WIC Participant

OMB Approval No. 0584-XXXX

Approval Expires: XX/XX/20XX

APPENDIX M.1

WIC ITFPS-2 Participant Interview

7 Month - ENGLISH

SOCIODEMOGRAPHICS AND BACKGROUND

Respondent still Caregiver?

1, 3, 5, 7, 9, 11, 13, 15, 18, 24

SD12. (1 mo.: Before we go any further/ All other: Before we begin today), I need to ask whether you are still {CHILD's} caregiver. [Source: New Development]

Yes 01

No 02

(If no, go to a)

a. Does {CHILD} still live with you?

Yes 01

No 02

b. (If a is Yes): Can you please tell me who in your household is now {CHILD's} caregiver? Can I speak with that person?

Name of New Caregiver______________________________________________

c. (If a is No): Can you please tell me who is caring for {CHILD} now, and how I could reach that person?

Name of New Caregiver______________________________________________

Phone of New Caregiver______________________________________________

Address of New Caregiver____________________________________________

Relation of New Caregiver to Child_____________________________________

Currently pregnant/due date

7, 13, 18

I’m going to start by asking you some questions about yourself and your household.

SD16. Are you currently pregnant? [Source: New Development]

Yes 01

No 02

Don’t know 98

Refused 99

SD17. (If yes) When is your baby due? [Source: FDA IFPS-2]

Month [January – Dec.]

Day [1-31]

{Year – autofill for next occurrence of the month}

Household size

Enrollment, 7, 13, 24

SD18. How many people live in your household? By household I mean people who live together and share living expenses. Please include yourself in this count, and (If PN enrollment: please add 1 to the total for your pregnancy, too/If postnatal enrollment or 7, 13, or 24 months: If you are pregnant right now please add 1 to the total for your pregnancy. [Source: FITS 2002, modified]

Number of people in household [number]

Household income

Enrollment, 7, 13, 24

SD19. During [PREVIOUS MONTH], what was your household income before taxes? Please include any income in the past month from you, your family members who live with you, and any other people who live with you and share living expenses with you [Source: WIC IFPS-1, modified]

$500 or less 01

$501-$1000 02

$1001-$1500 03

$1501-$2000 04

$2001-$2500 05

$2501-$3000 06

$3001-$3500 07

$3501-$4000 08

$4001-$4500 09

$4501-$5000 10

$5001+ 11

Don’t know 98

Refused 99

Household food insecurity

7, 13

SD22. Now I’m going to read you several statements that people have made about their food situation. For each of these statements, please tell me whether this was often true, sometimes true, or never true for your household in the last 12 months—that is, since last (name of current month). [Source: USDA Food Security Module subscale; Hager et al., 2010; Nord et al., 2009]

a. "We worried whether our food would run out before we got money to buy more.” Was that often true, sometimes true, or never true for your household in the last 12 months?

Often true 01

Sometimes true 02

Never true 03

Don't know 98

Refused 99

b. "The food that we bought just didn’t last, and we didn’t have money to get more.” Was that often, sometimes, or never true for your household in the last 12 months?

Often true 01

Sometimes true 02

Never true 03

Don't know 98

Refused 99

Continuation/discontinuation of WIC participation (timing, reasons, location)

1, 3, 5, 7, 9, 11, 13, 15, 18, 24

Next I’d like to ask you some questions about WIC.

SD31. Are you currently getting WIC food or checks for yourself or {CHILD}? [Source: FDA IFPS-2; modified]

Yes 01

No 02

(if no for the first time go to SD34, if no previously go to next applicable module)

SD32. The last time we talked with you, you were going to WIC at [fill in location]. Do you still go there, or do you go to a new location? [Source: FDA IFPS-2 modified]

Yes, still that location 01

No, new location 02

SD33. (If SD32 is no) Please tell me where you go now

Record location _______________________________________

Ask SD34 and SD35 only if SD31 is 'no'

SD34. How old was {CHILD} when you stopped going to WIC? [Source: LA WIC Survey; modified]

Age [weeks/months]

SD35. I'm going to read some reasons why you might have stopped going to WIC. Please tell me if each one is a reason you stopped going to WIC: [Source: LA WIC Survey; modified]

You no longer qualify for WIC 01

It was inconvenient for you 02

You no longer need WIC 03

Other reason (record response) 04

WIC PROGRAM AWARENESS, SATISFACTION, UTILIZATION

Administer WIC module only if respondent indicated in SD31 that they are still on WIC

Utilization: Extended benefits for breastfeeding mothers

7

Don’t ask if mother currently pregnant again (SD16)

WC14. (Don’t ask if mother currently pregnant again) Your baby is now receiving baby foods and infant cereal from WIC. Are you still receiving WIC foods for YOURSELF? [Source: New Development]

Yes 01

No 02

Don’t Know 98

a. (If yes) Last month, did you purchase all of the WIC foods for which you were issued checks or EBT benefits for yourself and {CHILD}? [Source: New Development]

