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MY DAUGHTER
This questionnaire asks about your baby. We are interested to know about her health and behaviour. We also ask about you and your baby and the reaction of any other children you might have to the baby. Your answers will help us to understand the developing child and identify problems that babies and their parents have.
The questionnaire is like other questionnaires you have received. To answer simply tick the box which best describes your baby or your baby's situation. Some questions will seem similar but they are not the same. Please answer all questions that you can. If you cannot answer any question or a question does not apply to you please put a line through them. There are no right or wrong answers. Please just describe what happens in your situation. You may make additional comments at the end.
All answers are confidential.
THANK YOU FOR YOUR HELP
SECTION A: YOUR BABY

How would you assess the health of your baby: In the first few months

1
very healthy, no problems
2
healthy, but a few minor problems
3
sometimes quite ill
4
almost always unwell

How would you assess the health of your baby: In the past month

1
very healthy, no problems
2
healthy, but a few minor problems
3
sometimes quite ill
4
almost always unwell
How many of the following immunisations has the baby had? (If you are unsure put 9, if no immunisations put 0)
Number
How many
No. of BCGs (for tuberculosis)
No. of DTP or Triple (includes whooping cough)
No. of DT (without whooping cough)
No. of Polio
No. of Hib (for meningitis)

No. of other immunisations (please describe)

How many
Other

Did she have a temperature or was she unwell after any immunisation?

1
Yes
2
No
If no, go to A3, on page 4
If yes, please describe
qc_A2_g == 1

which immunisation:

Generic text

how long after the immunisation did this start?

1
under 3 hours
2
3-24 hours
3
1-2 days
4
3-6 days or
5
1 week or more
9
don't know

what happened?

Generic text

Has she had fluoride treatment?

1
Yes
2
No
9
Don't know

Has the doctor ever been called to the house because your baby was ill?

1
Yes
2
No
If no, go to A5a
If yes,
qc_A4_a == 1

how many times?

1
once
2
twice
3
3-4 times
4
5 or more times

Has your baby been taken to the doctor because she had a problem you were worried about?

1
Yes
2
No
If no, go to A6
If yes,
qc_A5_a == 1

how many times

1
once
2
twice
3
3-4 times
4
5 or more times

Has your baby had any of the following: diarrhoea

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: blood in the stools

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: vomiting

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: cough

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: high temperature

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: snuffles/cold

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: ear ache

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: ear discharge (pus not wax)

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: convulsions/fits

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: colic

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: rash

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: wheezing

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: breathlessness

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: episodes of stopping breathing

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: an accident

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have

Has your baby had any of the following: other (please describe)

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have
Other

Has your baby ever been admitted to hospital?

1
Yes
2
No
If no, go to A8, on page 6
If yes,
qc_A7_a == 1

how many times?

How many
please describe for each admission:
Age of baby (months) Reason for admission No. of nights baby stayed
How manyAge in monthsGeneric textHow manyAge in monthsGeneric textAge in monthsGeneric textHow many How manyAge in monthsGeneric textHow manyAge in monthsGeneric textAge in monthsGeneric textHow many How manyAge in monthsGeneric textHow manyAge in monthsGeneric textAge in monthsGeneric textHow many
1
2
3
4

How often did you see your baby while she was in hospital?

1
not at all
2
quite often
3
every day
4
all the time

Did you stay overnight in hospital with your baby?

1
Yes
2
No

Has your child had the following? hernia repair

1
Yes
2
No

Has your child had the following? other operation (please describe)

1
Yes
2
No
Other

How often has your baby gone to the Child Health Clinic or Baby Clinic?

1
not at all
2
once
3
2-3 times
4
4-5 times
5
6 or more times
9
don't know

Has your baby ever had wheezing with whistling on her chest when she breathed?

1
Yes
2
No
If no, go to A10h, on page 8
If yes,
qc_A10_a == 1

How many separate times has this happened

1
once
2
twice
3
3-4 times
4
5 or more times
9
don't know

How many days altogether would you say she had wheezed?

1
1
2
2-3
3
4-9
4
10-19
5
20 or more
9
don't know

Was she breathless during any of these times?

1
Yes for all
2
Yes for some
3
No not at all

Did she have a fever during any of these times?

1
Yes for all
2
Yes for some
3
No not at all

How old was she? for the first occurrence: ... months

Age in months

How old was she? for the most recent occurrence: ... months

Age in months

What do you think brings them on? chest infection or bronchitis

1
Yes
2
No
9
Don't know

What do you think brings them on? being in a smoky room

1
Yes
2
No
9
Don't know

What do you think brings them on? cold weather

1
Yes
2
No
9
Don't know

What do you think brings them on? other (please describe)

1
Yes
2
No
9
Don't know
Other

Have any of your other children had episodes of wheezing with whistling on the chest?

1
Yes
2
No
7
have no other children

Has the baby had a rash in the joints and creases of her body (e.g. behind the knees, under the arms)?

1
Yes
2
No
If no, go to A12
If yes,
qc_A11_a == 1

how bad was this?

1
very bad
2
quite bad
3
mild
4
no problem

does she have this sort of rash now?

1
Yes
2
No

Has she had an itchy, dry, oozing or crusted rash on the face, forearms or shins?

1
Yes
2
No
If no, go to A13, on page 9
If yes,
qc_A12_a == 1

how bad was this?

