Form Approved
OMB No. 0920-xxxx
Exp. Date xx/xx/xxxx
IFPS-3: MONTH 8
The information you are being asked to provide is authorized to be collected under Section 301 of The Public Health Service Act (42 USC 241). Providing this information is voluntary. CDC will use this information in its study, Feeding My Baby and Me (also known as the Infant Feeding Practices Study III), in order to learn more about the choices mothers make in feeding their babies and toddlers in the first 2 years of life. This information will support efforts to improve the health of our nation’s children. This information will be shared with a contractor, Westat, with which CDC has entered into an agreement to assist with carrying out this study.
Public reporting burden of this collection of information varies from 2 to 24 minutes with an average of 15 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. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx)
DEMOGRAPHICS
A9. Are you currently {CHILD'S NAME}’s caregiver?
Yes (GO TO A29)
No
A10. Does {CHILD'S NAME} currently live with you?
Yes
No
[IF A9 AND A10 = NO, END SURVEY, MAY BE ELIGIBLE FOR FUTURE SURVEYS. SHOW SURVEY INELIGIBILITY SCREEN AND THEN END SURVEY.]
[START SURVEY INELIGIBILITY SCREEN]
We’re sorry, you are not eligible to complete this survey if you are not currently the study child’s caregiver and the child doesn’t live with you. We will check back with you to see if you are eligible for study surveys in the future. Thank you.
[END SURVEY INELIGIBILITY SCREEN]
A29. Have you moved out of the United States?
Yes
No
FEEDING
Foods Your Baby Eats
[PROGRAMMER: LIST EACH REPETITION OF INSTRUCTIONS AND THE GRID THAT FOLLOWS THOSE INSTRUCTIONS ON A SEPARATE PAGE]
In the past 7 days, how often was {CHILD’S NAME} fed each food listed below? Include feedings by everyone who feeds the baby and include snack and night time feedings.
Fill in only one column for each item.
If {CHILD’S NAME} was fed the food once a day or more, enter the number of feedings per day in the first column.
If {CHILD’S NAME} was fed the food less than once a day, enter the number of feedings per week in the second column.
If {CHILD’S NAME} was not fed the food at all during the past 7 days, fill in 0 in the second column.
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER LINE, EITHER FEEDINGS PER DAY OR FEEDINGS PER WEEK]
Breast milk and infant formula |
Feedings per day |
Feedings per week |
Breast milk at your breast |
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Breast milk in a bottle/cup |
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Infant formula |
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|
[IF INFANT FORMULA >0] In the past week, about how many ounces of infant formula did your baby drink at each feeding?
1 to 2
3 to 4
5 to 6
7 to 8
More than 8
In the past 7 days, how often was {CHILD’S NAME} fed each beverage listed below? Include feedings by everyone who feeds the baby and include snack and night time feedings.
Fill in only one column for each item.
If {CHILD’S NAME} was fed the beverage once a day or more, enter the number of feedings per day in the first column.
If {CHILD’S NAME} was fed the beverage less than once a day, enter the number of feedings per week in the second column.
If {CHILD’S NAME} was not fed the beverage at all during the past 7 days, fill in 0 in the second column.
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER LINE, EITHER FEEDINGS PER DAY OR FEEDINGS PER WEEK]
Beverages |
Feedings per day |
Feedings per week |
Water: include tap, bottled, or unflavored sparkling water |
|
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100% pure fruit juice or 100% pure vegetable juice |
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Regular soda or pop that contains sugar. Don't include diet soda or diet pop |
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Sweetened fruit drinks such as Kool-Aid, lemonade, sweet tea, Hi-C, cranberry cocktail, Gatorade, or flavored milk (e.g., chocolate, strawberry, vanilla) |
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Unsweetened cow's milk (includes milk added to foods such as cereals) |
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Unsweetened other milk such as soy milk, rice milk, or goat milk. |
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In the past 7 days, how often was {CHILD’S NAME} fed each food listed below? Include feedings by everyone who feeds the baby and include snack and night time feedings.
Fill in only one column for each item.
If {CHILD’S NAME} was fed the food once a day or more, enter the number of feedings per day in the first column.
If {CHILD’S NAME} was fed the food less than once a day, enter the number of feedings per week in the second column.
If {CHILD’S NAME} was not fed the food at all during the past 7 days, fill in 0 in the second column.