Yes 01

No 02

Don’t Know 98

Utilization: Information on initiation of supplemental foods

7

WC15. Have you received any information from WIC about when to start giving solid foods to {CHILD}? [Source: IFPS-1, modified}

Yes 01

No 02

Don’t Know 98

CURRENT FEEDING PRACTICES

AMPM Module (Asking child’s food intake in past 24 hours)

24-HR Recall for Food Intake

1, 3, 5, 7, 9, 11, 13, 15, 18, 24

Nutrition intake

Number of breastmilk/formula feedings per day

Type of formula used

Adherence to formula dilution instructions

Use/timing of supplemental formula for breastfeeding mothers

Addition of anything other than human milk/formula to child’s bottle

Specific food item intake

Use of jarred baby foods

Meal and snack pattern

Eating locations (eating on the go)

Use of dietary supplements for infants (direct administration)

Now I’m going to ask you some questions about things you might be doing to feed your baby.

Current feeding choice

1, 3, 5, 7, 9, 11, 13

CF1. Are you currently feeding {CHILD} breastmilk either from your breast or from a bottle, formula, (1-5 months: or both) (7-13 months: both, or neither)? [Source: New Development]

Only breastmilk 01

Only formula 02

Both breastmilk and formula 03

Neither breastmilk nor formula 04

IF CF1 = 02, SKIP TO CF19

IF CF1 = 04, AND CF30 NOT ADMINISTERED AT A PREVIOUS INTERVIEW, GO TO CF30.

IF CF1 = 04, AND CF30 ADMINISTERED AT A PREVIOUS INTERVIEW, GO TO CF34.

Breastfeeding Module (Asked only if mother currently feeding breastmilk, based on CF1)

Questions CF6 – CF18

Use of breast pump

1, 3, 5, 7, 9, 11, 13

You said that you are currently feeding {CHILD} breastmilk. I’d like to ask you some questions about that now.

CF6. Some mothers are able to pump breastmilk and others are not. Are you currently pumping breastmilk?

Interviewer: code yes if mother is pumping at all, even if infrequently.

Yes 01

No 02

Refused 99

If CF6 is NO, skip to CF18

Time of day of pumping

1, 3, 5, 7, 9, 11, 13

Ask only if currently pumping breastmilk in CF6

CF12. Now I’d like to ask you about the times of day when you usually pump. [Source: New Development]

a. When you pump, how often do you pump in the morning, before noon? Would you say usually, sometimes, or never?

Usually 01

Sometimes 02

Never 03

Don’t know 98

Refused 99

b. When you pump, how often do you pump mid-day, from noon to 5pm? Would you say usually, sometimes, or never?

Usually 01

Sometimes 02

Never 03

Don’t know 98

Refused 99

c. When you pump, how often to you pump in the evening or night time, after 5pm? Would you say usually, sometimes, or never?

Usually 01

Sometimes 02

Never 03

Don’t know 98

Refused 99

Frequency of pumping

1, 3, 5, 7, 9, 11, 13

Ask only if currently pumping breastmilk in CF6

CF11. Thinking about the past two weeks, how many times did you pump milk? (Interviewer allow open-ended, calculate numbers for response if needed, and confirm with respondent)[Source: FDA IFPS-2, modified]

Times pumped [times]

Reasons for pumping

1, 3, 5, 7

Ask only if currently pumping breastmilk in CF6

CF15. I’m going to read you some reasons why you might have pumped breastmilk in the past month. For each one, tell me if this was a reason you pumped breastmilk. (CATI to randomize order of sub-items) [Source: FDA IFPS-2, modified]

a. To relieve engorgement or swelling

Yes 01

No 02

b. To keep your milk supply up when your baby could not nurse (such as while you were away from your baby or when your baby was too sick to nurse)

Yes 01

No 02

c. To mix with cereal or other food

Yes 01

No 02

d. To increase your milk supply

Yes 01

No 02

e. To have an emergency supply of milk

Yes 01

No 02

f. To get milk so that someone else can feed your baby

Yes 01

No 02

g. Any other reason you have pumped breastmilk in the past month?

Yes (specify_________________________________) 01

No 02

Storage practices for pumped/expressed human milk

1, 3, 5, 7, 9, 11, 13

Ask only if currently pumping breastmilk in CF6

CF16. In the last month, how long was your pumped milk usually stored in the refrigerator? [Source: FDA IFPS-2, modified]

I do not store milk in a refrigerator 01

1 day or less 02

2 to 3 days 03

4 to 5 days 04

6 to 8 days 05

More than 8 days 06

CF17. How long is your frozen milk usually stored? [Source: FDA IFPS-2]

Only include 4 months or more after the 5 month interview

I do not freeze my milk 01

Less than 1 week 02

1 to 4 weeks 03

1 to 3 months 04

4 months or more 05

How is breastmilk feeding schedule determined (time schedule, child seems hungry, mixed)

1, 3, 5, 7, 9, 11, 13

CF18. Do you breastfeed or feed {CHILD} breastmilk from a bottle on a regular schedule, or when [HE/SHE] cries or seems hungry? [Source: IFPS-1, modified]

Schedule 01

Cries or seems hungry 02

Both on a schedule and when baby cries or seems hungry 03

IF CF1 = 01 SKIP TO CF52

Formula Feeding Module (Asked only if mother currently formula feeding)

Questions CF19 – CF27

You said that you are currently feeding {CHILD} formula. I’d like to ask you some questions about that.