1
very bad
2
quite bad
3
mild
4
no problem

does she have this sort of rash now?

1
Yes
2
No

Has she had a nappy rash?

1
Yes
2
No
If no, go to A14
If yes,
qc_A13_a == 1

how bad was this?

1
very bad
2
quite bad
3
mild
4
no problem

does she have this sort of rash now?

1
Yes
2
No

Has she had cradle cap (scaly or crusty scalp)?

1
Yes
2
No
If no, go to A15, on page 10
If yes,
qc_A14_a == 1

how bad was this?

1
very bad
2
quite bad
3
mild
4
no problem

was there redness with it?

1
Yes
2
No

was there itching with it?

1
Yes
2
No

is there any cradle cap now?

1
Yes
2
No

Does she ever posset (bring up small vomits)?

1
yes often
2
yes sometimes
3
no

Has she ever vomited (brought up most or all of her meal)?

1
yes often
2
yes sometimes
3
yes once
4
no not at all

How many times a day (24 hours) does she usually dirty her nappy nowadays?

1
4 or more times
2
2 - 3 times
3
once a day
4
once in 2-4 days
5
once a week
9
can't say

How often are her stools: hard

1
Usually
2
Sometimes
3
Never

How often are her stools: soft

1
Usually
2
Sometimes
3
Never

How often are her stools: curdy

1
Usually
2
Sometimes
3
Never

How often are her stools: liquid

1
Usually
2
Sometimes
3
Never

How often are her stools: green

1
Usually
2
Sometimes
3
Never

How often are her stools: brown

1
Usually
2
Sometimes
3
Never

How often are her stools: black

1
Usually
2
Sometimes
3
Never

How often are her stools: yellow

1
Usually
2
Sometimes
3
Never

Has she ever had diarrhoea or gastro-enteritis?

1
Yes
2
No
If no, go to A20a, on page 12
If yes,
qc_A19_a == 1

how many times?

How many

how many days did the worst bout last?

How many

Did you: call the doctor to come to your home

1
Yes
2
No

Did you: go to your doctor

1
Yes
2
No

Did you: treat it yourself

1
Yes
2
No

Did you: other (please describe)

1
Yes
2
No
Other

Did you continue feeding as usual?

1
Yes
2
No
If yes, go to A19f, below
If no,
qc_A19_e == 2

how long was normal feeding disturbed?

1
less than 1 day
2
1 day
3
2 days
4
3-4 days
5
5 or more days

Was the baby treated with an oral rehydration solution?

1
Yes
2
No
9
Don't know
If no, go to A19g, on page 12
If yes,
qc_A19_f == 1

give type if known:

Generic text

how long was the solution given?

1
less than 1 day
2
1 day
3
2 days
4
3-4 days
5
5 or more days

What other treatment was given?

Generic text

Has your child ever had a time when she has coughed for at least 2 days?

1
Yes
2
No
If no go to A21, on page 13
If yes,
qc_A20_a == 1

how old was she when this first happened? (Put 0 if less than 1 month) ... months

Age in months

how many times has this happened?

1
once
2
twice
3
3-9 times
4
10 or more times

did she have a fever at any of these times?

1
Yes for all
2
Yes for some
3
No not at all

did she have a runny nose during any of these spells?

1
Yes for all
2
Yes for some
3
No not at all
Your baby's hearing
The following questions are about your baby's ears or hearing.

Generally, does your baby listen to people or to things that happen nearby:

1
Yes usually
2
Yes often
3
Sometimes
4
Usually not
9
Don't know

Does she turn her head towards sounds?

1
only to very loud sounds
2
yes usually
3
yes sometimes
4
never turns towards sounds
5
don't know

During or after a cold, is her hearing worse than usual?

1
yes much worse
2
yes a little worse
3
no, about the same
7
has never had a cold
9
don't know

During a cold, is the dripping (discharge) from your baby's nose:

7
Hasn't had a cold
During a cold, is the dripping (discharge) from your baby's nose:
-

1 - Yes

2 - No

clear
slightly white in colour
thick heavy yellow and/or green in colour (catarrh)
very little discharge occurs at all
don't know

Does she pull, scratch or poke at her ears?

1
quite often
2
only at times when poorly, fretful, or in pain
3
hardly ever
9
don't know

Do her ears go red and sore looking for a long time? (Remember - an ear that has just been slept on may look red for a short time.)

1
quite often
2
only at times when poorly, fretful, or in pain
3
hardly ever
9
don't know

Has pus or a sticky mucus (not ear wax) ever leaked out of her ear?

1
never
2
once
3
more than once
9
don't know

Does she breathe through her mouth rather than through her nose?

1
all the time
2
much of the time
3
rarely
4
never
9
don't know

Does she snore for more than a few minutes at a time?

1
most nights
2
quite often
3
only rarely
9
don't know

When she is asleep, does she seem to stop breathing or hold her breath for several seconds at a time?

1
yes, often
2
yes, sometimes
3
no
9
don't know
SECTION B: ACCIDENTS AND INJURIES
However careful a parent is, most children have accidents at some time or other. Please list on the next pages the times your child has had an accident whether or not she was injured as a result.

Has your child ever been burnt or scalded?

1
Yes
2
No
If no, go to B2a, on page 18
If yes,
qc_B1_a == 1

how many times?

