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Asian Pacific Islander Breastfeeding Task Force Community Breastfeeding Survey (FFE Project)
Hello! Thank you for taking the time to fill out the Asian Pacific Islander Breastfeeding Task Force Community Breastfeeding Survey. We are reaching out to families in the Asian American, Native Hawaiian, and Pacific Islander communities to learn more about the landscape of infant feeding. The information you share will be compiled into a report and used to shape future resources and services for our community. No personal information will be shared with others. This survey should take 5 minutes to complete. Please complete the form by August 31, 2021. Thank you again for your time. For more information about this survey, please contact Cindy Young at
cyoung@breastfeedla.org
.
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* Indicates required question
I am currently pregnant.
*
Yes
No
I have given birth in the last 3 years.
*
Yes
No
What is the highest degree or level of education you have completed?
Some High School
High School
Bachelor's Degree
Master's Degree
Doctorate or higher
Trade School
Prefer not to share
Other:
Clear selection
Please specify your ethnicity (check all that apply).
Central Asian (Afghani, Armenian, Azerbaijani, Georgians, Kazakh, Krgyz, Mongolian, Tajik, Turkmen, Uzbek)
East Asian (Chinese, Japanese, Korean, Okinawan, Taiwanese, Tibetan)
Native Hawaiian and Pacific Islander (Carolinian, Chamorro, Chuukese, Fijian, Guamanian, Hawaiian, Kosraean, Marshallesse, Native Hawaiian, Niuean, Palauan, Pohnpeian, Papua New Guinean, Samoan, Tokelauan, Tongan, Yapese)
Southeast Asian (Bruneian, Burmese, Cambodian, Filipino, Hmong, Indonesian, Laotian, Malaysian, Mien, Singaporean, Timorese, Thai, Vietnamese)
South Asian (Bangladeshi, Bhutanese, Indian, Maldivians, Nepali, Pakistani, Sri Lankan)
West Asian/Middle Eastern (Individuals from Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Palestine, Qatar, Saudi Arabia, Syria, Turkey, United Arab Emirates, Yemen)
Other AANHPI
None of the above
If you are Asian American, what is your national origin?
Japanese
Korean
Vietnamese
Chinese
Filipino
Asian Indian
Pakistani
Cambodian
Hmong
Thai
Laotian
Taiwanese
Bangladeshi
Burmese
Indonesionan
Nepalese
Sri Lankan
Malaysian
Mongolian
Bhutanese
Okinawan
Other Asian, not specified
I am not Asian American
Clear selection
What is your age?
18-24
25-34
35-44
45-54
above 54
Prefer not to share
Clear selection
What is your annual household income?
Less than $25,000
$25,000 - $50,000
$50,000 - $75,000
$75,000 - $100,000
$100,000 - $150,000
$150,000 - $200,000
Above $200,000
Prefer not to share
Clear selection
In your opinion, how supportive of breastfeeding is (or was) your place of employment?
Very supportive
Somewhat supportive
Not very supportive
Not at all supportive
I do not work
Clear selection
Do you (or did you) plan to work outside your home during your baby's first year?
Yes
No
Maybe
Clear selection
How many weeks after the baby is (or was) born do you (or did you) plan to return to work?
Fewer than 4 weeks
4 to 6 weeks
7 to 9 weeks
10 to 12 weeks
13 to 16 weeks
17 to 20 weeks
21 to 30 weeks
More than 30 weeks
I do not plan to return to work
Clear selection
How many hours per week do you (or did you) plan to 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
I do not plan to work
Clear selection
How many hours per week would you prefer (or did you prefer) to work when you return(ed) to 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
Would prefer not to work
Clear selection
What will you (or did you) do with your baby while you are (or were) working? (Check all that apply)
My baby will be cared for by a family member
I will keep my baby with me while I work at home
My baby will be cared for by someone not in my family
I have not decided yet
I will keep my baby with me while I work outside my home
I do not plan to work
What method do you plan to (or did you) use to feed your new baby in the first few weeks?
Breastfeed/human milk only (baby will not be given formula)
Formula feed only
Both breast/human milk and formula feed
Don't know yet
Clear selection
Do you (or did you) plan to continue breastfeeding after you return to work?
Yes
No
Do not (or did not) plan to work after the baby’s birth
Clear selection
How old do you think your baby will be (or were they) when you completely stop (or stopped) breastfeeding? (In months and weeks)
Your answer
How confident are you (or were you) that you will be (or would be) able to breastfeed until the baby is the age you marked in the previous question?
1 Not At All Confident
2
3
4
5 Very Confident
Clear selection
Have you obtained (or received) information about feeding babies from any of the following sources for this pregnancy or a previous one?
Yes
No
Doctor, nurse, or other health professional
Internationally Board Certified Lactation Consultant (IBCLC)
Breastfeeding Peer Counselor
Certified Lactation Counselor/Specialist (CLC/CLS)
WIC food program
Relative or friend
Books or videos
Newspaper or magazine
Television or radio
Website/social media
Community Organization
Home visitor
Case Manager
Other
Yes
No
Doctor, nurse, or other health professional
Internationally Board Certified Lactation Consultant (IBCLC)
Breastfeeding Peer Counselor
Certified Lactation Counselor/Specialist (CLC/CLS)
WIC food program
Relative or friend
Books or videos
Newspaper or magazine
Television or radio
Website/social media
Community Organization
Home visitor
Case Manager
Other
Have you received (or plan to receive) breastfeeding support from any of the following sources after your baby was (is) born?
Yes
No
Doctor, nurse, or other health professional
Internationally Board Certified Lactation Consultant (IBCLC)
Breastfeeding Peer Counselor
Certified Lactation Counselor/Specialist (CLC/CLS)
WIC food program
Relative or friend
Books or videos
Newspaper or magazine
Television or radio
Website/social media
Community Organization
Home visitor
Case Manager
Other
Yes
No
Doctor, nurse, or other health professional
Internationally Board Certified Lactation Consultant (IBCLC)
Breastfeeding Peer Counselor
Certified Lactation Counselor/Specialist (CLC/CLS)
WIC food program
Relative or friend
Books or videos
Newspaper or magazine
Television or radio
Website/social media
Community Organization
Home visitor
Case Manager
Other
Did you use or are you aware of breastfeeding resources that are culturally relevant to you? If yes, what are they?
Your answer
What was helpful during your breastfeeding experience?
Your answer
What would have been a wish for you during your breastfeeding experience?
Your answer
What is one strength you see in your community that supports the intention to breastfeed, the start of breastfeeding, and the continuation of breastfeeding for at least 6 weeks?
Your answer
What is one thing you would like to see implemented to support birthing families that supports breastfeeding intention, initiation and duration at 6 weeks?
Your answer
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