Who provided formula

1, 3, 5, 7, 9, 11, 13

CF19. Where do you get the formula that you use to feed {CHILD}? Do you get it from WIC, from somewhere else, or both WIC and somewhere else? [Source: New Development]

WIC 01

Somewhere else 02

Both WIC and somewhere else 03

CF20. (If indicated in CF19 getting formula from WIC) Is the amount of formula that you get from WIC to help feed {CHILD} more than you usually need, less than you usually need, or about right? [Source: PHFE WIC Survey 2010, modified]

More 01

Less 02

About right 03

Don’t know 98

Refused 99

Reasons for formula use

1, 3, 5, 7, 9, 11, 13 (ask for the last time at the interview where mom indicates she has completely stopped breastfeeding)

CF21. There are many reasons for using formula. Please tell me if any of the following are reasons why you feed your baby formula? [Source: FDA IFPS-2, modified]

If not currently breastfeeding at all (CF1) and never tried to breastfeed (HF10, CF29), skip to h.

Ask (a) only in months 1, 3, 5

a. My baby had trouble sucking or latching on to the breast

Yes 01

No 02

b. My baby lost interest in nursing or began to stop nursing by him or herself

Yes 01

No 02

c. Breastmilk alone did not satisfy my baby

Yes 01

No 02

d. I thought that my baby was not gaining enough weight

Yes 01

No 02

e. I didn’t have enough breastmilk

Yes 01

No 02

f. Breastfeeding was too painful

Yes 01

No 02

g. I wanted my baby to have both formula and breastmilk.

Yes 01

No 02

Ask h-n if mother is either exclusively formula feeding or feeding both breastmilk and formula

h. I chose not to breastfeed

Yes 01

No 02

i. My baby was sick and could not breastfeed

Yes 01

No 02

j. I was sick or had to take medicine

Yes 01

No 02

k. Breastfeeding seemed too inconvenient

Yes 01

No 02

l. I could not or did not want to pump

Yes 01

No 02

m. I wanted or needed someone else to feed my baby

Yes 01

No 02

n. For another reason

Yes (specify______________________________________) 01

No 02

Formula Food Safety Questions

3, 7, 11

People have different routines they follow when preparing formula. Now I’d like to ask you about things you might do when you prepare formula for your baby.

CF54. In the past month, when you prepared infant formula for {CHILD} how often did you mix it with water that you had boiled first? Would you say you did that always, sometimes, never, or did you use ready-to-feed formula instead?

Always 01

Sometimes 02

Never 03

Use ready-to-feed [skip to CF22] 04

CF55. Some people mix their infant formula with water, and keep it until they need it to feed their babies. In the past month, how often did you mix infant formula more than 24 hours before you fed it to {CHILD}? Would you say that you always mixed it more than 24 hours before you fed it to {CHILD}, sometimes did that, never did that, or did you use ready-to-feed formula instead?

Always 01

Sometimes 02

Never 03

Use ready-to-feed 04

If not adhering to formula dilution instructions, why? Prescribed by Dr., nutritionist?

1, 3, 5, 7, 9, 11, 13

CF22. In the past month, did you ever mix the formula with extra water to make it last longer? [Source: IFPS-1]

Yes 01

No 02

If CF22 = NO, skip to CF24.

CF23. (If yes to CF22) Who told you to prepare the formula this way? [Source: New Development]

Doctor 01

Someone who works at the WIC office or clinic 02

Another health care provider 03

Friend 04

Family member 05

Other 06

No one told me 07

CF24. In the past month, did you ever mix the formula with less water than directed in order to concentrate it or make it stronger? [Source: IFPS-1, modified]

Yes 01

No 02

Not applicable – use ready-to-feed 03

If CF24 = NO, skip to CF27.

CF25. (If yes to CF24) Who told you to prepare the formula this way? [Source: New Development]

Doctor 01

Someone who works at the WIC office or clinic 02

Another health care provider 03

Friend 04

Family member 05

Other 06

No one told me 07

How is formula feeding schedule determined (set, on demand, mixed)

1, 3, 5, 7, 9, 11, 13

CF27. Do you feed {CHILD} formula on a regular schedule or when [HE/SHE] cries or seems hungry? [Source: IFPS-1]

Schedule 01

Cries or seems hungry 02

Both on a schedule and when baby cries or seems hungry 03

Move to Partial Breastfeeding

Timing of move to partial breastfeeding

(any time 1-13)

Ask of all women who indicated fully BF in CF1. Once answered affirmatively, drop from subsequent interviews.

CF52. Has {CHILD} ever been fed infant formula, even just one time? Do not count while you were in the hospital after {CHILD’s} birth.