How many
For each burn or scald please describe below what happened:
Place accident happened (eg. kitchen, garden, creche) What was she burnt with? (e.g tea, iron, electric fire) Date of accident (month, year) Injuries caused (if no injury write none) Who was with the baby? What did the person with the baby do? What did the person with the baby do? Other (please describe) What treatment did the person with the baby give? What other treatment did she have?
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
1st accident
2nd accident
3rd accident

Please describe how each accident happened: Burn 1

Generic text

Please describe how each accident happened: Burn 2

Generic text

Please describe how each accident happened: Burn 3

Generic text

Has your child ever been dropped or had a fall?

1
Yes
2
No
If no, go to B3a, on page 19
If yes,
qc_B2_a == 1

how many times?

How many
For each fall please describe below what happened.
Place accident happened (eg. kitchen, garden, creche) What did she fall or drop from (eg. table, baby walker, pram, bed, your arms) Date of fall (month, year) Injuries caused (if no injury write none) Who was with the baby? What did the person with the baby do? What did the person with the baby do? Other (please describe) What treatment did the person with the baby give? What other treatment did she have?
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
1st accident
2nd accident
3rd accident

Please describe how each accident happened: Fall 1

Generic text

Please describe how each accident happened: Fall 2

Generic text

Please describe how each accident happened: Fall 3

Generic text

Has the child had any other accidents or injuries?

1
Yes
2
No
If no, go to Section C
If yes,
qc_B3_a == 1

how many other accidents?

How many
For each accident or injury please describe below what happened.
Place accident happened (eg. kitchen, garden, creche) What happened? Date of accident (month, year) Injuries caused (if no injury write none) Who was with the baby? What did the person with the baby do? What did the person with the baby do? Other (please describe) What treatment did the person with the baby give? What other treatment did she have?
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
1st accident
2nd accident
3rd accident

Please describe how each accident happened: Accident 1

Generic text

Please describe how each accident happened: Accident 2

Generic text

Please describe how each accident happened: Accident 3

Generic text
SECTION C: FEEDING
Has your baby ever had the following:
- Age started (Put 0 if less than 1 month) ... months How often nowadays (Put 66 if she has this milk all the time now) ... times a week
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
bottle of ordinary baby milk (formula)
powdered follow-on milk
soya milk
goat's milk
hypo-allergenic formula
ordinary cow's milk

Did you breast feed?

1
Yes, I am still breast feeding
2
Yes, I breast fed but have now stopped
3
I never breast fed
If Yes, I am still breast feeding to question C2
qc_C2 == 1

How many times a day?

How many
If Yes, I breast fed but have now stopped to question C2
qc_C2 == 2

How old was the baby when you stopped? ... months ... weeks

Age in months
Age in weeks

In how many meals a day does she eat solids now?

How many

Do you ever add cereal to your baby's bottle?

1
yes always
2
yes often
3
yes sometimes
4
no never

Do you add sugar to your baby's food or bottle?

1
yes always
2
yes often
3
yes sometimes
4
no never
Has your baby ever had:
- Age started (Put 0 if less than 1 month) ... months How often nowadays ... times a week
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
plain baby rice
flavoured baby rice
other cereal
sweetened rusks
plain rusks
bread or toast
biscuits
Has your baby ever had any of the following prepared baby foods (from jar, tin or packet)?
- Age started (Put 0 if less than 1 month) ... months How often nowadays ... times a week
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
savoury - meat
savoury - fish
savoury - vegetable
baby fruit pudding
baby milk pudding
Has your baby ever had any of the following foods cooked by you at home?
- Age started (Put 0 if less than 1 month) ... months How often nowadays ... times a week
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
egg
meat
fish
potatoes
other vegetables
fruit puddings
milk puddings
Has your baby ever had:
- Age started (Put 0 if less than 1 month) ... months How often nowadays ... times a week
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
Age in months

1 - No

2 - Yes

How manyAge in months

1 - No

2 - Yes

How many

1 - No

2 - Yes

How manyAge in months
coca cola or pepsi
other fizzy drink
apple juice
a little alcohol
blackcurrant juice or rosehip syrup
other fruit drink
herbal drink (please describe)
gripe water
tea
coffee
raw fruit (eg. apple)
crisps
chocolates
sweets
raw vegetable (eg. carrot)

Has your baby ever had: herbal drink (please describe)

Generic text

Please indicate if your baby had any of the following feeding behaviours and when they occurred: (tick all that apply). slow feeding

1
Yes 0 - 3 months
2
Yes 4 - 6 months
4
No not at all

Please indicate if your baby had any of the following feeding behaviours and when they occurred: (tick all that apply). taking only small quantitites at each feed

1
Yes 0 - 3 months
2
Yes 4 - 6 months
4
No not at all

Please indicate if your baby had any of the following feeding behaviours and when they occurred: (tick all that apply). choking

1
Yes 0 - 3 months
2
Yes 4 - 6 months
4
No not at all

Please indicate if your baby had any of the following feeding behaviours and when they occurred: (tick all that apply). hungry/not satisfied

1
Yes 0 - 3 months
2
Yes 4 - 6 months
4
No not at all

Please indicate if your baby had any of the following feeding behaviours and when they occurred: (tick all that apply). allergy to milk