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER LINE, EITHER FEEDINGS PER DAY OR FEEDINGS PER WEEK]
Grains |
Feedings per day |
Feedings per week |
Baby cereal |
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Infant snacks (includes baby puffs, melts, or teething biscuits) |
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Hot or cold cereal (do not include baby cereal) |
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Rice, pasta, breads (includes, rice, pasta, toast, rolls, bagels, cornbread, tortillas, bread in sandwiches, pancakes, waffles, crackers, etc.) |
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In the past 7 days, how often was {CHILD’S NAME} fed each food listed below? Include feedings by everyone who feeds the baby and include snack and night time feedings.
Fill in only one column for each item.
If {CHILD’S NAME} was fed the food once a day or more, enter the number of feedings per day in the first column.
If {CHILD’S NAME} was fed the food less than once a day, enter the number of feedings per week in the second column.
If {CHILD’S NAME} was not fed the food at all during the past 7 days, fill in 0 in the second column.
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER LINE, EITHER FEEDINGS PER DAY OR FEEDINGS PER WEEK]
Meats and Other Protein Foods |
Feedings per day |
Feedings per week |
Meat (not processed): chicken, turkey, pork, beef, or lamb |
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Processed meat: baby food meats, combination dinners, bacon, ham, lunch meats, hot dogs, etc. |
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Fish or shellfish |
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Eggs |
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Beans: Refried beans, black beans, white beans, baked beans, beans in soup, pork and beans, or any other cooked dried beans. Don't include green beans. |
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Peanut butter, other peanut foods, or nuts |
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Soy foods: tofu, frozen soy desserts, etc. |
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In the past 7 days, how often was {CHILD’S NAME} fed each food listed below? Include feedings by everyone who feeds the baby and include snack and night time feedings.
Fill in only one column for each item.
If {CHILD’S NAME} was fed the food once a day or more, enter the number of feedings per day in the first column.
If {CHILD’S NAME} was fed the food less than once a day, enter the number of feedings per week in the second column.
If {CHILD’S NAME} was not fed the food at all during the past 7 days, fill in 0 in the second column.
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER LINE, EITHER FEEDINGS PER DAY OR FEEDINGS PER WEEK]
Fruits and Vegetables |
Feedings per day |
Feedings per week |
Fruits: fresh, frozen, or canned, pureed baby food, or in squeezable pouches. Don't include juice. |
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Potatoes: baked, boiled, or mashed potatoes, or sweet potatoes |
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Fried potatoes including French fries, home fries, or hash browns |
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Green leafy vegetables: spinach, kale, collards, lettuce, or other green leafy vegetables |
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Other vegetables: fresh, frozen, or canned, or in squeezable pouches (other than green leafy or lettuce salads, potatoes, or cooked dried beans) |
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Tomato sauces: Mexican-type salsa with tomato, spaghetti noodles with tomato sauce, or mixed into foods such as lasagna (do not include tomato sauce on pizza) |
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In the past 7 days, how often was {CHILD’S NAME} fed each food listed below? Include feedings by everyone who feeds the baby and include snack and night time feedings.
Fill in only one column for each item.
If {CHILD’S NAME} was fed the food once a day or more, enter the number of feedings per day in the first column.
If {CHILD’S NAME} was fed the food less than once a day, enter the number of feedings per week in the second column.
If {CHILD’S NAME} was not fed the food at all during the past 7 days, fill in 0 in the second column.
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER LINE, EITHER FEEDINGS PER DAY OR FEEDINGS PER WEEK]
Dairy |
Feedings per day |
Feedings per week |
Cheese: all types (include cheese as a snack, on a sandwich, or in foods such as lasagna, quesadillas, or casseroles). Do not count cheese on pizza |
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|
Other dairy products, such as pudding or yogurt. Don't include sugar free or plain kinds |
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In the past 7 days, how often was {CHILD’S NAME} fed each food listed below? Include feedings by everyone who feeds the baby and include snack and night time feedings.
Fill in only one column for each item.
If {CHILD’S NAME} was fed the food once a day or more, enter the number of feedings per day in the first column.
If {CHILD’S NAME} was fed the food less than once a day, enter the number of feedings per week in the second column.
If {CHILD’S NAME} was not fed the food at all during the past 7 days, fill in 0 in the second column.
