KAP, INTERVIEW SCHEDULE ON BREAST FEEDING PRACTICES

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Name of the Women:_________________________________ Age ( in completed years):_____________________________ Address:___________________________________________ Husband Occupation:_________________________________ Levels of Education: i. Illiterate ii. Just Literate/No formal education iii. Upto Primary iv. Upto Middle v. Upto Higher Secondary vi. Upto Graduation vii. Post Graduation and above

8. Does the mother work outside the house? 1. Yes 2. No If yes, What is her job?______________________ 9. Present Status of women? i. ii. iii. iv. v. Pregnant Baby of 0-2 months of age Baby of 2-4 months of age Baby of 4-6 months of age Baby of 6months -1 year of age Total _______,

10. Number of living children of the mother: Male_______, Female____ 11. Did you have check up during pregnancy? 1. Yes 2. No 12. If yes, By whom? i. Doctor ii. ANM/Nurse iii. TBA iv. Other (specify)________

13. Did anybody give you advice/guidance counselling on breastfeeding during check up? 1. Yes 2. No If yes, What was the content of this?_____________________________ 14. Where was the child [Name] born? i. Home ii. PHC/CHC iii. Govt. Hospital iv. Pvt. Hospital v. Other (Specify)_______ Type of delivery? i. Normal ii. Caesarian iii. Forceps

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16. After how much time after the birth of the child you started breastfeeding? i. Within one hour ii. 1-4 hours iii. 5-12 hours iv. 13-24 hours v. More than 24 hours. 18. Was anything given to the child [name] before starting the breastfeeding? 1. Yes 2. No 19. If yes, what was given: (More than one answer could be possible) i. Water ii. Artificial milk iii. Powder/tinned milk iv. Sugar Water v. Tea/Coffee vi. Gutti vii. Honey viii. Glucose ix. Gur x. Other (Specify) _________________

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If No in question 18, who told you not to give? i. Doctor ii. ANM/AWW/Nurse iii. Mother-in-law iv. Dai v. Husband vi. Other (Specify) __________

21. How many times did you breastfeed yesterday during the day? ___________ 22. How many times did you breastfeed last night? ______________________ 23.
24. ITEM

For how many months you plan to breastfeed?_____________

Did Baby receive any of the following item of food or drink from birth to up till now? Starting Age (Month) Yes No Regularly Sometimes

Mother's Milk Plain Water Sweetened Water with Sugar Gur/Glucose/Honey Tea/Coffee Fruit Juice/Aereated Drinks Cow/Goat/Buffalo Milk Powder/tinned Milk Others medicated fluid Solid or semi-solid (mushy) food Any other (Specify

25. Did drink anything from a bottle with a nipple since birth? 1. Yes 2. No 26. At what age did baby start receiving solid/semi-solid/mushy foods on a regular basis, i.e.daily/ _________ (in months) 27. If the baby is taking solid/semi-solid/mushy foods, please tell how many times during the last 24 hours?

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Should mother take extra diet while breastfeeding? 1. Yes 2. No Does breastfeeding help in reducing the weight of mother? 1. Yes 2. No

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30. Does the practice of giving prelacteal feeding like Ghutti, Gur, water delay starting of breastfeeding? 1. Yes 2. No 31. Should mother start feeding the child every time from different breast? 1. Yes 2. No How should mother feed the child i) On time schedule ii) On demand day and night

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33. Should mother continue to feed the child even when she is pregnant again? 1. Yes 2. No 34. In situations like cracked nipple/engorgement how you wil l feed your child? i) By expressing milk from breast through spoon ii) Give some other milk 35. Does breastfeeding help in delaying the next pregnancy? 1. Yes 2. No