1
Yes 0 - 3 months
2
Yes 4 - 6 months
4
No not at all

Please indicate if your baby had any of the following feeding behaviours and when they occurred: (tick all that apply). refused to take breast milk

1
Yes 0 - 3 months
2
Yes 4 - 6 months
4
No not at all
7
Never fed this

Please indicate if your baby had any of the following feeding behaviours and when they occurred: (tick all that apply). refused to take other milk

1
Yes 0 - 3 months
2
Yes 4 - 6 months
4
No not at all
7
Never fed this

Please indicate if your baby had any of the following feeding behaviours and when they occurred: (tick all that apply). refused to take solids

1
Yes 0 - 3 months
2
Yes 4 - 6 months
4
No not at all
7
Never fed this

Please indicate if your baby had any of the following feeding behaviours and when they occurred: (tick all that apply). no feeding routine could be established

1
Yes 0 - 3 months
2
Yes 4 - 6 months
4
No not at all

Do you feel you have ever had difficulties feeding your baby?

1
yes, great difficulty
2
yes, some difficulties
3
no, no difficulties

How often is your baby fed in the following ways: lying with bottle propped up or held by baby

1
Always
2
Often
3
Sometimes
4
Never

How often is your baby fed in the following ways: lying with bottle held by you or other carer

1
Always
2
Often
3
Sometimes
4
Never

How often is your baby fed in the following ways: baby sitting with bottle held by herself

1
Always
2
Often
3
Sometimes
4
Never

How often is your baby fed in the following ways: baby sitting with bottle held by you or other carer

1
Always
2
Often
3
Sometimes
4
Never

How often is your baby fed in the following ways: baby fed while held in someone's arms

1
Always
2
Often
3
Sometimes
4
Never

Is the baby fed 'on demand', i.e. whenever she is hungry?

1
Yes always
2
Yes some of the time
3
No not at all

Who most often feeds the baby during the day (answer one only)?

1
you
2
partner
3
paid helper
4
other (describe)
Other

Who usually feeds the baby at night (answer one only)?

1
you
2
partner
3
paid helper
4
don't feed at night
5
other person (describe)
Other

Is the baby given a dummy?

1
yes, night time only
2
yes, most of the time
3
yes, sometimes
4
no, never

Does she drink out of a cup at all?

1
yes, usually
2
yes, sometimes
3
no, not at all
SECTION D: SLEEPING AND CRYING

Does your baby have a regular sleeping routine now?

1
Yes
2
No

Approximately how many hours sleep does your baby have during each: morning

How many

Approximately how many hours sleep does your baby have during each: afternoon

How many

Approximately how many hours sleep does your baby have during each: night

How many

On a normal day what time in the evening does your baby go to sleep?

Generic time

On a normal day what time does she wake up in the morning?

Generic time

Is your baby ever difficult when she is put to bed?

1
most of the time
2
often
3
at times
4
rarely
5
never

How often does your baby wake at night?

1
never
2
occasionally
3
most nights
4
every night
5
more than once per night
If more than once per night to question D3
qc_D3 == 5

How many times?

How many

When your baby wakes at night what do you do? feed her milk

1
Always
2
Usually
3
Sometimes
4
Never

When your baby wakes at night what do you do? give other drink (including water)

1
Always
2
Usually
3
Sometimes
4
Never

When your baby wakes at night what do you do? rock or cuddle her

1
Always
2
Usually
3
Sometimes
4
Never

When your baby wakes at night what do you do? give her a dummy

1
Always
2
Usually
3
Sometimes
4
Never

When your baby wakes at night what do you do? bring her into your bed

1
Always
2
Usually
3
Sometimes
4
Never

When your baby wakes at night what do you do? change her nappy

1
Always
2
Usually
3
Sometimes
4
Never

When your baby wakes at night what do you do? other (please describe)

1
Always
2
Usually
3
Sometimes
4
Never
Other

Do you ever wake your baby for a feed during the night?

1
Yes usually
2
Yes sometimes
3
No not at all

In which room does the baby sleep? When you put her down at night

1
in her own room on her own
2
in a room with other children
3
in your bedroom
4
other place (please describe)
Other

In which room does the baby sleep? When she wakes in the morning from her night sleep

1
in her own room on her own
2
in a room with other children
3
in your bedroom
4
other place (please describe)
Other

Does the baby sleep on her own most nights or does she share a bed or cot? When you put her down

1
on her own
2
in bed/cot with other children
3
in your bed
4
other place (please describe)
Other

Does the baby sleep on her own most nights or does she share a bed or cot? When she wakes in the morning from her night sleep

1
on her own
2
in bed/cot with other children
3
in your bed
4
other place (please describe)
Other

In the room where the baby sleeps most of the night: is the heating on at night?

1
Yes always
2
Yes sometimes
3
No not at all

In the room where the baby sleeps most of the night: is there a window open at night?

1
Yes always
2
Yes sometimes
3
No not at all

In the room where the baby sleeps most of the night: does she sleep with a duvet?

1
Yes always
2
Yes sometimes
3
No not at all

In the room where the baby sleeps most of the night: does she have an electric blanket

1
Yes always
2
Yes sometimes
3
No not at all

In the room where the baby sleeps most of the night: does she sleep with a pillow?

