| Type of birth |
| a. Vaginal b. Cesarean |
| Did you have a single birth or multiples? |
| a. Single birth b. Twins c. Triplets |
| Baby’s gestational age in weeks: _____ |
| Have you given birth to any other children? |
| Did you breastfeed your other children? |
| Are you still breastfeeding the child you just gave birth to? |
| If you are still breastfeeding, are you breastfeeding exclusively or offering supplements? |
| a. Breastfeeding exclusively with no supplements |
| b. Breastfeeding with one supplement per 24 hours |
| c. Breastfeeding with 2–3 supplements per 24 hours |
| d. Breastfeeding with 4 or more supplements per 24 hours |
| If you are supplementing, are you supplementing with (check all that apply): |
| a. Expressed breastmilk |
| b. Formula |
| c. Other |
| While you were in the hospital, can you remember when the first time you breastfed your baby? |
| a. Within the first hour of birth |
| b. Within 2–3 hours of birth |
| c. Within 4–6 hours of birth |
| d. Within 7–24 hours of birth |
| e. After 24 hours of birth |
