13. Questionnaire Pemberian ASI Ekslusif

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    QUESTIONNAIRE

    Relationship of Knowledge, Attitude, and Behaviour BetweenMother Who Has Baby Above 6 Months Until 12 Months About

    Breast-feeding Milk with Lower Rate of Exclusive Breastfeeding

    at Working Territory of KAWUNGLUWUK, SUKARESMI Year

    2012

    I. Identity1. Name of mother/child :

    2. Dateof data collection :

    3. Address :

    4. Age of mother/child :

    5. Job

    a. Housewife

    b. Farmers

    c. Factory workers

    d. Police

    e. Seller

    6. Education

    a. None

    b. Elementary school

    c. Junior high school

    d. Senior high school

    e. University

    II. KNOWLEDGE

    1. Do you know about breast-feeding milk?

    a. Yes

    b. No

    90

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    2. Do you know about exclusive breast-feeding ?

    a. Yes

    b. No

    3. What is exclusive breat-feeding ?

    a. Breast-feeding for 6 months

    b. Breast-feeding for 4 months

    c. Breast-feeding for 12 months

    d. Breastmilk withfood/food additives companion breast-milk for 6 monthse. Dont know

    4. Do you know about colostrum?

    a. Yes

    b. No

    5.What is colostrum?

    a. The yellow first breast-fed term

    b. Milk bottle

    c. Breast-fed term

    d. Dont know

    6. How about giving colostrum to your baby?

    a. Yes

    b. No

    7. When should give the first time breast-fed in infants?

    a. 30 minutes after birth

    b. 3-4 hours after birth

    c. Waiting for the next day

    d. Waiting for 3 - 4 days after birth

    8. When the proper time give breast-fed in infants?

    a. Every time the baby want/cry

    b. Every 3 hours

    c. Everytime the mother want

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    9. How to breastfeed correctly your baby ?

    a. Only left breast

    b. Only right breast

    c. Alternate between the left and right breast

    10. Do you know about food/food additives companion breast-fed term?

    a. Yes

    b. No

    11. What is food/food additives companion breast-milk ?

    a. Food other breast milk

    b. Addition breast-fed milk

    c. Dont know

    12. When babies may given breast milk/food companion?

    a. 2 months

    b. 4 months

    c. > 6 months

    13. What kind of food additives companion breast-milk?

    a. Fruit/juice

    b. Biscuit

    c. Instant porridge

    d. Rice team

    e. Others

    14. How about giving breastmilk while mom is sick?

    a. Keep giving

    b. Replace with milk bottle

    c. Not given

    15. How about giving breastmilk while mom is going to work?

    a. Keep givingb. Replace with milk bottle

    c. Not given

    16. Until when will you giving breat milk for your baby?

    a. 6 months

    b. 1 year

    c. 2 years

    d. Until the child does not want to

    17. What are the benefits of breast milk for infants?

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    a. Babies growth and development

    b. Make baby satisfied

    c. Dont know

    18. What are the benefit of breastfeeding for mother?

    a. Help uterus faster to normal size

    b. Reduce bleeding after childbirth

    c. Decreased risk breast cancer

    d. Prevent pregnancy

    e. Dont know

    III. ATTITUDE

    1. Do you agree about exclusive breast-feeding?

    a. Agree

    b. Disagree

    2. Do you agree about breast-feeding the baby just after birth?

    a. Agree

    b. Disagree

    3. Do you agree to give colostrum to your baby?

    a. Agree

    b. Disagree

    4. Do you agree with the provision of complementary foods at the age less than 6

    months?

    a. Agree

    b. Disagree

    5. Do you agree with breastfeeding up to 2 years?

    a. Agree

    b. Disagree

    6. Do you agree with breastfeeding when child crying?

    a. Agree

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    b. Disagree

    7. Do you agree with the current breastfeeding while the mother is sick?

    a. Agree

    b. Disagree

    8. Do you agree with breastfeeding if the mother work?

    a. Agree

    b. Disagree

    9. Do you ever look at other mothers do not breast feed her baby?

    a. Yes

    b. No

    IV. BEHAVIOR

    1. Is your mother breastfeeding mothers?

    a. Yes

    b. No

    2. Are mothers gave the exclusive breastfed to the baby?

    a. Yes

    b. No

    3. Do you give colostrum (first breast-fed) to the baby?

    a. Yes

    b. No

    4. When was the first time a mother breastfeeding to their babies?

    a. 30minutes after birth

    b. 1 day after birth

    c. 3-4 day after birth

    5. Did you ever give bottle milk / formula milk to your babies when they was less

    than 6 months?

    a. Yes

    b. No

    6. Are you currently providing bottled milk / baby formula milk?

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    a. Yes

    b. No

    7. Are you currently providing complementary foods to the baby?

    a. Yes

    b. No

    8. At what age Mom started giving extra food to your baby?

    a. > 6 months

    b. 4 months

    c. < 2 months

    9. What kind of complementary food is given for the first time?a. Fruit/juice

    b. Biscuit

    c. Instant porridge

    d. Rice team

    e. Others

    10. Are you still breastfeeding your baby when you were sick?

    a. Yes

    b. Replace with milk bottle

    c. Not given

    11. Are you still breastfeeding your baby while working?

    a. Yes

    b. Replace with milk bottle

    c. Not given

    12. Until how old ASI will be given to the babies?

    a. 2 years

    b. 1 years

    c. 6 months