1
Yes always
2
Yes sometimes
3
No not at all

We are interested in the pattern of your baby's crying during a day. Does your baby cry at the following times: mornings

1
Yes always
2
Yes often
3
Yes sometimes
4
Hardly ever
9
Don't know

We are interested in the pattern of your baby's crying during a day. Does your baby cry at the following times: afternoon (before 5pm)

1
Yes always
2
Yes often
3
Yes sometimes
4
Hardly ever
9
Don't know

We are interested in the pattern of your baby's crying during a day. Does your baby cry at the following times: in the late afternoon/evenings (5 pm onwards)

1
Yes always
2
Yes often
3
Yes sometimes
4
Hardly ever
9
Don't know

We are interested in the pattern of your baby's crying during a day. Does your baby cry at the following times: during the night

1
Yes always
2
Yes often
3
Yes sometimes
4
Hardly ever
9
Don't know

We are interested in the pattern of your baby's crying during a day. Does your baby cry at the following times: other (please describe)

1
Yes always
2
Yes often
3
Yes sometimes
4
Hardly ever
9
Don't know
Other

Has your baby ever had times when she appears to be in agony, screams, draws her legs up to her body and can't be calmed?

1
yes often
2
yes sometimes
3
yes once only
4
no
9
don't know
If no or don't know go to D9.
If yes,
qc_D8_a == 1 || qc_D8_a == 2 || qc_D8_a == 3

does this tend to happen at a particular time of day?

1
yes
2
no
3
can't say
If yes,
qc_D8_b == 1

at which time of day?

Generic time

Have you noticed whether anything brings these attacks on?

1
yes
2
no
3
can't say
If yes,
qc_D8_c == 1

please describe:

Generic text

How long do these attacks usually last?

1
few minutes
2
less than 1 hour
3
1 - 2 hours
4
more than 2 hours

How much do you feel that your baby cries in comparison with other babies of her age?

1
she cries more than other babies
2
she is the same as other babies
3
she cries less than other babies
9
don't know

Do you feel that your child's crying is a problem?

1
Yes
2
No

If she cries do you:

1
pick her up immediately
2
let her cry for a while, then, if she doesn't stop, pick her up
3
never pick her up until you are ready to do so

Can you usually calm your child when she cries?

1
no
2
yes, usually fairly easily
3
yes, but it takes a while
4
yes, after much effort

Does the baby have a special object that she uses for comfort?

1
Yes
2
No
If yes,
qc_D12_a == 1

what is this?

1
blanket
2
cuddly toy
3
other (describe)
Other

How often does the baby usually have a bath:

1
more than once a day
2
once every day
3
once every other day
4
once a week
5
hardly ever
SECTION E: YOU AND YOUR BABY

About how often do you take your child to: local shops

1
More than once a week
2
About once a week
3
About once a month
4
Less than once a month
5
Never

About how often do you take your child to: department store

1
More than once a week
2
About once a week
3
About once a month
4
Less than once a month
5
Never

About how often do you take your child to: supermarket

1
More than once a week
2
About once a week
3
About once a month
4
Less than once a month
5
Never

About how often do you take your child to: park

1
More than once a week
2
About once a week
3
About once a month
4
Less than once a month
5
Never

About how often do you take your child to: visits to friends or family

1
More than once a week
2
About once a week
3
About once a month
4
Less than once a month
5
Never

Does your child have: cuddly toys

1
Yes
2
No

Does your child have: push or pull toys

1
Yes
2
No

Does your child have: co-ordination toys (eg. set of blocks, shape posting box, stacking cups)

1
Yes
2
No

Does your child have: walker

1
Yes
2
No

Does your child have: baby bouncer

1
Yes
2
No

About how many books does your child have of her own?

1
none
2
1 - 2 books
3
3 - 9 books
4
10 or more

Do you try to teach your child?

1
no, she is too young
2
no, I do not have time
3
yes, occasionally
4
yes, often
If yes,
qc_E4 == 3 || qc_E4 == 4

which things do you try to teach?

Generic text

Do you talk to your baby while you work? ( eg. while you do housework).

1
never
2
rarely
3
sometimes
4
often
5
always

At what age would you expect a youngster to be dry? during the day:

Generic text

At what age would you expect a youngster to be dry? at night:

Generic text

Are you potty training your baby?

1
Yes
2
No
7
My child already uses the potty and is dry in the day

Please indicate how often during the day the baby is in a room or enclosed place where people are smoking: Weekdays

1
all the time
2
more than 5 hours
3
3-5 hours
4
1-2 hours
5
less than 1 hour
6
not at all

Please indicate how often during the day the baby is in a room or enclosed place where people are smoking: Weekends

1
all the time
2
more than 5 hours
3
3-5 hours
4
1-2 hours
5
less than 1 hour
6
not at all

Does your baby see children (other than brothers or sisters)?

1
yes everyday
2
yes 2-6 times a week
3
once a week
4
less than once a week
5
never

How often do you play with your baby?

1
everyday
2
most days
3
rarely, I don't have time
4
rarely, I don't enjoy it

How often do you do these activities with your baby? sing to her

1
Often
2
Occasionally
3
Hardly ever

How often do you do these activities with your baby? show her pictures in books

1
Often
2
Occasionally
3
Hardly ever

How often do you do these activities with your baby? play with toys

1
Often
2
Occasionally
3
Hardly ever

How often do you do these activities with your baby? cuddle her

1
Often
2
Occasionally
3
Hardly ever

How often do you do these activities with your baby? physical play (eg. clapping, rolling over)

1
Often
2
Occasionally
3
Hardly ever

How often do you do these activities with your baby? take her for walks

1
Often
2
Occasionally
3
Hardly ever

How often do you do these activities with your baby? other (please describe)

1
Often
2
Occasionally
3
Hardly ever
Other

Does your partner play with your baby?

