WIC Participant

OMB Approval No. 0584-XXXX

Approval Expires: XX/XX/20XX

APPENDIX K.1

WIC ITFPS-2 Participant Interview

3 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_____________________________________

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

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

I’d like to begin by asking 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 full WIC module only if respondent indicated in SD31 that they are still on WIC. If not on WIC, skip to WC21.

I’m going to ask you some questions about WIC, including what your WIC site offers and what WIC services you use.

Awareness: WIC Food Packages

Prenatal, 3

First I’m going to read you a few questions and I’d like you to tell me if these things are offered at your WIC office or clinic:

WC1. There is a special WIC food package for breastfeeding women who do not accept infant formula from WIC. Is this food package offered at your WIC office or clinic? [Source: IFPS-1, modified]

Yes 01

No 02

Don’t Know 98

Perceptions of impact of WIC food package on breastfeeding behavior

3, 7

If WC1 was yes, ask KA25

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

Awareness: WIC Food Packages

Prenatal, 3

WC2. At your WIC office or clinic does the amount of infant formula you can get from WIC change based on the age of the baby? [Source: New Development]

Yes 01

No 02

Don’t Know 98

WC3. At your WIC office or clinic does the amount of infant formula you can get from WIC change depending on how much breastfeeding the mother is doing? [Source: New Development]

Yes 01

No 02

Don’t Know 98

Awareness: Breastfeeding counseling and education

Prenatal, 3

Now I’m going to ask you some questions about information and services you might have gotten from WIC.

WC4. Do you think that WIC recommends breastfeeding only, formula feeding only, or that both are equally ok? [Source: IFPS-1, modified]

Breastfeeding only 01

Formula feeding only 02

Both are equally ok 03

Don’t Know 98

Utilization: Breastfeeding counseling and education

Prenatal, 3

WC5. Have you received any information from WIC about breastfeeding (during this pregnancy/{CHILD})? [Source: IFPS-1, modified]

Yes 01

No 02

Don’t Know 98

Utilization: Nutrition education and counseling

Prenatal, 3

WC6. Have you received information from WIC about what you should be eating? [Source: New Development]

Yes 01

No 02

Don’t Know 98

3 only:

WC7. Have you received information from WIC about how to feed formula to your child? [Source: WIC IFPS-1 modified]

Yes 01

No 02

Don’t Know 98

WC8. Have you received information from WIC about how to prepare formula? [Source: WIC IFPS-1 modified]

Yes 01

No 02

Don’t Know 98

WC9. Have you received information from WIC about when to begin giving cereal and other foods to {CHILD}? [Source: New Development]

Yes 01

No 02

Don’t Know 98

Utilization: Peer counseling for breastfeeding

3

WC10. Did someone who works for your WIC office or clinic visit you in the hospital when you had {CHILD}, to provide breastfeeding support? [Source: New Development]

Yes 01

No 02

Didn’t need it 03

Don’t Know 98

WC11. Did someone who works for your WIC office or clinic call you after {CHILD} was born to provide breastfeeding support? [Source: New Development]

Yes 01

No 02

Didn’t need it 03

Don’t Know 98

Utilization: Food package

Prenatal, 3

Now I’m going to ask you a few questions about how you have used WIC food and education.

WC12. During the last month did you buy all of the WIC foods for which you were issued checks or EBT benefits? [Source: New Development]

Yes 01

No 02

Haven’t shopped yet 03

Don’t Know 98

WC13. During the last month did you buy the full amount of the fruit and vegetable benefit?

Yes 01

No 02

Haven’t shopped yet 03

Don’t Know 98

Perceptions of Impact of Nutrition Education

3, 13, 24

WC20. Your WIC benefits include both education and food. Which is more important to you—the food you get from WIC, the education you get from WIC, or are they equally important? [Source: New Development]

Food is more important 01

Education is more important 02

They are equally important 03

Don’t know 98

Refused 99

If no longer on WIC, say: I’d like to ask you about how you used WIC education.

WC21. Have you changed how you feed yourself or your family because of something you learned at WIC? [Source: New Development]

Yes 01

No 02

Don’t Know 98

WC22. (If YES to WC21) What is the most important change you have made based on education you received from WIC? (Open-ended; Interviewer record response) [Source: New Development]

I/we eat more fruits and vegetables 01

I/we eat more whole grains 02

I/we drink more reduced fat/low-fat/non-fat milk 03

I am breastfeeding/breastfed 04

I know how to prepare formula/feed the right amount of formula 05

We have more family meals/eat together 06

We don’t watch TV when eating meals 07

We drink/buy fewer sugar sweetened beverages 08

I/we offer the right amount of foods (portion) 09

I know how to choose more healthy foods for myself/my family 10

Other (specify____________________________________) 11

Don’t know 98

Refused 99

HOSPITAL EXPERIENCES AND FEEDING PRACTICES

NICU Feeding Module

1, *3 for last question

*HF5. (If child was still in NICU at 1 month from HF3) When we spoke with you last time your baby was still in the NICU. At what age did your baby come home from the NICU?