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER LINE, EITHER FEEDINGS PER DAY OR FEEDINGS PER WEEK]
Sweets and Desserts |
Feedings per day |
Feedings per week |
Ice cream or other frozen dairy desserts, such as frozen yogurt and sherbet. Don't include sugar free kinds |
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Sugar free frozen dairy desserts or sugar free pudding, plain or sugar free yogurt, or other sugar free dairy products |
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Sweet foods: candy, cookies, cake, doughnuts, muffins, pop-tarts, etc. Don't count frozen or sugar free desserts |
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|
In the past 7 days, how often was {CHILD’S NAME} fed each food listed below? Include feedings by everyone who feeds the baby and include snack and night time feedings.
Fill in only one column for each item.
If {CHILD’S NAME} was fed the food once a day or more, enter the number of feedings per day in the first column.
If {CHILD’S NAME} was fed the food less than once a day, enter the number of feedings per week in the second column.
If {CHILD’S NAME} was not fed the food at all during the past 7 days, fill in 0 in the second column.
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER LINE, EITHER FEEDINGS PER DAY OR FEEDINGS PER WEEK]
Snacks and Other Foods |
Feedings per day |
Feedings per week |
Pizza: frozen pizza, fast food pizza, homemade pizza, or other pizza |
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|
Snacks such as potato chips, corn chips, pretzels, or popcorn |
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|
C13. [ASK ONLY IF BREAST MILK FROM BREAST AND BREAST MILK FROM BOTTLE/CUP ENDORSED IN FFQ] Babies might drink breast milk from the breast, a bottle, or a cup. Which of the following best describes how {CHILD'S NAME} was drinking breast milk in the past week.
Mostly at the breast but some breast milk from a bottle or cup
About half at the breast and half from a bottle or cup
Some at the breast but most from a bottle or cup
Feeding Breast Milk
These next questions are about feeding your baby breast milk.
E5. [ASK IF E4 FROM PREVIOUS SURVEY INCLUDES DATE AND R HAS NOT ALREADY ANSWERED YES] Has {CHILD'S NAME} stopped directly feeding at your breast?
Yes
No (GO TO E10)
E6. How old was {FILL: HE/SHE} when {FILL: HE/SHE} completely stopped feeding directly from your breast? Do not answer about pumped or expressed milk. You will be asked about that later. (Day 0 is the day your baby was born)
My baby completely stopped feeding at my breast at ___ days OR ___ weeks OR ___ months
E8. What were the two most important reasons for your decision to stop feeding your baby directly at your breast?
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER COLUMN, DO NOT ALLOW BOTH COLUMNS CHECKED FOR SAME LINE]
|
Most important reason |
Second most important reason |
I wanted or needed someone else to feed my baby |
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|
Breast milk alone did not satisfy my baby |
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I wanted my body back to myself |
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I was sick or had to take medicine |
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I could not breastfeed while working or going to school |
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My baby lost interest in nursing or began to wean himself or herself |
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|
I was pregnant |
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Other reason |
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|
These next questions are about pumped and expressed breast milk.
[PROGRAMMER: DISPLAY E10 AND E15 ON THE SAME SCREEN]
E10. [DO NOT DISPLAY IF ANSWERED WITH DATE IN PREVIOUS SURVEY] How old was {FILL: HE/SHE} when you first pumped your breast milk? (Day 0 is the day your baby was born)
I first pumped my breast milk at___ days OR ___ weeks OR ___ months
OR
I have never pumped my breast milk
E15. [DO NOT DISPLAY IF ANSWERED WITH DATE IN PREVIOUS SURVEY] How old was {FILL: HE/SHE} when you first fed your baby pumped or hand-expressed breast milk? (Day 0 is the day your baby was born)
I first gave my baby pumped or hand-expressed breast milk at___ days OR ___ weeks OR ___ months
OR
I have never given my baby pumped or hand-expressed breast milk
[IF E10 = NEVER PUMPED, SKIP TO C21]
C19. Are you currently pumping breast milk on a regular schedule?
Yes
No
C20. In the past week, how many times did you pump breast milk?
__ Times in past week
C21. [IF E15 = NEVER FED PUMPED MILK, SKIP TO E11] How long was pumped milk usually kept at room temperature before it was fed to {CHILD’S NAME}? Please answer separately for fresh milk and frozen milk. By fresh milk, we mean milk that has not yet been stored. By previously frozen milk, we mean pumped milk that was stored in the freezer and moved to room temperature.