Yes 01 (go to CF53)

No 02 (go to CF32)

Don’t know 03

Refused 04

Ask of fully BF women who answered yes to CF52, partially BF women (based on CF1), and fully formula feeding women (based in CF1) who indicated that they ever breastfed in CF29 or HF10. Ask once, first time formula feeding indicated in CF1 or CF52, then drop from subsequent interviews.

CF53. How old was {CHILD} the first time [HE/SHE] was fed infant formula? Do not count while you were in the hospital after {CHILD’S} birth.

Age [days/weeks/months]

Don’t know 98

Refused 99

Asked of all partially BF women and all fully formula feeding women who ever breastfed based on CF29 or HF10. Ask until an age, don’t know, or refused is given in response, then drop from subsequent interviews.

CF28. How old was {CHILD} when [HE/SHE] was first fed formula every day? [Source: FITS 2002, modified]

Age [days/weeks/months]

Child is not fed formula every day 97

Don’t Know 98

Refused 99

Breastfeeding Cessation Module: (asked once first time mother indicates not currently feeding breastmilk in CF1)

Questions CF30 – CF31

Timing of cessation of breastfeeding

(any time 1-13)

Ask at first interview when mother says she is not feeding breastmilk, if she indicated feeding breastmilk in CF1 on previous interviews or if she answered ‘yes’ to ever breastfed or tried to breastfeed in CF29

CF30. How old was {CHILD} when you completely stopped breastfeeding or feeding [HIM/HER] breastmilk from a bottle? [Source: IFPS-1, modified]

Age [days/weeks/months]

Reasons for cessation of breastfeeding

(any time 1-13)

CF31. There are many reasons mothers stop breastfeeding. Please tell me if any of the following reasons helped you to decide to stop breastfeeding {CHILD}? [Source: FDA IFPS-2, modified]

Do not ask (a) if interview is 5 months or later

a. My baby had trouble sucking or latching on

Yes 01

No 02

b. My baby began to bite

Yes 01

No 02

c. My baby lost interest in nursing or began to stop nursing by him or herself

Yes 01

No 02

d. Breastmilk alone did not satisfy my baby

Yes 01

No 02

e. I thought that my baby was not gaining enough weight

Yes 01

No 02

f. I didn’t have enough milk

Yes 01

No 02

g. Breastfeeding was too painful

Yes 01

No 02

h. I was sick or had to take medicine

Yes 01

No 02

i. Breastfeeding was too inconvenient

Yes 01

No 02

j. I wanted or needed someone else to feed my baby

Yes 01

No 02

k. I did not want to breastfeed in public

Yes 01

No 02

l. Another reason (specify ________________________________)

Yes 01

No 02

Time to cessation of bottle feeding

7, 9, 11, 13, 15, 18, 24 (ask until affirmative, then stop asking)

CF34. Is {CHILD} still drinking anything from a bottle? [Source: New Development]

Yes 01

No 02

CF35. (If CF34 = NO, ask:) How old was {CHILD} when he/she stopped using a bottle? [Source: New Development]

Age [weeks/months/years]

Supplemental Foods Initiation (asked all interviews 1-24 until all endorsed)

Fed other than breastmilk or formula

1, 3, 5, 7, 9, 11, 13, 15, 18, 24

Ask CF32 at every interview until mother answers yes, then drop from later interviews and go straight to CF36.

CF32. Has {CHILD} been given anything to eat or drink besides formula or breastmilk? [Source: WIC IFPS-1, modified]

Yes 01

No 02

Were foods other than breastmilk or formula fed by bottle? If so, why?

1, 3, 5, 7

Ask only if CF34 = YES – still drinking from bottle

CF36. Now I’m going to ask you some questions about things you might have added to your baby’s bottle of infant formula or pumped breastmilk. [Source: FDA IFPS-2, modified; New Development for reasons]

a In the past two weeks, how often have you added baby cereal to your baby’s bottle?

Every feeding 01

At most feedings 02

About once a day 03

Every few days 04

Rarely 05

Never 06

b. (If anything other than never) Why did you add baby cereal to your baby’s bottle?

To make him/her full 01

To make him/her drink more milk 02

To give him/her a special treat 03

As a remedy 04

A doctor or other health professional told me to 05

A friend or relative told me to 06

Other 07

c. In the past two weeks, how often have you added sweetener to your baby’s bottle?

Every feeding 01

At most feedings 02

About once a day 03

Every few days 04

Rarely 05

Never 06

d. (If anything other than never) Why did you add sweetener to your baby’s bottle?

To make him/her full 01

To make him/her drink more milk 02

To give him/her a special treat 03

As a remedy 04

A doctor or other health professional told me to 05

A friend or relative told me to 06

Other 07

e. Have you added anything else?(Specify OTHER)_____________________) In the past two weeks, how often have you added [OTHER] to your baby’s bottle?

Every feeding 01

At most feedings 02

About once a day 03

Every few days 04

Rarely 05

Never 06

f. (If anything other than never) Why did you add [OTHER] to your baby’s bottle?