Age [weeks]

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)

Current feeding choice

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

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

First postnatal interview (1 or 3), if mother indicates formula feeding only in CF1, and if 1 month answered no to HF10 breastfeeding initiated in hospital, ask:

CF29. Did you ever feed your baby breastmilk, either from your breast or from a bottle? [Source: FDA IFPS-2, modified]

Yes 01

No 02

IF CF1 = 02, SKIP TO CF19

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

Questions CF2 – CF18

Frequency and nature of breastfeeding problems

Resolution of breastfeeding problems

1, 3, 5

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

CF2. I would like to ask you about some of the problems you might have had with breastfeeding during the past month. During the past month, have you had any of the following problems:

Ask items (a/b) only at 1 month, then drop at 3 and 5.

a. In the past month, did your baby have trouble latching on?

Yes 01

No 02

b. (If yes) What did you do about this problem? (Interviewer allow open-ended and check all responses offered)

Turned to someone for advice 01

Bottle fed baby with formula 02

Pumped breastmilk to be fed to baby with bottle 03

Nothing, just continued breastfeeding 04

Other (specify ____________________________________) 05

Ask at 1, 3, 5

c. In the past month did your baby have problems with choking?

Yes 01

No 02

d. (If yes) What did you do about this problem? (Interviewer allow open-ended and check all responses offered)

Turned to someone for advice 01

Bottle fed baby with formula 02

Pumped breastmilk to be fed to baby with bottle 03

Nothing, just continued breastfeeding 04

Other (specify ____________________________________) 05

e. In the past month did you have sore or cracked nipples?

Yes 01

No 02

f. (If yes) What did you do about this problem? (Interviewer allow open-ended and check all responses offered)

Turned to someone for advice 01

Took medications or used creams 02

Bottle fed baby with formula 03

Pumped breastmilk to be fed to baby with bottle 04

Nothing, just continued breastfeeding 05

Other (specify ____________________________________) 06

g. In the past month did you have a breast infection?

Yes 01

No 02

h. (If yes) What did you do about this problem? (Interviewer allow open-ended and check all responses offered)

Turned to someone for advice 01

Took medications or used creams 02

Bottle fed baby with formula 03

Pumped breastmilk to be fed to baby with bottle 04

Nothing, just continued breastfeeding 05

Other (specify ____________________________________) 06

i. In the past month were your breasts too full?

Yes 01

No 02

j. (If yes) What did you do about this problem? (Interviewer allow open-ended and check all responses offered)

Turned to someone for advice 01

Bottle fed baby with formula 02

Pumped breastmilk to be fed to baby with bottle 03

Pumped or expressed breastmilk to relieve fullness 04

Nothing, just continued breastfeeding 05

Other (specify ____________________________________) 06

k. In the past month did you not have enough milk to satisfy the baby?

Yes 01

No 02

l. (If yes) What did you do about this problem? (Interviewer allow open-ended and check all responses offered)

Turned to someone for advice 01

Changed what I ate 02

Bottle fed baby with formula 03

Pumped breastmilk to be fed to baby with bottle 04

Nothing 05

Other (specify ____________________________________) 06

m. In the past month did you have any other problems breastfeeding? (specify___________________________________)

Yes 01

No 02

n. (If yes) What did you do about this problem? (Interviewer allow open-ended and check all responses offered)

Turned to someone for advice 01

Took antibiotics/medications 02

Bottle fed baby with formula 03

Pumped breastmilk to be fed to baby with bottle 04

Nothing, just continued breastfeeding 05

Other (specify ____________________________________) 06

Support received for breastfeeding problem

1, 3, 5

CF3. (If yes to any problem in CF2) When you have encountered problems with breastfeeding have any of the following people given you advice about what to do? [Source: IFPS-1, modified]

a. People who work at your WIC office or clinic

Yes 01

No 02

b. Doctors or nurses

Yes 01

No 02

c. Friends or relatives

Yes 01

No 02

d. Breastfeeding support people outside of WIC such as La Leche League or a lactation counselor

Yes 01

No 02

e. Anyone else?

Yes 01

No 02

Frequency and nature of breastfeeding barriers

Best solutions to identified barriers

1, 3, 5

CF4. I’m going to read you some statements about things that might make it hard to breastfeed or keep you from breastfeeding. For each one, please tell me if this has happened to you in the past month: [FDA IFPS-2, modified]

a. I had to return to work or school and I could not or did not want to pump or breastfeed there. Did this happen to you in the past month?

