[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-535984-105":3,"doc-detail-535984-en":80,"detail-sidebar-cat-0-en-105":96},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","child-and-adult-care-food-program-infant-formulafood-waiver-notification","CHILD AND ADULT CARE FOOD PROGRAM INFANT FORMULA/FOOD WAIVER NOTIFICATION","","Infant Formula/Food Waiver Notification form for parents or guardians of infants aged birth through 11 months participating in the Child and Adult Care Food Program (CACFP). The center follows the Infant Meal Pattern and introduces solid foods at about 6 months when developmentally appropriate. Parents select options for infant formula or breast milk, infant cereal, and baby food while in care, including procedures for forgetting items and requesting substitutions via a physician’s statement when medically necessary.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/child-and-adult-care-food-program-infant-formulafood-waiver-notification/535984/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/child-and-adult-care-food-program-infant-formulafood-waiver-notification/535984.png","ImageObject",300,407,{"name":42,"@type":43},"Terk","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-14","2026-10-10",true,{"@type":52,"interactionType":53,"userInteractionCount":33},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"Who should complete and sign this infant formula/food waiver form?","Question",{"text":62,"@type":63},"The center/home completes the center-provided section for parents/guardians. The parent or guardian answers the choices in the form, then signs and dates it.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"What choices are available for infant formula or breast milk?",{"text":67,"@type":63},"Parents can choose center-provided iron-fortified infant formula (and not bring formula), bring their own formula/breast milk, or directly breastfeed on site with options if breastfeeding is not possible.",{"name":69,"@type":60,"acceptedAnswer":70},"What should parents do if they forget to bring formula, cereal, or baby food?",{"text":71,"@type":63},"The child care center/home will contact the parent immediately, and the parent may request the center serve the item the center provides that day.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},535984,1791689550,{"code":4,"msg":81,"data":82},"success",{"doc_id":78,"user_id":83,"nickname":42,"user_avatar":84,"doc_module":4,"category_id":85,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":86,"file_id":87,"file_url":88,"file_type":89,"file_size":90,"view_count":33,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":91,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":92,"faqs":93,"seo_title":94,"seo_description":12,"update_tm":95,"read_time":30},1099525198933,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d",7,"CHILD AND ADULT CARE FOOD PROGRAM INFANT FORMULA/FOOD WAIVER NOTIFICATION  \n100 North First Street, W-270 Springfield, Illinois 62777-0001  \nNUTRITION DEPARTMENT  \nNAME OF CHILD CARE CENTER/HOME NAME OF INFANT BIRTH DATE (MM/DD/YYYY)  \nFor Parent/Guardian of Infants Age Birth Through 11 Months  \nThis child care center/day care home participates in the Child and Adult Care Food Program (CACFP) and is required to follow the Infant Meal Pattern for infants ages birth through 11 months. Solid foods are introduced at 6 months or when developmentally appropriate for the infant. The child care center/day care home should work with you to determine when solid foods should be served. To better meet your personal preferences and your infant’s needs, please complete this document.  \nInstructions: The center/home should complete this section before giving to the parent/guardian.  \nThis child care center/day care home will provide: Iron-fortified infant formula (list brand)   +  ; Iron-fortified infant cereal (list type such as baby rice cereal)   ; and  \nFood appropriate for infants: Commercial baby food and/or  \nTable food offered at the appropriate consistency for the development of the infant.  \nInstructions: The parent/guardian should answer the following question and mark one of the choices from each of the three sections below; then sign and date this form.  \nWhat do you currently feed your infant?  Iron-fortified infant formula  \n Breast milk  \n Low-iron or another type of infant formula provided for medical reasons. I will  \nobtain and provide the center/home with a Physician’s Statement for Food Substitutions.  \nThe parent or guardian would like their infant to be fed the following while in care:  \nSection 1 – Infant Formula or Breast Milk  \n Choice 1 : I want my infant to receive the child care center/day care home-provided iron-fortified infant formula identified above. I will not bring infant formula from home.  \n Choice 2: I understand I am not required to bring infant formula that I purchase or receive from Women, Infants, and Children (WIC), however, I want to bring my own formula/breast milk.  \nList brand/type:    \nIf I should forget to bring infant formula/breast milk, the child care center/home will contact me immediately and I may request they serve my infant the child care center/day care home-provided iron-fortified infant formula that day.  \n Choice 3: I want to directly breastfeed my infant on site. If I should be unable to breastfeed my infant on-site, I may request child care center/day care home serve my infant the child care center/day care home provided iron-fortified formula that day, or I may bring expressed breast milk that day.  \nSection 2 – Infant Cereal  \n Choice 1 : I want my infant to receive the child care center/day care home-provided iron-fortified infant cereal identified above.  \nI will not bring infant cereal from home.  \n Choice 2: I understand that I am not required to bring iron-fortified infant cereal that I purchase or receive from WIC, however, I want to bring my own infant cereal.  \nList brand/type:   If I should forget to bring the cereal, the child care center/day care home will contact me immediately and I may request they serve my infant the child care center/day care home-provided iron-fortified infant cereal that day.  \nSection 3 – Baby Food  \n Choice 1 : I want my infant to receive the child care center/day care home-provided commercial baby food identified above.  \nI will not bring baby food from home.  \nChoice 2: I understand that I am not required to bring baby food that I purchase, prepare, or receive from WIC, however, I want to bring in my own baby food. If I should forget to bring the baby food, the child care center/day care home will contact me immediately and I may request they serve my infant the child care center/day care home-provided commercial baby food that day.  \nIf I decide to change the selections I made above, I will complete another form.  \nParent/Guardian Signat","cbCaijtaPG57LBSd","https://ap.wps.com/l/cbCaijtaPG57LBSd","pdf",323917,"English","# Parent/Guardian Instruction\n# Child Care Center/Home Provided Options\n## Infant Formula or Breast Milk\n## Infant Cereal\n## Baby Food\n# Signature and Date","[{\"question\":\"Who should complete and sign this infant formula/food waiver form?\",\"answer\":\"The center/home completes the center-provided section for parents/guardians. The parent or guardian answers the choices in the form, then signs and dates it.\"},{\"question\":\"What choices are available for infant formula or breast milk?\",\"answer\":\"Parents can choose center-provided iron-fortified infant formula (and not bring formula), bring their own formula/breast milk, or directly breastfeed on site with options if breastfeeding is not possible.\"},{\"question\":\"What should parents do if they forget to bring formula, cereal, or baby food?\",\"answer\":\"The child care center/home will contact the parent immediately, and the parent may request the center serve the item the center provides that day.\"}]","CHILD AND ADULT CARE FOOD PROGRAM INFANT FORMULA/FOOD WAIVER NOTIFICATION | PDF",1791601511,{"code":4,"msg":81,"data":97},[98,102,106,110,115,120,123,128,133,136,140],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":99,"show_sort_weight":100,"slug":101},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":107,"show_sort_weight":108,"slug":109},"Exam",70,"exam",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},5,"Comic",60,"comic",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},6,"Technology",50,"technology",{"id":85,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":121,"slug":122},40,"healthcare",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":126,"slug":127},8,"Research & Report",30,"research-report",{"id":129,"doc_module":4,"doc_module_name":25,"category_name":130,"show_sort_weight":131,"slug":132},9,"Religion & Spirituality",20,"religion-spirituality",{"id":131,"doc_module":4,"doc_module_name":25,"category_name":134,"show_sort_weight":131,"slug":135},"World Cup","world-cup",{"id":137,"doc_module":4,"doc_module_name":25,"category_name":138,"show_sort_weight":137,"slug":139},10,"Lifestyle","lifestyle",{"id":141,"doc_module":4,"doc_module_name":25,"category_name":142,"show_sort_weight":111,"slug":143},19,"General","general"]