1
no, never
2
less than once per week
3
about once a week
4
2-6 times per week
5
every day
7
I don't have a partner
If you don't have a partner, go to Section F on page 35
qc_E10 == 7
Else

What sort of activities does your partner do with your baby? baths her

1
Yes often
2
Yes occasionally
3
Hardly ever

What sort of activities does your partner do with your baby? feeds her

1
Yes often
2
Yes occasionally
3
Hardly ever

What sort of activities does your partner do with your baby? sings to her

1
Yes often
2
Yes occasionally
3
Hardly ever

What sort of activities does your partner do with your baby? shows her pictures in books

1
Yes often
2
Yes occasionally
3
Hardly ever

What sort of activities does your partner do with your baby? plays with toys

1
Yes often
2
Yes occasionally
3
Hardly ever

What sort of activities does your partner do with your baby? cuddles her

1
Yes often
2
Yes occasionally
3
Hardly ever

What sort of activities does your partner do with your baby? physical play (eg. clapping, rolling over)

1
Yes often
2
Yes occasionally
3
Hardly ever

What sort of activities does your partner do with your baby? takes her for walks

1
Yes often
2
Yes occasionally
3
Hardly ever

What sort of activities does your partner do with your baby? other (please describe)

1
Yes often
2
Yes occasionally
3
Hardly ever
Other
SECTION F: BROTHERS AND SISTERS
We are interested in the other children who live with your baby. Please include half-brothers and half-sisters, step-brothers and step-sisters, fostered or adopted children.

Do any other children live with you?

1
Yes
2
No
If no, go to F2, on page 36
If yes,
qc_F1_a == 1

How many? boys:

How many

How many? girls:

How many
Please give each child's name, age and sex: (oldest child first please)
Name Age Sex
Generic textAge in weeksGeneric textGeneric textAge in weeksGeneric textAge in weeksGeneric textGeneric text Generic textAge in weeksGeneric textGeneric textAge in weeksGeneric textAge in weeksGeneric textGeneric text Generic textAge in weeksGeneric textGeneric textAge in weeksGeneric textAge in weeksGeneric textGeneric text
Child 1
Child 2
Child 3
Child 4
Child 5

When your baby was born what was the reaction of these other children? Child 1

1
pleased
2
didn't mind
3
unhappy

When your baby was born what was the reaction of these other children? Child 2

1
pleased
2
didn't mind
3
unhappy

When your baby was born what was the reaction of these other children? Child 3

1
pleased
2
didn't mind
3
unhappy

When your baby was born what was the reaction of these other children? Child 4

1
pleased
2
didn't mind
3
unhappy

When your baby was born what was the reaction of these other children? Child 5

1
pleased
2
didn't mind
3
unhappy

Have any of these children been particularly jealous/unhappy about the baby?

1
Yes
2
No
If yes,
qc_F1_e == 1

which children: Child 1

1
Yes
2
No

which children: Child 2

1
Yes
2
No

which children: Child 3

1
Yes
2
No

which children: Child 4

1
Yes
2
No

which children: Child 5

1
Yes
2
No

Are there any additional comments you would like to make about the way your other children have reacted?

1
Yes
2
No
If yes,
qc_F1_f == 1

please describe:

Generic text

Does your baby have a twin?

1
Yes
2
No
If no, go to Section G
If yes,
qc_F2_a == 1

would you say they are alike: in looks

1
Yes
2
No

would you say they are alike: in behaviour

1
Yes
2
No

would you say they are alike: personality/character

1
Yes
2
No

would you say they are alike: in health

1
Yes
2
No

How do you dress them?

1
in similar clothes each day
2
in similar clothes sometimes
3
never in similar clothes

How does this twin react to the other? she likes to be with her twin

1
Yes, most of the time
2
Yes, some of the time time
3
No, hardly ever

How does this twin react to the other? she doesn't seem to notice her twin

1
Yes, most of the time
2
Yes, some of the time time
3
No, hardly ever

How does this twin react to the other? she is upset if she is parted from her twin

1
Yes, most of the time
2
Yes, some of the time time
3
No, hardly ever
SECTION G: PROBLEMS AND TREATMENT
Children often have accidents or illnesses that need treatment. Please indicate which of the following have been given to your child in the past six months.
- If yes, give names of substances if you can

1 - Never

2 - Yes for one episode only

3 - Yes for 2 or more episodes

Generic text

1 - Never

2 - Yes for one episode only

3 - Yes for 2 or more episodes

Generic text

1 - Never

2 - Yes for one episode only

3 - Yes for 2 or more episodes

Generic text

1 - Never

2 - Yes for one episode only

3 - Yes for 2 or more episodes

Generic text
cough medicine
antibiotics/penicillin
throat medicine
vitamins
paracetamol/calpol
ointment for skin
eye ointment
diarrhoea mixture
dimotapp/decongestant
ear drops
eye drops
teething gel
laxative
other (please describe)

Children often have accidents or illnesses that need treatment. Please indicate which of the following have been given to your child in the past six months. other (please describe)

Other

Are there any pills, ointments or medicines that your child has taken every day for the last 3 months? (Include vitamins, fluoride, ointment to prevent nappy rash.)

