Tennessee State Government
|[pic] |Tennessee Department of Human Services |
| |Infant Meal Menu/Meal Count Record for 0 through 5 Months |
|Name: | | | | |
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|Week of: | | | | |
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|Age: | | | | |
| Months | | | | |
|Birthdate: | | | | |
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|Type of Formula Served or Breastfed: | | | | |
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|Select either Breast Milk or Formula. To plan your menu, indicate what the child will be served for each day of the week. |
|Meal Component |Min. Serving Size |Day of Week |
| |
| Breast Milk or |
|Formula* |
| Breast Milk or |
|Formula* |
Breast Milk or
Formula* |4-6 fl. oz.† | | | | | | | | |
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