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Idaho State University Graduate Nutrition Program

You are invited to participate in a research survey conducted by the members of the Department of Nutrition and Dietetics at Idaho State University.

The purpose of the survey is to learn about vitamin D supplementation in breastfed infants enrolled in WIC.

This survey will take about 5 minutes or less.

Your responses to this survey are anonymous and DO NOT affect your WIC benefits or eligibility for the program. By completing this survey, you indicate consent to participate.

If you have questions or concerns about the survey, feel free to contact the researchers at dietetic@isu.edu or the Idaho State University Human Subjects Committee at humsubj@isu.edu.

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* 1. Does your infant receive breastmilk at least once daily?

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* 2. In addition to breastmilk, does your infant receive MORE than 32 ounces of formula each day?

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* 3. How many days per week are you offering a vitamin D supplement to your infant?

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* 4. If you offer your infant a vitamin D supplement, please list the name brand and dose. If you aren't sure, type "unsure".

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* 5. If you are aware of the need for a vitamin D supplement for your infant, how did you learn about the need for this supplement? (For example: doctor, WIC, family, peer, etc.)

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* 6. If you DO NOT offer your infant a vitamin D supplement daily, please briefly describe why. (For example: cost, fear of safety, forget, unaware of need, etc.)

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* 7. What part of Idaho do currently live in?

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* 8. What age is the main caregiver of this infant? (Optional)

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* 9. What race most accurately describes your infant? (Optional)

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* 10. What best describes the relationship status of the primary caregiver of this infant? (Optional)

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