PostPartum Support
Did you take a breastfeeding class?
Yes
No
Were you separated from your baby after birth?
How soon did your baby latch after birth?
Who assisted you and baby?
Did you see lactation in birth hospital?
Yes
No
How satisfied were you on a scale of 1-10?
Did you supplement with formula?
Yes
No
Did you use bottles or pacifiers after birth?
Did you use any tools to assist with feeding?
Cups
Spoons
Syringe
Tubes
How would you say breastfeeding is going?
Excellent
Good
Ok
Terrible
Did/Does your baby have the following?
Jaundice
Hypothermia
Slow Weight Gain
Sleepy at Breast
Are you experiencing the following?
Painful Latch
Low Milk Supply
Engorgement
Mastitis
Plugged Ducts
Other
What are your concerns?
Are you and your family experiencing hard times and need help with supplies? Please list what is needed.
Submit
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