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER COLUMN]
|
Fresh milk |
Previously frozen milk |
I do not keep my milk at room temperature |
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Less than 1 hour |
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1 to 2 hours |
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3 to 4 hours |
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|
5 to 8 hours |
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More than 8 hours |
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I don’t know |
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|
C22. How long was pumped milk usually stored in the refrigerator before it was fed to {CHILD’S NAME}? (Include cooler with cold source such as freezer packs.) Please answer separately for fresh milk and frozen milk. By fresh milk, we mean milk that has not yet been stored. By previously frozen milk, we mean pumped milk that was stored in the freezer and moved to the refrigerator.
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER COLUMN]
|
Fresh milk |
Previously frozen milk |
I do not store milk in a refrigerator |
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|
1 day or less |
|
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2 to 3 days |
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|
4 to 5 days |
|
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6 to 8 days |
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More than 8 days |
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I don’t know |
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C23. How long was pumped milk usually stored in a freezer before it was fed to {CHILD’S NAME}? (Include closed freezer compartments or standing, standalone freezers, and deep freezers.)
I do not keep my milk in a freezer
Less than 1 week
1 to 2 weeks
3 to 4 weeks
5 to 8 weeks
9 to 11 weeks
12 to 16 weeks
More than 16 weeks
I don’t know
E11. [IF E10=NEVER PUMPED, SKIP TO E16. ASK IF E10 FROM CURRENT OR PREVIOUS SURVEY INCLUDES DATE AND R HAS NOT ALREADY ANSWERED YES] Have you stopped pumping or hand-expressing breast milk?
Yes
No (GO TO E16)
[IF E11 = VALID SKIP, GO TO E16]
E12. How old was {CHILD’S NAME} when you completely stopped pumping or hand-expressing breast milk? (Day 0 is the day your baby was born). Do not answer about feeding your baby your pumped breast milk. You will be asked about that later.
I completely stopped pumping or hand-expressing my breast milk at___ days OR ___ weeks OR ___ months
E13. What were the two most important reasons for your decision to stop pumping or hand-expressing breast milk?
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER COLUMN, DO NOT ALLOW BOTH COLUMNS CHECKED FOR SAME LINE]
|
Most important reason |
Second most important reason |
Pumping milk no longer seemed worth the effort it required |
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|
Too many challenges related to pumping at work or school |
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Pumping supplies cost too much |
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I was not getting enough pumped milk |
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I had enough milk stored to reach my breastfeeding goal |
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I was pregnant |
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I was sick or had to take medicine |
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Other reason |
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E16. [ASK IF E15 FROM CURRENT OR PREVIOUS SURVEY INCLUDES DATE AND R HAS NOT ALREADY ANSWERED YES] Have you stopped feeding your baby pumped or expressed breast milk?
Yes
No (GO TO E20)
[IF E16 = VALID SKIP, GO TO E19]
E17. How old was {FILL: HE/SHE} when {FILL: HE/SHE} completely stopped being fed any pumped or expressed breast milk? Do not answer about feeding directly at your breast. (Day 0 is the day your baby was born)
My baby completely stopped being fed pumped or expressed breast milk at___ days OR ___ weeks OR ___ months
E19. [IF E4 OR E15 HAVE DATE IN ANY SURVEY AND E5 ≠ NO AND E16 ≠ NO, ASK E19. ONCE ANSWERED, DO NOT ASK AGAIN IN FUTURE SURVEYS] Did you feed your baby breast milk (at the breast or pumped/expressed milk) as long as you wanted?
Yes
No
E20. [ASK IF E3 FROM M1 OR M2 = YES] Did you exclusively breastfeed, or feed {CHILD’S NAME} only breast milk and nothing else, as long as you wanted?
Yes
No
Feeding Formula
These next questions are about feeding your baby infant formula.
E22. [DO NOT ASK IF E22 = YES IN A PREVIOUS SURVEY; IF FORMULA ENDORSED IN FFQ CODE YES AND CONTINUE TO E23] Did you ever feed {CHILD’S NAME} infant formula?