To make him/her full 01

To make him/her drink more milk 02

To give him/her a special treat 03

As a remedy 04

A doctor or other health professional told me to 05

A friend or relative told me to 06

Other 07

Time to introduction of supplemental foods

1, 3, 5, 7, 9, 11, 13, 15, 18, 24

Only ask CF33 if CF32 = YES now or at a previous interview

Next I’m going to ask you some questions about when you first started feeding {CHILD} different types of foods.

Ask each food until answer is affirmative, then stop asking that food in subsequent interviews

CF33. For each of the following, please tell me if {CHILD} has been given this food or drink, and if so, how old {CHILD} was when he/she first had that food. [Sources: FITS 2008; IFPS-1; WHO Toolkit 1996]

a. Has [HE/SHE] been given plain bottled or tap water?

Yes 01

No 02

b. (If yes) How old was {CHILD} when [HE/SHE] was first fed plain bottled or tap water?

Age [weeks/months]

Don’t know 98

Refused 99

c. Has [HE/SHE] been given soda or soft drinks?

Yes 01

No 02

d. (If yes) How old was {CHILD} when [HE/SHE] was first fed soda or soft drinks?

Age [weeks/months]

Don’t know 98

Refused 99

e. Has [HE/SHE] been given other sweetened beverages (such as Kool Aid, Hi-C, Fruit Punch, sweetened juice, sweetened or flavored water, Gatorade, or sweet tea)?

Yes 01

No 02

f. (If yes) How old was {CHILD} when [HE/SHE] was first fed other sweetened beverages?

Age [weeks/months]

Don’t know 98

Refused 99

g. Has [HE/SHE] been given 100% fruit juice such as apple juice, orange juice, or other types of 100% juice. Do not include fruit-flavored drinks with added sugar or fruit juice you made at home and added sugar to?

Yes 01

No 02

h. (If yes) How old was {CHILD} when [HE/SHE] was first fed 100% fruit juice?

Age [weeks/months]

Don’t know 98

Refused 99

i. Has [HE/SHE] been given other drinks and liquids, including teas and broths?

Yes 01

No 02

j. (If yes) How old was {CHILD} when [HE/SHE] was first fed Other drinks and liquids, including teas and broths?

Age [weeks/months]

Don’t know 98

Refused 99

k. Has [HE/SHE] been given Cow’s milk, including whole milk, 2%, 1%, or skim? Please include milk you add to other foods such as cereal.

Yes 01

No 02

l. (If yes) How old was {CHILD} when [HE/SHE] was first fed cow’s milk?

Age [weeks/months]

Don’t know 98

Refused 99

m. Has [HE/SHE] been given dairy products other than cow’s milk including cheese, yogurt, or goat’s milk? Please include any dairy products other than cow’s milk that you add to other foods.

Yes 01

No 02

n. (If yes) How old was {CHILD} when [HE/SHE] was first fed dairy products other than cow’s milk?

Age [weeks/months]

Don’t know 98

Refused 99

o. Has [HE/SHE] been given baby cereal, either with a spoon or by adding it to a bottle of breastmilk or formula?

Yes 01

No 02

p. (If yes) How old was {CHILD} when [HE/SHE] was first fed baby cereal?

Age [weeks/months]

Don’t know 98

Refused 99

q. Has [HE/SHE] been given other cereal besides baby cereal?

Yes 01

No 02

r. (If yes) How old was {CHILD} when [HE/SHE] was first fed other cereal besides baby cereal?

Age [weeks/months]

Don’t know 98

Refused 99

s. Has [HE/SHE] been given eggs?

Yes 01

No 02

t. (If yes) How old was {CHILD} when [HE/SHE] was first fed eggs?

Age [weeks/months]

Don’t know 98

Refused 99

u. Has [HE/SHE] been given fruit, including baby food or regular fruit?

Yes 01

No 02

v. (If yes) How old was {CHILD} when [HE/SHE] was first fed fruit?

Age [weeks/months]

Don’t know 98

Refused 99

w. Has [HE/SHE] been given vegetables, including baby food or regular vegetables?

Yes 01

No 02

x. (If yes) How old was {CHILD} when [HE/SHE] was first fed vegetables?

Age [weeks/months]

Don’t know 98

Refused 99

y. Has [HE/SHE] been given beans, such as black beans, pinto beans, or chick peas?

Yes 01

No 02

z. (If yes) How old was {CHILD} when [HE/SHE] was first fed beans?

Age [weeks/months]

Don’t know 98

Refused 99

aa. Has [HE/SHE] been given peanut butter

Yes 01

No 02

bb. (If yes) How old was {CHILD} when [HE/SHE] was first fed peanut butter?

Age [weeks/months]

Don’t know 98

Refused 99

cc. Has [HE/SHE] been given meats,, chicken, or fish, including baby food and baby food combination dinners containing these foods?

Yes 01

No 02

dd. (If yes) How old was {CHILD} when [HE/SHE] was first fed meat, chicken, or fish?

