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The Questionnaires
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Download the Surveys |
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Each of the survey instruments used in the Infant Feeding Practices Survey
II is available in downloadable PDF format. |
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The Infant Feeding Practices Survey II followed women continuously from
early pregnancy throughout their infant’s first year of life. During the
pregnancy, each woman received a Prenatal Questionnaire, and a subsample of
1,500 of these women received the Diet History Questionnaire in the mail.
These questionnaires were followed by a telephone Birth Screener interview
around the expected date of delivery to determine whether the baby had been
born.
Each mother and baby was followed with a Neonatal Questionnaire mailed two
to four weeks after the baby's birth. Then came a series of nine Postnatal
Questionnaires mailed approximately monthly throughout the infant's first
year of life, each consisting of several modules sent in various
combinations according to a specified timeline.
(PDF-47k) When the infant was about 4 months old, another Diet History
Questionnaire was sent to a subsample of 1,500 to assess the mother’s diet.
To the extent possible, the postnatal Diet History Questionnaire was sent to
the same women who completed it prenatally.
The Consumer Opinion Panel members who participated in the Infant Feeding
Practices Study were given a name for their subpanel, "Project FIRST
(Feeding Infants Research STudy)." This name was used on all questionnaires
sent to IFPS respondents so that they would recognize the materials as being
part of the study.
With the exception of the Diet History Questionnaire and the Birth Screener,
all questionnaires asked families about their participation in the
USDA Special Supplemental Nutrition
Program for Women, Infants, and Children (WIC).
A Demographic Questionnaire was routinely sent to consumer opinion panel members. This questionnaire asked for basic demographic data
including age and sex of all household members, household size, race and
Hispanic ethnicity, marital status, education, employment status,
occupation, household income, and home ownership.
The Prenatal Questionnaire was
sent when the woman was in the third trimester of pregnancy. It focused on
factors associated with infant feeding choices, the baby's family medical
history, and the mother's employment and social support system.
The Prenatal and Postpartum Diet History Questionnaires collected
information from a subsample of mothers about their food consumption and
intake of nutrients from foods and dietary supplements. Using identical
questionnaires mailed near the end of pregnancy and about four months
postpartum, this part of the study provided information on the mother's
consumption of certain fortified foods, foods of concern during pregnancy
and lactation, alcohol intake, prenatal vitamin supplements, and herbal and
botanical preparations sometimes used for conditions of pregnancy or
breastfeeding. Until the IFPS II, little was known about the use of herbal
products among pregnant and lactating women.
The Birth Screener consisted of a very short telephone interview with any
adult household member to determine whether the infant had been born and to
determine whether the family qualified to continue their participation in
the study. If the family could not be reached by telephone, they were mailed
a postcard asking them to dial into an Interactive Voice Response
questionnaire. If they did not respond to the post card, they were mailed a
copy of the Birth Screener questions along with the Neonatal Questionnaire
around the time they would have received this questionnaire if the baby had
been born on the due date. To qualify, women and their infants had to meet
these criteria:
- Healthy infant and mother
- Full-term or near-term birth
- Birth weight of at least 5 pounds
- A single birth (no twins or multiple births)
The Neonatal Questionnaire was sent to the
mother when her infant is approximately three weeks old. This questionnaire
examined factors that commonly occur near the time of the birth and that
affect infant feeding choices. It also asked about early feeding
practices (including herbal intake by the infant), sources of information,
sources of support, and any feeding-related treatment for jaundice.
The Postnatal Questionnaires consist of various combinations of eight
modules that were mailed to the mother approximately monthly from the time
her infant is 2 months through 7 months of age, then three times (about
every 7 weeks) until 12 months of age. Many of the modules include questions
that are asked in some months but not others. View the timetable
timetable (PDF-43k) for the administration of
each topic.
Module A: Infant Feeding and Health
Module A was sent with each Postnatal Questionnaire. This module
contained one of the major measures of the study, the infant's food frequency
checklist. It also asked about dietary supplement and herbal intake by
infants, details about breastfeeding and infant formula feeding, infant
health and use of medicines, infant weight and length, stool
characteristics, and feeding of commercial baby foods. In month 2 only, it
included a measure of postpartum depression.
