Prenatal Breastfeeding Survey

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Lake ForestSan ClementeSan Juan Capistrano

Please answer with the response that most closely describes how you feel about each statement.
1. Breastfeeding is more convenient than formula feeding.
AgreeNeitherDisagree
2. Breast milk is healthy for the baby.
AgreeNeitherDisagree
3. Breast milk is more nutritious than infant formula.
AgreeNeitherDisagree
4. Breastfeeding makes your breasts sag.
AgreeNeitherDisagree
5. Breastfeeding makes you closer to your baby.
AgreeNeitherDisagree
6. Breastfeeding makes returning to work more difficult.
AgreeNeitherDisagree
7. Breastfeeding is more economical than formula feeding.
AgreeNeitherDisagree
8. When you breastfeed you never know if the baby is getting enough milk.
AgreeNeitherDisagree
9. Mothers who formula feed get more rest than breastfeeding mothers.
AgreeNeitherDisagree
10. Breastfeeding is more time consuming than formula feeding.
AgreeNeitherDisagree
11. Breastfeeding is messy.
AgreeNeitherDisagree
12. Breastfeeding ties you down.
AgreeNeitherDisagree
13. Breastfeeding helps you bond with your baby.
AgreeNeitherDisagree
14. Breastfeeding is better than formula.
AgreeNeitherDisagree
For each of the following individuals, indicate how they think you should feed your infant.
15. The baby's father thinks I should:
Feed FormulaNo OpinionFeed Breast Milk
16. My mother thinks I should:
Feed FormulaNo OpinionFeed Breast Milk
17. My mother-in-law thinks I should:
Feed FormulaNo OpinionFeed Breast Milk
18. My sister thinks I should:
Feed FormulaNo OpinionFeed Breast Milk
19. My doctor thinks I should:
Feed FormulaNo OpinionFeed Breast Milk
Please indicate whether you agree or disagree with the following statements: Would YOU…
20. I have the necessary skills to breastfeed.
AgreeNeitherDisagree
21. I am physically able to breastfeed.
AgreeNeitherDisagree
22. I know how to breastfeed.
AgreeNeitherDisagree
23. I am determined to breastfeed.
AgreeNeitherDisagree
24. I won't need help to breastfeed.
AgreeNeitherDisagree
25. Breastfeeding is easy.
AgreeNeitherDisagree
26. I am confident I can breastfeed.
AgreeNeitherDisagree