Age [weeks/months]

Don’t know 98

Refused 99

ee. Has [HE/SHE] been given salty snacks, such as chips, pretzels, crackers, or other snack foods including baby snacks?

Yes 01

No 02

ff. (If yes) How old was {CHILD} when [HE/SHE] was first fed salty snacks?

Age [weeks/months]

Don’t know 98

Refused 99

gg. Has [HE/SHE] been given sweets, such as cake, cookies, candy, or jam?

Yes 01

No 02

hh. (If yes) How old was {CHILD} when [HE/SHE] was first fed sweets?

Age [weeks/months]

Don’t know 98

Refused 99

Next I’m going to ask you some questions about the types of food you buy or make for {CHILD}, how you prepare those foods and feed them to {CHILD}, and what foods you get through WIC.

Source of baby food (homemade or purchased; if purchased, was it all with WIC vouchers or some purchased without WIC vouchers)

7, 9, 11, 13

CF37. For each food category I read to you, please tell me about how much of the food fed to your baby over the past 7 days was store-bought baby food in a jar or container. Baby foods in a jar or container are those sold especially for babies. Foods that are not baby foods in a jar or container include fresh fruit, fruit juices other than those especially sold for babies, foods you prepare especially for the baby, and table food. [Source: FDA IFPS-2, modified]

a. Fruit and vegetable juice

All store-bought baby food 01

Mostly store-bought baby food 02

Some store-bought baby food 03

No store-bought baby food 04

Not fed this food in past 7 days 05

b. Fruit

All store-bought baby food 01

Mostly store-bought baby food 02

Some store-bought baby food 03

No store-bought baby food 04

Not fed this food in past 7 days 05

c. Vegetables

All store-bought baby food 01

Mostly store-bought baby food 02

Some store-bought baby food 03

No store-bought baby food 04

Not fed this food in past 7 days 05

d. Meat, such as beef and chicken

All store-bought baby food 01

Mostly store-bought baby food 02

Some store-bought baby food 03

No store-bought baby food 04

Not fed this food in past 7 days 05

d. Combination dinners

All store-bought baby food 01

Mostly store-bought baby food 02

Some store-bought baby food 03

No store-bought baby food 04

Not fed this food in past 7 days 05

CF38. [If all, mostly or some store-bought baby food indicated above, then ask:] Was all of the store-bought baby food in jars or containers bought with WIC checks, only some with WIC checks, or none with WIC checks? [Source: New Development]

All with WIC checks 01

Some with WIC checks 02

None with WIC checks 03

Don’t know 98

Refused 99

Methods and frequency of methods used to prepare child foods

7, 9, 11, 13

CF39. [If mostly, some, or no store-bought baby food fed in past 7 days from above, ask:] I’m going to read you some ways people prepare homemade food for babies. For each one, please tell me if you do this to make food for {CHILD}. [Source: New Development]

a. Puree, such as in a blender or food processor

Yes 01

No 02

b. Mash, such as with a fork or spoon

Yes 01

No 02

c. Chop or dice

Yes 01

No 02

d. Chew foods yourself before giving to [HIM/HER]

Yes 01

No 02

e. Is there any other way you make food for {CHILD}?

Yes (specify _____________________________) 01

No 02

Method of feeding child (spoon, infant feeder, bottle/modified bottle, etc.)

*3, 5, 7, 9, 11, 13, 15

*only ask if indicated that child is eating solid foods (something other than formula or BM)

CF40. In the past 7 days, have you given {CHILD} any foods with a spoon? [Source: IFPS-1, modified]

Yes 01

No 02

CF41. In the past 7 days, have you given {CHILD} any foods with an infant feeder or with a bottle that has an extra large nipple hole? [Source: IFPS-1, modified]

Yes 01

No 02

Infant/child food package – does child eat foods from WIC food package?

7, 13, 15, 18, 24

At 7 mo only:

CF42. Which of the following WIC foods does {CHILD} eat? Does [HE/SHE] eat: [Source: FITS 2008, modified]

a. Infant formula from WIC

Yes 01

No 02

Don’t Know 98

b. Baby cereal from WIC

Yes 01

No 02

Don’t Know 98

c. Baby food fruits from WIC

Yes 01

No 02

Don’t Know 98

d. Does [HE/SHE] eat baby food vegetables from WIC

Yes 01

No 02

Don’t Know 98

e. Baby food meats from WIC

Yes 01

No 02

Don’t Know 98

f. Does [HE/SHE] eat any other food from WIC (Specify________________________________________)

Yes 01

No 02

Don’t Know 98

Perceptions of impact of WIC food package choices on food child receives

7, 15

KA28. Are the foods you can buy with WIC checks the kinds of foods that you would typically feed {CHILD}? [Source: New Development]

Yes 01

No 02

Don’t know 98

MATERNAL HEALTH AND LIFESTYLE

Now I’d like to change topics and ask you some questions about work, school, and child care.

