Infant Personal Care Plan



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Brand Amount Preferred time of day given Formula/Milk Breast Milk Juice If your baby is exclusively breast fed, please outline your daily plan: If your baby is breast fed or receiving expressed breast milk, how can we support you List special dietary requests, and restrictions: Have solid foods been introduced Yes No If yes, please identify: Food likes and eating preferences: Child Eats With: Spoon: Fork: Child is Fed in: Highchair: In Arms: Fingers: Bouncy Seat: Other: Preferred time of day to feed child: A.M. A.M. P.M. P.M. Additional Information: 3 Infant Personal Care Plan - Developmental History Form CHILD’S NAME: SLEEPING ROUTINES Pre-nap routines/rituals: Number of naps daily: From: To: From: To: From: To: Preferred sleep position : At home child sleeps in (Check all that apply: Bassinet: Crib: Bed: Child’s typical waking behavior/routine: Special sleeping concerns: Note: Bright Horizons places infants to sleep on their backs in crib unless a waiver has been signed by the parents and the child’s physician, stating that the child should be placed in a position other than on his/her back and if allowed by the state licensing agency..




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