Yes
No (GO TO C26)
E23. [DO NOT DISPLAY IF ANSWERED WITH DATE IN PREVIOUS SURVEY] How old was {FILL: HE/SHE} when {FILL: HE/SHE} was first fed infant formula? (Day 0 is the day your baby was born)
My baby was first fed infant formula at___ days OR ___ weeks OR ___ months
D8. [ASK ONLY IF BREAST MILK AND FORMULA ENDORSED IN FFQ] What were the two most important reasons for feeding your baby formula in addition to breastfeeding?
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER COLUMN, DO NOT ALLOW BOTH COLUMNS CHECKED FOR SAME LINE]
|
Most important reason |
Second most important reason |
I believe that breast milk and formula together are the best for the baby |
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I did not have enough breast milk |
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I went back to work or school |
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A health professional thought I should |
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I was sick or had to take medicine |
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Other reason |
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Solid Foods
These next questions are about introducing solid foods to your baby.
C26. [ONCE ANSWERED WITH ANYTHING OTHER THAN “I HAVE NOT YET FED MY BABY SOLID FOODS,” DO NOT ASK AGAIN] How old was {CHILD’S NAME} when {FILL: HE/SHE} was first fed solid foods? Please include any foods such as infant cereal, fruit, vegetables, meat or other foods, even if it was just a small amount fed from a spoon, a bottle or your hands. The first solid food means the first time your baby had any food other than breast milk or infant formula.
____ Months [HAVE A DROP DOWN OPTION FOR LESS THAN ONE MONTH ALL OTHER RESPONSES ARE WRITE-IN]
[NOTE TO PROGRAMMER – DO NOT ALLOW FOR OPTIONS THAT ARE OLDER THAN CHILD’S AGE AT TIME OF SURVEY]
I have not yet fed my baby solid foods (GO TO G3)
D19. [ONCE ANSWERED, DO NOT ASK AGAIN] What were the most important reasons for feeding {CHILD’S NAME} solid food for the very first time? Solid foods are foods such as infant cereal (not in a bottle), baby foods, or table food.
[PROGRAMMER: ONLY ALLOW ONE RESPONSE PER COLUMN, DO NOT ALLOW BOTH COLUMNS CHECKED FOR SAME LINE]
|
Most important reason |
Second most important reason |
I didn’t have enough breast milk |
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My baby was not gaining enough weight |
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It would help my baby sleep longer at night |
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A doctor or other health professional said my baby should begin eating solid foods |
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Friends or relatives said my baby should begin eating solid foods |
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My baby wanted food I ate or in other ways showed an interest in solid food |
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Other reason |
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C27. [ONCE ANSWERED, DO NOT ASK AGAIN] What was the first solid food you fed {CHILD’S NAME}? The first solid food means the first time your baby had any food other than breast milk or infant formula. This can also include anything added to the bottle.
Infant rice cereal
Infant cereal (not rice)
Fruits
Vegetables
Meats
Other food
I fed my baby several different foods mixed together
C31. When you introduced your baby to new foods (such as a specific type of cereal, fruit, vegetable, or meat), about how often did you usually introduce these foods to your baby?
About 1 new food per week or less often
About 1 new food every 4 or 5 days
About 1 new food every 3 days
About 1 new food every 2 days
About 1 new food every day
More than 1 new food every day
I have not introduced NEW food to my baby
EMPLOYMENT AND CHILD CARE
G3. Was {CHILD’S NAME} cared for by someone other than you or your partner on a regular schedule during the past month? That is, did someone else usually keep your baby at least once a week for three or more hours at a time?
Include arrangements in which the exact day or time may change if the child care usually occurred at least once a week.
Yes
No (GO TO G3A)
G4. Where did your usual child care occur? (Please select one. If you have more than one, please select the one you use the most often)
A daycare center
An in-home daycare
In a private home with (this includes your own home)
G5. How many days in an average week was {CHILD’S NAME} cared for by your regularly scheduled child care provider(s)? (Include days your baby was cared for by family members if they regularly provide child care while you are away from the baby.)
__________ DAYS PER WEEK
G6. On an average day while {CHILD’S NAME} was with your child care provider, how many meals or snacks did {CHILD’S NAME} have?
Please include breast milk, formula, and all other foods, and include meals and snacks.
_________ Number PER DAY FED BABY
G8. Under your regular child care arrangements in the past month, who usually provided {CHILD’S NAME}’s food?