Educational status

3, 7, 13, 18, 24

SD27. As of today, are you in school or college? [Source: WIC IFPS-1]

Yes 01

No 02

Current employment status

3, 7, 13, 18, 24

SD29. Are you currently working for pay full time, part time, or not at all? [Source: LA WIC Survey]

Full time (35 hours or more) 01

Part time 02

Not at all 03

Ask SD30 first time answer to SD 27 or SD29 is ‘yes’ then discontinue

SD30. How old was {CHILD} when you started going to school or working? [Source: New Development]

Age [weeks, months]

Ever used regular non-maternal child care?

3, 7, 13, 24 (once answered affirmative, stop asking for subsequent interviews)

The next few questions are about childcare. By childcare, we mean any kind of arrangement where someone other than you or {CHILD’S} other parent takes care of {CHILD} on a regular basis. Please include care provided by a relative or non-relative, either in your home or someone else’s home, as well as in a child care center or family daycare home. Do not include care provided by you or {CHILD’S} other parent. [Source: PHFE WIC Survey 2010 modified]

MH18. Have you ever used a regular childcare arrangement for {CHILD}?

Yes 01

No 02

When did child first start non-maternal child care?

3, 7, 13, 24 (asked only if ever used is yes, then stop asking once answered)

MH19. At what age did {CHILD} first start a regular childcare arrangement? [Source: New Development]

Age [months]

Current use of non-maternal child care (and what kind)

3, 7, 13, 24

MH20. Which type of regular childcare arrangement are you currently using the most for {CHILD}? [Source: PHFE WIC Survey 2011, modified]

A child care center 01

A family daycare home 02

Early Head Start 03

Someone cares for {CHILD} in their home 04

Someone cares for {CHILD} in your home 05

Some other kind of childcare 06

Not currently using childcare 07

Contact info for child care (for CACFP status)

3, 7, 13, 24

MH21. (If center or family daycare or EHS from MH20) Can we get the official name and address of the child care? We won’t contact them without your permission, we just need it to for our records. [Source: New Development]

Name ___________________________________________________

Address _________________________________________________

Barriers to breastfeeding in child care

3, 7

Ask MH22 only if mother answered indicated in CF1 that she is fully or partially breastfeeding and in MH20 that she is currently using child care

MH22. Do you have problems continuing to feed {CHILD} breastmilk while he/she is in childcare? [Source: New Development]

Yes 01

No 02

(If yes), Please tell me if you have any of the following problems feeding {CHILD} breastmilk while he/she is in childcare:

a. Lack of time

Yes 01

No 02

b. Lack of privacy at child care site

Yes 01

No 02

c. Too difficult to transport pumped milk to child care

Yes 01

No 02

d. Child care provider doesn’t encourage it

Yes 01

No 02

e. Any other problem (describe ____________________________________)

Yes 01

No 02

Who provides food to child care location (provided by mother, or by facility)

3, 7, 13, 24

Ask only if indicated current child care use in MH20

MH23. Who provides most of the food {CHILD} eats at childcare – the child care provider, you, or is the food divided about equally between you and the childcare provider? [Source: PHFE WIC Survey 2011]

Child care provider 01

Parent 02

Equally divided 03

If child care provides food, program timing for transition to supplemental foods

7, 13

Ask only if MH23 indicates child care provides food

7 mo:

MH24. (If the child care provider supplies food) At what age does the child care provider start giving jarred or homemade baby foods? [Source: New Development]

Age [weeks/months]

Human milk given by bottle, or mother comes to breastfeed at child care location?

3, 7

Ask MH27 only if mother answered indicated in CF1 that she is fully or partially breastfeeding and in MH20 that she is currently using child care

MH27. Do you take pumped breast milk to the child care facility/person, or do you go there to breastfeed your baby? [Source: New Development]

Pumped milk 01

Go there to feed 02

Both 03

EXPERIENCE, KNOWLEDGE, ADVICE, BELIEFS

Ask KA24, KA25, KA28 only if still on WIC. If not on WIC, skip to CH1.

Next I’d like to ask you about foods you get from WIC.

Perceptions of impact of WIC food package on breastfeeding behavior

3, 7

KA24. At your WIC office or clinic, do you know if there is a special WIC food package for breastfeeding mothers who do not accept infant formula from WIC? [Source: IFPS-1, modified]

Yes 01

No 02

Don’t Know 98

KA25. (If yes) How important was the special food package for breastfeeding mothers in your decision to breastfeed {CHILD}? [Source: New Development]

Very important 01

Somewhat important 02

Not important 03

CHILD HEALTH, BEHAVIOR, AND CHILD REARING

Finally I’m going to ask you some questions about your child’s health and behavior.