Yes 01

No 02

b. Breastfeeding took too much out of me. Did this happen to you in the past month?

Yes 01

No 02

c. I did not have time to breastfeed. Did this happen to you in the past month?

Yes 01

No 02

d. I felt tied down by breastfeeding. Did this happen to you in the past month?

Yes 01

No 02

e. My husband or boyfriend was against it. Did this happen to you in the past month?

Yes 01

No 02

CF5. (If yes to any barriers in CF4) What do you think is the best way to deal with this/these things that made it hard to breastfeed? (Interviewer allow open-ended and check all responses offered) [Source: New Development]

Seek support from a friend or relative to help you

to continue breastfeeding 01

Seek support from a health professional to help you

to continue breastfeeding 02

Make arrangements with work or school to continue

breastfeeding or pumping during the day 03

Stop breastfeeding and switch to formula feeding 04

Mix breastfeeding with formula feeding 05

Nothing, just continue breastfeeding 06

Other (specify_____________________________) 07

Use of breast pump

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

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

From where mom received pump

1, 3 (ask at 1 month, or at 3 if mother indicates pumping for the first time at 3 months)

Ask only if currently pumping breastmilk in CF6

CF7. What are you using most often to pump breastmilk, is it an electric pump, a manual pump, pumping by hand, or something else? [Source: New Development]

An electric pump 01

A manual pump 02

Pumping by hand 03

Other 04

CF10. (Do not ask if CF7 pumping by hand) How did you get the breast pump that you use most often? (Interviewer read options)[Source: FDA IFPS-2, modified]

WIC loaned it to you or paid for it 01

You bought it or rented it 02

You borrowed it from a friend or relative 03

It was given to you as a gift 04

You use one provided by a hospital,

your place of work, or someplace else 05

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

Who provided formula

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

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

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

If CF19 = 02, skip to CF21.

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

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 CF33.

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

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

If CF32 = NO, skip to CF50.

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

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

Yes 01

No 02

h. (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

i. 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

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

Age [weeks/months]

Don’t know 98

Refused 99

k. 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

l. (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

m. Has [HE/SHE] been given baby cereal

Yes 01

No 02

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

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 other cereal besides baby cereal?

Age [weeks/months]

Don’t know 98

Refused 99

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

Yes 01

No 02

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

Age [weeks/months]

Don’t know 98

Refused 99

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

Yes 01

No 02

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

Age [weeks/months]

Don’t know 98

Refused 99

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

Yes 01

No 02

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

Age [weeks/months]

Don’t know 98

Refused 99

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

Yes 01

No 02

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

Age [weeks/months]

Don’t know 98

Refused 99

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

Yes 01

No 02

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

Age [weeks/months]

Don’t know 98

Refused 99

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

Yes 01

No 02

bb. (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

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

Yes 01

No 02

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

Age [weeks/months]

Don’t know 98

Refused 99

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

Yes 01

No 02

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

Age [weeks/months]

Don’t know 98

Refused 99

[End supplemental foods module]

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

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

*only ask at 3 months if indicated that child is eating solid foods (something other than formula or BM) in CF32

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 bottle feeding practices

3, 9

At 9 months, ask only if child is still using a bottle (CF34)

CF50. I am going to read some things that parents may do. Please tell me how often each statement is true for you and {CHILD}. [Source: Thompson et al., 2009]

a. When {CHILD} has a bottle, I prop it up

Always 01

Usually 02

About half of the time 03

Occasionally 04

Never 05

b. I try to get {CHILD} to finish (his/her) bottle of breastmilk or formula

Always 01

Usually 02

About half of the time 03

Occasionally 04

Never 05

MATERNAL HEALTH AND LIFESTYLE

Next I’m going to ask you some questions about your health and how you have been feeling.

Maternal weight

1, 3, 13, 24

MH13. Right now, about how much do you weigh, without shoes? [Source: PHFE WIC Postpartum Questionnaire 2010]

Pounds [number]

Postpartum depression (Edinburgh scale)