You, the mother
The child care provider
Someone else
G3A. In the past month, was your regular childcare arrangement disrupted due to the COVID-19 pandemic?
Yes
No
G28. Are you currently attending school?
Yes, full-time
Yes, part-time
No
G23. Are you currently working for pay?
Yes, currently working for pay
No, not currently working for pay (GO TO C105)
G23A. In the past month, have you been working from home?
Yes, I only work at home
Yes, I work both at home and outside the home
No, I only work outside the home
G24. [ONCE ANSWERD, DO NOT ASK AGAIN] How old was {CHILD’S NAME} when you began working after your delivery?
_____ days or ______ weeks or _____ months
G25. How many hours per week did you usually work for pay at your job during the past month? (Answer for whatever time you have been working if less than 1 month) (If you work at two or more jobs, answer for the total number of hours you work.)
1 to 9 hours per week
10 to 19 hours per week
20 to 29 hours per week
30 to 34 hours per week
35 to 40 hours per week
More than 40 hours per week
G29A. [PROGRAMMER: ONLY DISPLAY IF STILL FEEDING OR PUMPING BREAST MILK (E5 OR E11= NO)] [IF G23A= ONLY WORK AT HOME OR BOTH HOME AND OUTSIDE HOME] When you work at home, does your employer currently do any of the following things to help you while you breastfeed?
Select all that apply.
Allow reasonable breaks for pumping
Provide flexible work arrangements (e.g., hours, location)
Allow me to have my baby with me at work
G29B. [PROGRAMMER: ONLY DISPLAY IF STILL FEEDING OR PUMPING BREAST MILK (E5 OR E11= NO)] [IF G23A= ONLY WORK OUTSIDE THE HOME OR BOTH HOME AND OUTSIDE HOME] When you are at your worksite (not your home), does your employer currently do any of the following things to help you while you breastfeed?
Select all that apply.
Allow reasonable breaks for pumping
Provide a private space that isn’t a bathroom where you can pump milk
Provide flexible work arrangements (e.g., hours, location)
Allow me to have my baby with me at my worksite while I work
G30. [PROGRAMMER: ONLY DISPLAY IF STILL FEEDING OR PUMPING BREAST MILK (E5 OR E11 = NO)] Have you had any of the following experiences during the past month? Mark “No” if the item does not describe your circumstances, such as if you have no coworkers for the first item. (If you have stopped breastfeeding, please answer for the time you were breastfeeding.)
|
Yes |
No |
A coworker made negative comments or complained to me about breastfeeding or pumping breast milk. |
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|
It was hard for me to arrange break time for breastfeeding or pumping breast milk. |
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It was hard for me to find a place to breastfeed or pump breast milk. |
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I felt worried about keeping my job, or felt penalized at work, because of breastfeeding or pumping breast milk. |
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|
EATING BEHAVIOR
These next questions are about your eating behavior. Please indicate how much you agree or disagree with the following statements:
|
Strongly agree |
Disagree |
Neither agree or disagree |
Agree |
Strongly agree |
C105. I am always thinking about food. |
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C106. I often feel hungry when I am with someone who is eating. |
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C107. When I see or smell food that I like, it makes me want to eat. |
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C108. I get full up easily. |
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C109. I often get full before my meal is finished. |
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C110. I often leave food on my plate at the end of a meal. |
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C111. I cannot eat a meal if I have had a snack just before. |
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C112. I often decide that I don’t like a food before tasting it. |
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C113. I enjoy tasting new foods. |
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C114. I enjoy a wide variety of foods. |
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HEALTH AND LIFESTYLE
H23. Which of the following problems did your baby have during the past month?
|
Yes |
No |
Fever |
|
|
Diarrhea or vomiting |
|
|
Ear infection |
|
|
Severe respiratory infection (e.g., pneumonia, bronchiolitis) |
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Wheeze |
|
|
Eczema (atopic dermatitis) |
|
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COVID-19 |
|
|
H36. On a typical day, how much time does {CHILD’S NAME} spend sleeping over a 24 hour period?
_____ hours
G26. How many days in the past month did you or another caregiver (e.g., the baby's father) miss work because your child was sick?
_________ days
[PROGRAMMER: DISPLAY CONTACT INFORMATION SECTION]
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | April Fales |
File Modified | 0000-00-00 |
File Created | 2021-01-13 |