1
Yes
2
No
If yes,
qc_G2 == 1

please describe:

Generic text
During the child's early months of life various problems are often identified - yet when investigated further they are found not to be problems at all. In this section we are asking about any problem that might have arisen.
Your child's hips

Have your baby's hips been examined?

1
Yes
2
No
If no, go to G4, on page 39
If yes,
qc_G3_a == 1

at what age was the earliest examination?

1
in first month
2
age 1-2 months
3
older than 2 months
9
not known

was an ultrasound examination done on the hips?

1
Yes
2
No
9
Don't know

have the hips been X-rayed?

1
Yes
2
No
9
Don't know

were any problems found?

1
Yes
2
No
9
Don't know
If yes,
qc_G3_e == 1

please describe:

Generic text

how old was she? ... months

Age in months

Did your child have any treatment for her hips?

1
Yes
2
No
If no, go to G4
If yes,
qc_G3_f == 1

please describe

Generic text
Your child's hearing

Has anyone thought there might be a problem with her hearing?

1
Yes
2
No
If no, go to G5
If yes,
qc_G4_a == 1

Who first suspected a problem?

1
I did
2
my partner did
3
other relative or friend
4
health visitor
5
doctor
6
someone else (please describe)
Other

Has your child been seen at the Hearing Assessment Centre?

1
Yes
2
No
If no, go to G5
If yes,
qc_G4_c == 1

At what age? ... months

Age in months

What was decided?

Generic text
Your child's sight

Have you ever thought your child had a squint?

1
yes, definitely
2
sometimes yes, sometimes no
3
no, not at all

Have any health workers thought she had a squint?

1
Yes
2
No

Apart from a squint, have you felt there was anything else wrong her eyes?

1
Yes
2
No
If yes,
qc_G5_c == 1

please describe:

Generic text

Has your child ever been referred to an eye specialist?

1
Yes
2
No
If no go to G6
If yes,
qc_G5_d == 1

What was decided?

Generic text

What treatment was given?

Generic text
Other problems

Apart from hips, hearing and sight, have there been any other problems for which your child was referred to a specialist?

1
Yes
2
No
If no, go to Section H
If yes,
qc_G6_a == 1

For how many different problems?

How many
Please list, for each problem, what has happened:
What was thought to be the problem? Have you seen the specialist? What was decided?
Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text
Problem No. 1
Problem No. 2
Problem No. 3
SECTION H: TEMPERAMENT
These questions are about how your baby behaves. Although some of them seem similar to one another, please answer them all. How often has the baby's recent behaviour been like the following descriptions:

She eats about the same amount of solid food (within 2 spoonfuls) from day to day

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She is fussy on waking up and going to sleep (frowns, cries)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She plays with a toy for less than a minute and then looks for another toy or activity

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She sits still while watching TV or other nearby activity (such as children playing)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She accepts straight away a change in place or position of feeding or person doing it

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She accepts nail cutting without protest

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

Her hunger cry can be stopped for more than a minute by picking up, putting on a bib, or giving a dummy

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She plays continuously for more than 10 minutes with a favourite toy

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She accepts her bath any time of the day without resisting it

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She takes feeding quietly with mild expressions of likes and dislikes

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She indicates discomfort (fussy/squirms) when she has a dirty nappy

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She lies quietly in the bath

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She wants and takes milk feedings at about the same time (within one hour) from day to day

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She is shy (turns away or clings to you) on meeting another child for the first time

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She continues to fuss when her nappy is changed despite efforts to distract her with game, toy or singing etc.

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She amuses herself for half an hour or more in her cot or playpen (looking at mobile, playing with toy)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She moves about a lot (kicks, grabs, squirms) during nappy change and dressing

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She vigorously resists additional food or milk when full (spits out, clamps mouth closed, pushes spoon away etc)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She resists changes in feeding schedule (1 hour or more) even after 2 tries

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

Her bowel movements come at different times from day to day (over 1 hour difference)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She stops play and watches if someone walks by

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She ignores voices or other ordinary sounds when playing with a favourite toy

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She makes happy sounds (coos, laughs) when having her nappy changed, or being dressed

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She accepts new foods straight away, swallowing them promptly

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She watches other children playing for less than a minute and then looks elsewhere

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She reacts mildly (just blinks or is startled briefly) to a bright light such as flash bulb or sunlight let in by drawing back curtain

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She is pleasant (smiles, laughs) when first arriving in unfamiliar places (friend's house, shop)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She gets sleepy at about the same time each evening (within half hour)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She accepts regular procedures (hair brushing, face washing, etc) at any time without protest

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She perseveres for many minutes when working on a new skill (rolling over, picking up object, etc)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She moves a lot (squirms, bounces, kicks) while lying awake in her cot

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She objects to being bathed in a different place or by a different person even after 2 or 3 tries

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

For the first few minutes in a new place or situation (new shop or home) she is fretful

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She notices, looks carefully at changes in your appearance or dress (hairdo, unfamiliar clothing)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She reacts strongly to foods, whether positively (smacks lips, laughs, squeals) or negatively (cries)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She is pleasant (coos, smiles, etc) during procedures like hair brushing or face washing

