SurveyMonkey Powered Online Survey

Welcome!

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Thank you for taking the time to tell us about your experiences! In this survey, we're looking at a variety of topics related to breastfeeding, and we're grateful that you're here to share your thoughts.

As an extra thank you, when you complete this 4 minute survey, you will be entered into a draw to WIN one of five $100 gift cards to either Target or Sephora - your choice!

After this page, there will be another 5 short pages: they will ask you about breastfeeding out of your home, going back to work, how your partner factored in, and financial impact. The last page is a bit about you.

1. So we can be in touch if you win, please provide your contact information:

So we can be in touch if you win, please provide your contact information: Name:
Email Address:
Phone Number:

2. Your State or Province of residence:

Your State or Province of residence:

3. How many children do you have (if you are pregnant, please include that child)?

How many children do you have (if you are pregnant, please include that child)?

4. Your due date, or baby’s birthday (DD/MM/YYYY) (if you have several children, answer for your last child):

Your due date, or baby’s birthday (DD/MM/YYYY) (if you have several children, answer for your last child):

5. Right now, are you:

Right now, are you: Trying to conceive

Pregnant

Nursing, baby is 0-3 months

Not nursing, baby is 0-3 months

Nursing, baby is 3-6 months

Not nursing, baby is 3-6 months

Nursing, baby is 6-12 months

Not nursing, baby is 6-12 months

Nursing, baby is 1-3 years

Not nursing, baby is is 1-3 years

Child is 3+ years

I’m a grandparent/partner/friend

6. Please check which best describes you:

Please check which best describes you: I have previously breastfed, or am currently breastfeeding.

I have not previously breastfed. (For example, I am trying to conceive, pregnant now with my first, I have other child but did not breastfeed them, etc.)

7. At what point did you decide that you wanted to breastfeed?

At what point did you decide that you wanted to breastfeed? Before getting pregnant

Your first trimester of pregnancy

Your second trimester of pregnancy

Your last trimester of pregnancy

At the hospital, or just after you gave birth

I didn't breastfeed

8. What/who influenced your feeding decision, and in what way?

	Postively influenced (supported my decision)	Neutral/no influence	Negatively influenced (did not support my decision)
Research you did	*What/who influenced your feeding decision, and in what way? Research you did Postively influenced (supported my decision)	Research you did Neutral/no influence	Research you did Negatively influenced (did not support my decision)
Your partner	Your partner Postively influenced (supported my decision)	Your partner Neutral/no influence	Your partner Negatively influenced (did not support my decision)
Your mother	Your mother Postively influenced (supported my decision)	Your mother Neutral/no influence	Your mother Negatively influenced (did not support my decision)
Your mother-in-law	Your mother-in-law Postively influenced (supported my decision)	Your mother-in-law Neutral/no influence	Your mother-in-law Negatively influenced (did not support my decision)
Your grandmother, aunt, or family member other than your mother or mother-in-law	Your grandmother, aunt, or family member other than your mother or mother-in-law Postively influenced (supported my decision)	Your grandmother, aunt, or family member other than your mother or mother-in-law Neutral/no influence	Your grandmother, aunt, or family member other than your mother or mother-in-law Negatively influenced (did not support my decision)
Your friends	Your friends Postively influenced (supported my decision)	Your friends Neutral/no influence	Your friends Negatively influenced (did not support my decision)
Your partner's friends	Your partner's friends Postively influenced (supported my decision)	Your partner's friends Neutral/no influence	Your partner's friends Negatively influenced (did not support my decision)

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