Infant Feeding Survey Question Title * 1. What race/ethnicity best describes you? (Please choose only one) White (Non-Hispanic) Black/African American (Non-Hispanic) Hispanic/Latino American Indian/Alaska Native (Non-Hispanic) Asian (Non-Hispanic) Two or more races If not listed, please self-identify Question Title * 2. What is your zip code? 53501 53505 53511 53512 53525 53534 53536 53537 53542 53545 53546 53547 53548 53563 Other (please specify) Question Title * 3. What is your highest level of education? 8th grade or less Some High School High School/GED Some College Associate’s Degree/ Technical school graduate Bachelor’s Degree Master’s Degree Advanced Degree (Ph.D., M.D., etc) Question Title * 4. How do you describe yourself? (Please choose only one) Male Female If not listed, please self-identify Question Title * 5. Are you currently employed? Yes No If yes, where Question Title * 6. What support services have you used/are you currently using? (Select all that apply) None Women, Infants, Children (WIC) ECHO First Choice Health Care Center Doula Rock County Public Health Department Salvation Army Beloit Community Health System SNAP/QUEST Health care providers (doctor, nurse, midwife) Lactation consultant Le Leche League Child care provider Medicaid Other _____________ Question Title * 7. In your opinion, what is the best way to feed a baby? Breastfeeding is the best way to feed your baby Breastfeeding is ideal, but formula feeding is okay Formula is the best way to feed your baby There is no nutritional difference between breastfeeding and formula feeding Question Title * 8. Mothers should be able to breastfeed their child anywhere they want. Strongly agree Agree Neutral Disagree Strongly disagree Question Title * 9. Women should have accommodations for breastfeeding in the workplace. Strongly agree Agree Neutral Disagree Strongly disagree ________________________________________ If you are a parent or guardian, please continue with the survey. If not, stop here Question Title * 10. Are you a parent or a guardian? Yes No Next