Individual Infant Production Record Form - CACFP Breast Milk Formula Both Child’s First and Last Name: ____________________ Date of Birth: __________ Circle One: Type of Formula: __________________ FOOD COMPONENTS SERVING SIZES DATE: DATE: DATE: DATE: DATE: claimed claimed claimed claimed claimed BREAKFAST 0-5 MO 6-11 MO Breast Milk or Iron Fortified Infant Formula 4-6 oz. 6-8 oz. 0-4 Tbsp. Iron Fortified Infant Cereal, Meat, Fish, Poultry, Egg, Cooked Dry Beans, or Cooked Dry Peas OR 0-2 Cheese oz. OR --- Cottage Cheese OR 0-8 Yogurt Tbsp. 0-8 oz. Vegetable or Fruit or Combination of Both --- 0-2 Tbsp. claimed claimed claimed claimed claimed AM 0-5 MO 6-11 MO Breast Milk or Iron Fortified Infant Formula 4-6 oz. 2-4 oz. 0-4 Tbsp. Iron Fortified Infant Cereal OR 0-½ Bread OR slice --- Crackers OR 0-2 Ready to Eat Breakfast Cereal crackers 0-4 Tbsp. Vegetable or Fruit of Combination of Both --- 0-2 Tbsp. claimed claimed claimed claimed claimed LUNCH 0-5 MO 6-11 MO Breast Milk or Iron Fortified Infant Formula 4-6 oz. 6-8 oz. 0-4 Tbsp. Iron Fortified Infant Cereal, Meat, Fish, Poultry, Egg, --- Cooked Dry Beans, or Cooked Dry Peas OR 0-2 --- Cheese OR oz. --- Cottage Cheese OR 0-8 --- Yogurt Tbsp. --- 0-8 oz. Vegetable or Fruit or Combination of Both --- 0-2 Tbsp.
Individual Infant Production Record Form - CACFP Child’s First and Last Name: ____________________ Date of Birth: __________ Circle One: Breast Milk Formula Both Type of Formula: __________________ FOOD COMPONENTS SERVING SIZES DATE: DATE: DATE: DATE: DATE: BREAKFAST 0-5 MO 6-11 MO claimed claimed claimed claimed claimed Breast Milk or Iron Fortified Infant Formula 4-6 oz. 6-8 oz. Iron Fortified Infant Cereal, Meat, Fish, Poultry, Egg, Cooked Dry Beans, or Cooked Dry Peas OR Cheese OR Cottage Cheese OR Yogurt --- 0-4 Tbsp. 0-2 oz. 0-8 Tbsp. 0-8 oz. Vegetable or Fruit or Combination of Both --- 0-2 Tbsp. AM 0-5 MO 6-11 MO claimed claimed claimed claimed claimed Breast Milk or Iron Fortified Infant Formula 4-6 oz. 2-4 oz. Iron Fortified Infant Cereal OR Bread OR Crackers OR Ready to Eat Breakfast Cereal --- 0-4 Tbsp. 0-½ slice 0-2 crackers 0-4 Tbsp. Vegetable or Fruit of Combination of Both --- 0-2 Tbsp. LUNCH 0-5 MO 6-11 MO claimed claimed claimed claimed claimed Breast Milk or Iron Fortified Infant Formula 4-6 oz. 6-8 oz. Iron Fortified Infant Cereal, Meat, Fish, Poultry, Egg, Cooked Dry Beans, or Cooked Dry Peas OR Cheese OR Cottage Cheese OR Yogurt --- --- --- --- --- 0-4 Tbsp. 0-2 oz. 0-8 Tbsp. 0-8 oz. Vegetable or Fruit or Combination of Both --- 0-2 Tbsp.