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Breastfeeding Knowledge

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Age
 
Less than 30
 
31-40
 
41-50
 
51-60
 
More than 60
 
 
 
Sex
 
Female
 
Male
 
 
 
Role
 
Physician
 
Registered Nurse
 
Pharmacist
 
Physician Assistant
 
Nurse Practitioner
 
Certified Nurse Midwife (CNM)
 
Resident
 
Medical Student
 
Other
 
 
 
 
Specialty
 
Anesthesiology
 
Allergy
 
Dermatology
 
Emergency Medicine
 
Family Medicine
 
Gastroenterology
 
Internal Medicine, Generalist
 
Internal Medicine, Specialist
 
Medical Student
 
Med-Peds
 
Neurology
 
OB
 
Pathology
 
Pediatrics, Generalist
 
Pediatrics, Specialist
 
PM&R (Physical Medicine and Rehabilitation)
 
Psychiatry
 
Radiology
 
Surgery, generalist
 
Surgery, specialist
 
Other
 

 
 
 
Years in practice
 
< 5 years
 
6-15 years
 
16-25 years
 
More than 25 years
 
Not applicable
 
 
 
What percentage of your patients are mothers of children less than 1 year of age?
 
None
 
Up to 25%
 
25-50%
 
50-75%
 
75-100%
 
 
 
How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
 
What percentage of your patients are children 0-1 year?
 
None
 
Up to 25%
 
25-50%
 
50-75%
 
75-100%
 
 
 
How many children have you/your partner given birth to, if any?
   
 
 
 
If you do not have children, please skip to question 12

Were your children breastfed?
 
Yes
 
No