3

MH16. It is not easy being a new mother, and it is OK to feel unhappy at times. Because you have recently had a baby, we would like to know how you are feeling. I’m going to read you some statements about how you might have been feeling emotionally lately, and I’d like you to choose the answer that comes closest to how you have felt during the past week. In the past week [Interviewer: read items and response options]: [Source: FDA IFPS-2 version Edinburgh]

a. I have been able to laugh and see the funny side of things

As much as I always could 01

Not quite so much now 02

Definitely not so much now 03

Not at all 04

b. In the past week I have looked forward with enjoyment to things

As much as I ever did 01

Rather less than I used to 02

Definitely less than I used to 03

Hardly at all 04

c. In the past week I have blamed myself unnecessarily when things went wrong

Yes, most of the time 01

Yes, some of the time 02

Not very often 03

No, never 04

d. In the past week I have been anxious or worried for no good reason

No, not at all 01

Hardly ever 02

Yes, sometimes 03

Yes, very often 04

e. In the past week I have felt scared or panicky for no good reason -

Yes, quite a lot 01

Yes, sometimes 02

No, not much 03

No, not at all 04

f. In the past week things have been getting on top of me

Yes, most of the time I haven’t been able to cope at all 01

Yes, sometimes I haven’t been coping as well as usual 02

No, most of the time I have coped quite well 03

No, I have been coping as well as ever 04

g. In the past week I have been so unhappy that I have had difficulty sleeping

Yes, most of the time 01

Yes, some of the time 02

Not very often 03

No, not at all 04

h. In the past week I have felt sad or miserable

Yes, most of the time 01

Yes, some of the time 02

Not very often 03

No, not at all 04

i. In the past week I have been so unhappy that I have been crying

Yes, most of the time 01

Yes, quite often 02

Only occasionally 03

No, never 04

j. In the past week the thought of harming myself has occurred to me

Yes, quite often 01

Sometimes 02

Hardly ever 03

Never 04

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]

Workplace accommodations for pumping/expressing milk (if employed and breastfeeding)

3

Ask only if working (SD29 = 01 or 02), and feeding breastmilk (CF1)

MH17. Does your workplace do any of the following things to help you while you breastfeed? [Source: New Development]

a. Allow reasonable breaks for pumping?

Yes 01

No 02

Don’t Know 98

b. Provide a reasonable place to store pumped milk?

Yes 01

No 02

Don’t Know 98

c. Provide a private space that isn’t a bathroom where you can pump milk

Yes 01

No 02

Don’t Know 98

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, while you go to work or school.

Please include care provided by a relative or non-relative, either in your home or someone else’s home, as well as in a childcare 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 (to check 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 childcare? 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

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

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

EXPERIENCE, KNOWLEDGE, ADVICE, BELIEFS

Now I’m going to ask you about your thoughts on feeding babies.

Caregiver understanding of infant nonverbal satiety cues and crying; toddler satiety cues.

3, 13, 24

3 month questions:

KA26. I’m going to read you some statements about when babies are hungry or full. Please tell me how much you agree or disagree with these statements. [Source: First Steps Survey, modified]

a. If a baby is crying, then he or she has to be hungry. Would you say that you:

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

b. If a baby sucks his or her hand, then he or she has to be hungry. Would you say that you:

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

c. If a baby turns his/her head away from the nipple or bottle, then he or she has to be full. Would you say that you:

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

d. If a baby is given a bottle, the caregiver should always make sure he or she finishes it. Would you say that you:

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

e. A baby knows when he or she is full. Would you say that you:

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

Perceptions of infant/toddler size and role in feeding decisions

3, 13, 24

At 3, 13, 24:

KA29. Does your child’s weight influence your decisions about how and what to feed [HIM/HER]? [Source: New Development]

Yes 01

No 02

Don’t know 98

CHILD HEALTH, BEHAVIOR, AND CHILD REARING

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

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

Pacifier use/timing/reasons

3

CH12. When was {CHILD} given a pacifier for the first time? Would you say the first time was in the hospital after [HE/SHE] was born, in the first month after coming home from the hospital, sometime after that first month, or has {CHILD} never used a pacifier? [Source: New Development]

In hospital 01

In first month after coming home from hospital 02

After first month 03

Child has never used a pacifier 04

Don’t Know 98

CH13. (If child has used a pacifier, CH12 = 04) Why was {CHILD} given a pacifier? Was [HE/SHE] given one: [Source: New Development]

a. To stop him/her from crying

Yes 01

No 02

Don’t Know 98

b. To keep him/her calm

Yes 01

No 02

Don’t Know 98

c. To help him/her get to sleep

Yes 01

No 02

Don’t Know 98

d. Was there another reason? (specify________________________)

Yes 01

No 02

Don’t Know 98

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 only if core sample, at the 1^st interview after the child is born:

CM8. As we mentioned when you first joined the study, we’d like to get information from the hospital where {CHILD} was born, and you gave us permission to do that. Can I please have the name of the hospital, the phone number if you have it, and the city and state where you gave birth to {CHILD}?

Hospital name

Location

Phone

Child not born in a hospital 97

Don’t know 98

Refused 99

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 27 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.