Survey for Past and Present Nursing Mothers
What is your name?
Your answer
What is your email address?
Your answer
Mother's age
Your answer
This survey covers baby number
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How many months did you exclusively breastfeed (This means no water, liquids or solids; only mother's milk)?
Your answer
How many months did you nurse your baby?
Your answer
Did your baby use a pacifier? If so, when?
Your answer
Did your baby use a bottle? If so, when?
Your answer
Did you co-sleep with your nursing baby during the night? if so, for how long?
Your answer
Did you nurse lying down for your daily nap?
Your answer
Did you nurse lying down during the night?
Your answer
When did you finally leave your baby home with others?
Your answer
Did you stay close to your baby in the home?
Your answer
Did you nurse your baby frequently?
Your answer
Did your baby liked to be nursed to sleep?
Your answer
Were there other times when the baby liked to be pacified at the breast?
Your answer
Did you feed your baby by a schedule?
Your answer
How old was your baby when he or she began to take solid food?
Your answer
How old was your baby when he or she began to take liquids?
Your answer
How many months did you rely on ecological breastfeeding for postpartum infertility?
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Did you rely ONLY on breastfeeding amenorrhea before your periods returned?
Your answer
If you relied on breastfeeding for birth spacing, when did you conceive again or have you?
Your answer
Did you encourage or hasten weaning?
Your answer
Did you let the baby wean on its own?
Your answer
How old was your baby when your first postpartum period returned?
Your answer
Explain if possible the return of your periods (e.g. weaning, sickness, etc.)
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Was there any other possible reason for decreased nursings 2-4 weeks before the return of your periods?
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Any comments?
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