Premature Infant Breastfeeding Survey

Are you a mother of a premature infant whose infant was in the NICU?

The Central Coast Breastfeeding Coalition needs your help!!! Our coalition is made up of Lactation Consultants throughout San Luis Obispo County.  

We are interested in your breastfeeding experience. Our hope is to improve the breastfeeding experience for current and future mothers of premature babies in our community.

Would you be willing to complete the following short survey?  We anticipate this survey will take 15-20 minutes to complete. Your identity and answers will be kept strictly confidential unless you would like to share your name with us. With your help, we hope to identify the needs of breastfeeding mothers with premature babies along the central coast.

 

Name (Optional)
Name (Optional)
Phone (Optional)
Phone (Optional)
BEFORE BIRTH
1. Are you a mother of a premature infant whose infant was in the NICU?
(if yes, skip to question 3)
2. If no, did you breastfeed any of them?
3. While you were pregnant with this baby, did you plan to breastfeed? 
(if yes, skip to question 6)
4. If you didn’t plan to breastfeed, did this change after the baby was born? 
(if no, skip to question 6)
DURING HOSPITAL STAY
10. While in the NICU, were you able to breastfeed your baby? 
(if no, skip to question 14)
11. How often were you able to do this? 
12. Did you breastfeed your baby as often as you wanted while he/she was in the NICU?
(if yes, skip to question 14)
14. At time of discharge, which of the following best describes your baby’s feeding?
(Please check all that apply)
15. At discharge were you providing
16. Did you find the breastfeeding education & support you received in the NICU helpful?
(if yes, skip to question 18)
18. Before discharge did you receive any information about breastfeeding resources and support groups available in the community?
AFTER DISCHARGE
20. When your baby was discharged from the hospital, did you still plan to breastfeed your baby at home? 
21. Were you able to do any breastfeeding at home?
25. Were you ever able to exclusively breastfeed your baby? 
(if no, skip to question 27)

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