Immunizations

7

CH1. [BORN IN HOSPITAL: Since {CHILD} first came home from the hospital…; NOT BORN IN HOSPITAL: Since {CHILD} was born…]; has [he/she] been given any vaccines or vaccinations either by mouth or by shot? [Source: WIC IFPS-1]

Yes 01

No 02

Don’t Know 98

Health status/conditions

Actions to rectify health conditions

1, 3, 5, 7, 9, 11, 13, 15, 18, 24

CH2. Has the doctor told you that {CHILD} has any long-term medical problems or conditions that may affect what or how (he/she) eats? [Source: FITS 2008, modified]

(Interviewer, if necessary add) These medical problems or conditions may be things like food allergies, diabetes, metabolic disorders such as PKU or galactosemia, gastrointestinal problems such as gastric reflux, other problems like cleft palate or other mouth or facial conditions – any long-term problems that affect the baby’s ability to eat and swallow.

Yes 01

No 02

Don’t Know 98

(If yes) What medical problem or condition does {CHILD} have?

Specify ______________________________________________

CH3. (If yes to health status/conditions in CH2): What are you currently doing to treat this medical problem? [Source: New Development] (Open-ended, Interviewer check all that apply)

Taking her/him to the doctor for treatment 01

Treating him/her at home with medicine 02

Treating him/her at home with something other than

medicine (such as herbal remedies, special teas, or other

forms of treatment) 03

Changing his/her diet 04

Other 05

Don’t Know 98

Refused 99

PARTICIPANT CONTACT INFORMATION UPDATE

Thank you for taking the time to speak with me today. Because we’ll be calling you again for your next interview (EN: in a couple of weeks / all other times: when your child is {AGE – next interview}), I’d like to be sure we have all the right ways to contact you.

CM1. Is your full name still {NAME}?

Yes 01

No 02

(If no, go to a)

a. Can you please tell me what your full legal name is now?

_____________________________________________

Ask only if still on WIC:

CM2. {If have WIC ID on file: We have your WIC ID as {FILL}, is that correct?/If don’t have WIC ID on file: Do you know what your current WIC ID is?}

WIC ID is the same (fill below) 01

New WIC ID (specify below) 02

Don’t know WIC ID 98

Refused WIC ID 99

WIC ID___________________________________

CM3. I reached you today at {FILL #}. Will that still be the best number to call you at for your next interview?

Yes (if yes, go to b) 01

No (if no, go to a) 02

a. What is the best number to call you at for your next interview?

Number (specify ---/---/----)

NO PHONE (go to CM4) 97

Is that number home, work, cell, or something else?

Home 01

Work 02

Cell 03

Other (specify__________________) 04

b. Is there another number we could try in case we have trouble reaching you?

Number (specify ---/---/----)

Is that number home, work, cell, or something else?

Home 01

Work 02

Cell 03

Other (specify__________________) 04

We’d like to keep in touch with you even if we can’t get you by phone or your phone number changes, so I’m going to ask you about a few additional ways we might be able to contact you.

CM4. If have email on file: We have your email address as {FILL}, is that correct?/If no email: Do you have an email address we could use to contact you if necessary?

Email is the same (fill below) 01

New Email (specify below) 02

Don’t know Email 98

Refused Email 99

Email___________________________________

CM5. If mailing address on file: We have your current mailing address as {FILL}. Is that correct? If no mailing address on file: Can I get a mailing address we could use to contact you if necessary?

Address is the same (fill below) 01

New address (specify below) 02

Don’t know/don’t have address 98

Refused address 99

a. Can you please tell me what your current mailing address is?

Street/Apt#________________________________________

City______________________________________________

State_____________________________________________

ZIP______________________________________________

b. (If CM3a is 97 – no phone): Earlier you indicated that you do not have a phone. Since we need to speak with you by phone we will mail you a study phone. You will receive the phone before your next interview. The package will contain instructions on how to use the phone. Should we mail the phone to the mailing address you just provided?

Address is the same (fill below) 01

New address (specify below) 02

Don’t know/don’t have address 98

Refused address 99

Can you please provide the address where the phone should be mailed?

Street/Apt#________________________________________

City______________________________________________

State_____________________________________________

ZIP______________________________________________

CM6. [Social Media – will develop question when procedure is finalized]

CM7. (If contacts on file: Earlier you provided the names and contact information for two people who would always know how to find you. Can I read that information back to you and check that it’s still up to date?/If no contacts on file: Just in case we can’t get in touch with you using the information you just gave me, I’d like to ask you for the names and contact information for two people who would always know how to find you.

Person #1 (If contacts on file, read fill info and correct as needed)

Name

Who is this person to you?

Phone

Address

Email

Person #2 (If contacts on file, read fill info and correct as needed)

Name

Who is this person to you?

Phone

Address

Email

Ask at 7, 13, 24 months only if core sample, and no longer in WIC. Ask once and then confirm at interview prior to when the next height/weight measure is needed:

CM9. As we mentioned when you first joined the study, we’d like to get information from {CHILD}’s doctor, and you gave us permission to do that. Can I please have the name of your child’s doctor, the doctor’s phone number if you have it, and the city and state where the doctor’s office is?

Doctor’s name

Location

Phone

Child hasn’t seen a doctor 97

Don’t know 98

Refused 99

If CM9 = 97, 98, 99 refer case for home health service.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB number.  The valid OMB control number for this information collection is 0584-XXXX.  The time required to complete this information collection is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.