicely or showing good manners.
 Don’t use lollies (lollipops), chocolates or desserts as bribes.
Document No.
Date Developed:
II 2018 Issued by:
When to Burp Your Baby
The AAP recommends burping your baby during feeding breaks and when he's done eating.
For breastfeeding moms, try burping before switching breasts. For bottle-feeding moms, the
AAP recommends burping between every 2 to 3 ounces for newborns up to about 6 months
old.
The Best Burping Positions

How to burp a baby - position 1.
Hold your baby with her head over your shoulder and her
chest against your chest. Gently rub or pat the back. You do
not need to be too vigorous, just pat gently if you elect to pat
rather than rub. I cup my hand slightly to pat the back. Use a
burp cloth and put it over your shoulder to catch any small
vomit.
Sit your baby on your lap. Put the thumb and forefinger of one
hand (I use my left) on the bony part of the baby's jaw and hold
the baby's jaw forward. The other hand can gently rub or pat
the back. The baby's position should look like a triangle - by
pulling the head forward, the spine is stretched and pressure
on the stomach relieved.
Hold your baby with one hand on her chest and one on her back.
Gently lift her up so her body is stretched out. This stretching will
help release trapped gas. Give your baby a kiss on the head - it's
a lovely thing to do and will relax you both. This is a good
position to try and you change positions, so maybe between
positions 1 and 2, you could use this maneuver.
Lay your baby over your lap with her head on one side of
your thigh and the body stretched over your knee. Babies
love this position and will often fall asleep while lying over
your lap. You can gently rub or pat the back with the baby
lying.
Document No.
Date Developed:
II 2018 Issued by:
SELF-CHECK 1.3-4
I. TRUE OR FALSE: Write TRUE if the statement is true/ correct, and

FALSE if it is not. Write your answer before each number.
1. Force the child to sit before serving the food.

2. Allow the child to eat with their hands.
3. Remind the child gently when their manners slip, but don’t make an issue out of it.
4. Use lollies, chocolates or desserts as bribes.
5. Offer a variety of small portions on their plate.
6. Foods that contain carbohydrates are more likely to cause gas.
7. The APA recommends burping your baby during feeding breaks and when he's done
eating.
Document No.
Date Developed:
II 2018 Issued by:
ANSWER KEY 1.3-4
I. TRUE OR FALSE: Write TRUE if the statement is true/ correct, and

FALSE if it is not. Write your answer before each number.
1. False
2. True
3. True
4. False
5. True
6. True
7. False – AAP not APA
Document No.
Date Developed:
II 2018 Issued by:

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LEARNING OUTCOME 3 FEED INFANTS AND TODDLERS

Read Information Sheet 1.3-1 on

Answer Self-Check 1.3-1. In this learning outcome, you shall

Perform Task Sheet 1.3-1 on 1. Procedures in feeding

Perform Task Sheet 1.3-2 on

Read Information Sheet 1.3-3 on

Answer Self-Check 1.3-3.

Read Information Sheet 1.3-4 on

Answer Self-Check 1.3-4.

After doing all the activities of

Early Care Food

Mothers will be instructed in

There are many benefits of breast milk.

• Check the date on the label.

• An infant may need special formula (e.g., iron fortified, soy-based).

To warm refrigerated bottles:

 Place the bottle in a container of warm water (no more

 If an electric slow-cooking device or bottle-warmer is

 Remove the bottle from the water. Dry thoroughly

 Gently swirl or mix (do not shake) the bottle after

For both human milk and formula:

 Hold the infant during feeding. Caregivers may talk,

Do not prop a bottle!

B. Sitting on your lap

C. Face down across your lap

 Do not feed from the container.

A. Meal and Snack Patterns

B. Allow Sufficient Time for Each Child to Eat

C. Choose Lower Fat, Sugar, and Sodium

There are basic premises for healthy eating. Portion

 Food group (i.e., dairy, protein, fruit, vegetable,

 Child-size table and chairs should be provided.

I. ENUMERATION: Give at least five (5) benefits of breastfeeding.

1. “Feed on Demand, Not on Schedule”

I. ENUMERATION: Give at least five (5) benefits of breastfeeding.

- Helps fight infection

TITLE: Feeding an Infant

Performance Objective: After reading the information sheet on “Procedures

SITUATION: The trainees will do a return demonstration of preparing

Objective : The trainees must be able to prepare formula and feed an

PROCEDURE DONE NOT DONE

EVALUATED BY: DATE:

Task Sheet 1.3-1

SKILLS TECHNIQUE SAFETY COMMUNICATION TOTAL AVERAGE

PERFORMANCE ASSESSMENT SCALE

Trainee’s signature:____________________ Trainer’s signature:____________________

Bottle Washing Procedure

1. Rinse the baby bottles directly after use. As soon as

You can wash the bottle more thoroughly later on when

2. Gather the right cleaning materials. When cleaning

A bottle brush to help you clean the bottom and sides of

3. Rinse out the sink and fill with hot soapy

Use a sponge or scouring pad to scrub down

4. Dismantle the bottle and wash each part

This is important as a lot of old milk can build up

Place all of the bottle parts into the hot, soapy

6. Allow the bottles to dry thoroughly. After

Place the parts on a bottle drying rack (available at

Make sure the bottles are left to drain in a well-

7. Wash your hands before bottle feeding your

The Importance of sterilizing bottles

1. Understand that it's not necessary to sterilize

Trainee’s signature: Trainer’s signature:

Trainee’s signature: Trainer’s signature: