FORM 2: FATHER'S QUESTIONNAIRE

PART 1: IDENTIFICATION / No
A / B / C / D

A: 1. Guntur, 2. Gajah B. Form number, C. Visit number ..? D. Participant number..

  1. Name
/ : / 2.1.1.
  1. Address
/ : / 2.1.2.
Dukuh/dusun
RT RW / 2.1.3.
Village : / 2.1.4.
Subsdistrict: 1. Guntur 2. Gajah / 2.1.5.
Telephone number / 2.1.6.
Father's name / 2.1.7.
Mother's name / 2.1.8.
Place and date of birth of father / : / Usia: tahun / 2.1.9.
Education of father / : / …………………………………………
…. tahun / 2.1.10.
Occupation of father / : /
  1. Government employee
  2. Private
  3. Merchant-entrepreneur
  4. Farmers
  5. Housewife
  6. Other: please specify......
/ 2.1.11.

Interviewer's name: ______Sign ______

Date of interview……………………………………... / 2 / 0
Visit number / 2nd / 3rd / 4th / d / d / m / m / y / y / y / y

Supervisor's name ………………………………………….Sign ………………………….

Date of checked ……….…………………...... ……… / 2 / 0
d / d / m / m / y / y / y / y

PART 2: PRACTICE

I want to ask you a little bit about yourself and your activities related to breastfeeding

Does father have plans or desire for that mother to breastfeed her baby? / 1. Yes / 2. No, go to Part 2 / 221
If yes : For how long the mother should breastfeed the baby? / ______/ months / 222
How far father wants to the mother breastfeed her baby? /
  1. I really want the mother to breastfeed her baby,
  2. Sometimes I want mother to breastfeed their baby, sometimes I do not want
  3. Sometimes I think, a better formula
  4. I think a better formula
  5. Not sure
/ 223
How confident you are on the mother's ability to breastfeed her child? /
  1. Feel confident with the mother's ability to breastfeed
  2. Feel not confident with the mother's ability to breastfeed
  3. Do not know
/ 224

PART 3: KNOWLEDGE

Now, I will say a few things related to breastfeeding. Please, give your statement what I say True or False. (Put a check mark √ in the column: true or false)

No / Statement / True / False
The first yellowish breastmilk should be thrown out / 0 / 1
Colostrum is the baby's first immunization / 1 / 0 / 2b.7.1.
Children who are not breastfed are more susceptible to illness / 1 / 0 / 2b.7.2.
If within 1-2 days after birth, breasts produce less milk, babies need to be given formula or other foods / 0 / 1 / 2b.7.3.
Baby born will decrease weight, and will be back to birth weight in 2 weeks / 1 / 0 / 2b.7.4.
Onday1-2, ababy's stomach is about thesizeof a shootermarble / 1 / 0 / 2b.7.5.
Baby suckles at the nipple rather than at the breast / 0 / 1 / 2b.7.6.
Mothers who do not breastfeed their babies are more susceptible to anemia / 1 / 0 / 2b.7.7.
If the mother has breastfeeding difficulties, the baby can be given formula or other foods / 0 / 1 / 2b.7.8.
Babies cry because of a hunger / 0 / 1 / 2b.7.9.
Babies crying is a sign that breastmilk are not enough / 0 / 1 / 2b.7.10.
Giving only breastmilk until the age of 6 months and then start another foods / 1 / 0 / 2b.7.11.
The mother should let her baby finish one breast before she offers the other breast / 1 / 0 / 2b.7.12.
Breast care is important. Breasts need to be washed before breastfeeding / 0 / 1 / 2b.7.13.
Breastfeeding often and long may increase the milk supply / 1 / 0 / 2b.7.14.
Expressing breastmilk will not increase the supply of breastmilk in the breast / 0 / 1 / 2b.7.15.
A thin milk is a sign of a poor quality of breastmilk / 0 / 1 / 2b.7.16.
Breast engorgement can be solved with warm water compresses on the breast / 1 / 0 / 2b.7.17.
Nursing mother needs to eat at least one plate more than usual / 1 / 0 / 2b.7.18.

SECTION 4: ATTITUDES

Give your opinion on the statement which I will read.

(please mark X in the bottom of the column strongly agree, agree, disagree or strongly disagree)

No / Statement / Strongly agree / agree / Disagree / Strongly disagree
Breastfed children are often thin and do not grow well / 1 / 2 / 3 / 4 / 2b.8.1.
Actually breast milk alone can satisfy the baby until the age of 6 months / 4 / 3 / 2 / 1 / 2b.8.2.
Father feels disgusted if the baby continues to be placed on the mother's chest immediately after birth / 1 / 2 / 3 / 4 / 2b.8.3.
Breastfeeding at night is not important / 1 / 2 / 3 / 4 / 2b.8.4.
Cracked nipples in breastfeeding is normal / 1 / 2 / 3 / 4 / 2b.8.5.
One of the ways that I can be closed to the baby is to bottle feed the baby / 1 / 2 / 3 / 4 / 2b.8.6.
I feel ignored when mother breastfeeds their baby / 1 / 2 / 3 / 4 / 2b.8.7.
Father will be embarrassed when mother breastfeeds baby in a public place / 1 / 2 / 3 / 4 / 2b.8.8.
Breastmilk is good, but it would be better if the children were given formula milk as well / 1 / 2 / 3 / 4 / 2b.8.9.
Breastfeeding will make breasts saggy / 1 / 2 / 3 / 4 / 2b.8.10.
Pacifier is good for calming a fussy baby / 1 / 2 / 3 / 4 / 2b.8.11.
Breastfeeding is a simple thing / 4 / 3 / 2 / 1 / 2b.8.12.
Bottle feeding is better than breastfeeding / 1 / 2 / 3 / 4 / 2b.8.13.
Breastfeeding can lose mother's body weight after giving birth / 4 / 3 / 2 / 1 / 2b.8.14.
Father feels that breastfed only until 6 months may not fulfill the baby's needs. / 1 / 2 / 3 / 4 / 2b.8.15.
Breastfeeding is ancient (less modern) / 1 / 2 / 3 / 4 / 2b.8.16.
It is very difficult to give only breast milk until the age of 6 months / 1 / 2 / 3 / 4 / 2b.8.17.
Father feels pity if the baby cries often so that the baby should be given formula or other foods / 1 / 2 / 3 / 4 / 2b.8.18.
19 / Need to learn how to breastfeed / 4 / 3 / 2 / 1 / 2b.8.19.
Please observe and note interesting things during the interview

Thank you for taking the time to participate in this study.