The food frequency checklist in Module A enabled analysts to examine
these types of questions:
- Infant's age when introduced to solid food and the age when introduced
to specific food groups
- The infant's feeding schedule
- Feeding of allergenic foods
- Once supplemental foods are introduced, the frequency of feeding each
food group at each month of infancy
- Any changes in eating patterns from month to month
- The number of feedings per day of infant formula and breast milk
In addition, the checklist enabled researchers to analyze patterns of
breastfeeding exclusivity, in particular whether mothers occasionally gave
formula to an infant who is otherwise exclusively breastfed. Patterns of
feeding foods other than breast milk and formula indicated the extent to
which mothers followed current infant feeding guidelines, such as those
published by national professional organizations. Information on whether
foods fed to infants are baby foods or not provided information about
exposure of infants to foods marketed for older children and adults,
including foods fortified at levels only appropriate for older age groups.
Module B: Breastfeeding Cessation
Questions regarding breastfeeding cessation were included on each Postnatal
Questionnaire, but they were answered only once, just after the mother had
completely stopped breastfeeding. This module established the infant age
when breastfeeding ceased and asked reasons for breastfeeding cessation and
attitudes toward breastfeeding.
Module C: Food Allergy
The food allergy segment asked whether the mother believed that the infant
had a food allergy, details of the implicated food, and details of the
infant's symptoms, diagnosis, and treatment. Module C was sent at infant
ages 4 months, 9 months, and 12 months.
Module D: Breastfeeding
Module D asked for details about breastfeeding, the mother's sources of
information, any maternal dietary change due to breastfeeding, her reasons
for supplementing with formula or other foods, and details of her experience
expressing breast milk manually or with a breast pump. Module D also
included a measure of the mother's embarrassment about breastfeeding and how
she managed breastfeeding and work. This module was sent
three times, at months 2, 5, and 7.
Module E: Infant Formula
Module E asked for details about formula feeding, formula label use and
understanding, sources of information, brand choice, brand changing, and
food safety practices. It asked for type of formula fed to the infant but not
specific formula brand. Understanding current practices will contribute to
more relevant and targeted consumer education. Information about a mother's
use of infant formula labels and her evaluation of labels indicated how
well the different parts of the label communicate to mothers. Module E was sent four times, at months 2, 5, 7, and 9.
Module F: Information Sources
Module F had questions that were not asked together, but rather were
inserted among questions in the other modules as appropriate. A question
about sources of information on herbal products was sent at months 3 and 10.
Questions about information sources for breastfeeding were sent in month 2,
and questions about information sources for general infant feeding were sent
in months 4 and 10.
Module G: Breastfeeding Awareness Campaign Evaluation
Module G included the direct measures of the mother's awareness of the
National Breastfeeding Awareness Campaign messages and whether she agreed
with those messages. Like those questions presented in Module F, questions from Module
G were not asked as a separate module but rather as questions
incorporated at appropriate places in other modules. Questions from Module G
were sent in months 3 and 7.
Module H: Sleeping Arrangements, Child Care, Employment, and Health
Module H asked about all topics other than feeding. These included sleeping
arrangements and position; child care and child care support for
breastfeeding; details of the mother's employment and employer support for
breastfeeding; how mothers managed to combine breastfeeding and work for pay;
and the mother's overall health, weight status, and tobacco use. Module H
was sent in months 3, 6, 9, and 12. A question about exposure to
sunlight was administered at infant age 9 months.
Module J:
Questions about WIC participation and any severe health problems the infants
may have encountered were placed at the end of each Postnatal Questionnaire.
The presence of severe health conditions disqualified infants from
participating in the rest of the study. Certain questions from other modules
that did not fit elsewhere were also included in Module J in the months
those modules were administered.
The Non-pregnant/Non-postpartum Diet History Questionnaire was
identical to the prenatal and postpartum versions. It was sent to a sample
of 1,400 non-pregnant/non-postpartum women of child-bearing age for
comparison purposes.
Download the Surveys
List of questionnaires used in the IFPS II, in sequential order:
Demographic
Diet History Questionnaires (DHQ)
Prenatal
Birth Screener
Neonatal
Month 2
Month 3
Month 4
Month 5
Month 6
Month 7
Note: There was no Month 8 Questionnaire.
Month 9
Month 10.5
Month 12
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