Health

How long has your baby been breastfed?

Never

Less than 3 months

Less than 6 months

Less than 9 months

Less than 12 months

1 year

2 years

3 years

4 years

5+ years

How old is your baby?

How often does your baby get sick?

More than most babies

The same as most babies

Less than most babies

Has your baby been diagnosed with any of the following:

If your child was diagnosed with any of the above conditions, please tell us the age of the child at diagnosis.

Have you been diagnosed with any of the following:

Type 2 Diabetes

Breast cancer

Ovarian cancer

If you have been diagnosed with any of the previous conditions, please tell us if the diagnosis came before or after the birth of your baby.

If you are employed outside the home, how many days have you had to take off to care for your sick baby?

Have you had to bring your baby to the emergency room or have they been hospitalized?

No

Yes

If you answered YES to the last question, please tell us when and why your child was in the emergency room or hospital.