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She continues to cry in spite of several minutes of soothing

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She keeps trying to get a desired toy, which is out of reach for 2 minutes or more

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She greets a new toy with a loud voice and much expression of feeling (whether positive or negative)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She plays actively with her parents - much movement of arms, legs, body

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She watches another toy when offered even though already holding one

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

At home her initial reaction to strangers is acceptance

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She wants daytime naps at differing times (over 1 hour difference) from day to day

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She continues eating solid foods without reacting to differences in taste or consistency

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She cries when left to play alone

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She adjusts within 10 mins to new surroundings (home, shop, play area)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

Her naps are about the same length from day to day

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She moves about much during feeding (squirms, kicks, grabs)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She reacts (stares or is startled) to sudden changes in lighting (flash bulbs, turning on light)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She can be soothed by talking or games when sleepy

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She displays much feeling (vigorous laughing or crying) during nappy change or dressing

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She lies still when asleep and wakes up in the same position

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She reacts to changes in her milk (type or temperature) or if given juice instead

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She can be calmed for a few minutes by being picked up and played with, if fussing about a dirty nappy

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She wants and takes solid food at about the same time (within 1 hour) from day to day

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She is content (smiles, coos) during interruptions of milk or solid feeding

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She accepts within a few minutes a change in place of bath or person giving it

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She cries for less than 1 minute when given an injection

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She shows much bodily movement (kicks, waves, arms) when given an injection

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She continues to react to a loud noise (hammering,barking dog, etc) heard several times in the same day

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

Her initial reaction is withdrawal (turns head, spits out) when consistency, flavour or temperature of solid foods is changed

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

Her time of waking in the morning varies greatly (by 1 hour or more from day to day)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She continues to reject disliked food or medicine in spite of your efforts to distract with games or tricks

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She reacts even to a gentle touch (is startled, wriggles, laughs, cries)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She reacts strongly to strangers: laughing or crying

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She actively grasps or touches objects within her reach (hair, spoon, glasses, etc)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She will take any food offered without seeming to notice the difference

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

Her period of greatest physical activity comes at the same time every day

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She appears bothered (cries, squirms) when first put down in a different sleeping place

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She reacts mildly to meeting familiar people (quiet smiles or no response)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She wants an extra feed at a different time each day (over 1 hour difference)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She is still wary or frightened of strangers after 15 mins

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She lies still and moves little while playing with toys

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She can be distracted from fussing or squirming during a procedure (nail cutting, hair brushing, etc) by a game, singing, TV, etc

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She remains pleasant or calm with minor injuries (bumps, pinches)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

Her initial reaction to seeing doctor is acceptance (smiles, coos)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She reacts to a disliked food even if it is mixed with a preferred one

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She plays quietly and calmly with toys (little vocal or other noises)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She lies still during procedures like hair brushing or nail cutting

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She stops sucking and looks when she hears an unusual noise (telephone, door bell) when drinking milk

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She pays attention to a game with a parent for only a minute or so

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She is calm in the bath. Like or dislike is mildly expressed (smiles or frowns)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She requires introduction of a new food on 3 or more occasions before she will accept (swallow) it

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

Her first reaction to any new procedure (first haircut, new medicine, etc) is objection

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She acts the same when the nappy is wet as when it is dry

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She is fussy or cries during a physical examination by a doctor

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She accepts changes in solid foods (type, amount, timing) within 1 or 2 tries

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always

She moves much and for several minutes or more when playing by herself (kicking, waving arms and bouncing)

1
Almost never
2
Rarely
3
Usually does not
4
Usually does
5
Often
6
Almost always
SECTION I: MILESTONES
Below are a list of things which babies learn to do as they get older. Some of them your baby will be doing and others she won't have started yet. Please indicate which she is doing:
-

1 - Yes does often

2 - Has only done once or twice

3 - Has not started yet

Looks at older people's faces
She smiles when you smile at her
She does not want to let go of a toy when it is being taken away
She can feed herself a rusk or other similar food
She tries to get a toy that is out of her reach
She is shy when she first meets a stranger
She plays peek-a-boo
She plays pat-a-cake with you
She is able to drink from a cup
She indicates what she wants without crying for it
Below are a list of things which babies learn to do as they get older. Some of them your baby will be doing and others she won't have started yet. Please indicate which she is doing:
-

1 - Yes does often

2 - Has only done once or twice

3 - Has not started yet

She puts her hands together
She can hold a rattle
She can focus her eyes on a small object such as a raisin
She reaches for objects
In a sitting position she looks about for a hidden object
In a sitting position she can pick up 2 objects at once
She can pick up a small object such as a raisin
She can pass an object from one hand to another
She can bang together two similar objects that she is holding
She grabs objects using the whole hand
She can pick up a small object using forefinger & thumb only
Below are a list of things which babies learn to do as they get older. Some of them your baby will be doing and others she won't have started yet. Please indicate which she is doing:
-

1 - Yes does often

2 - Has only done once or twice

3 - Has not started yet

When a bell rings, she moves or makes a noise
She makes noises other than crying
She laughs
She squeals
She turns towards someone when they are speaking
She tries to copy what you say
She says 'dada' and 'mama'
She says 'dada' and 'mama' and knows what they mean
Below are a list of things which babies learn to do as they get older. Some of them your baby will be doing and others she won't have started yet. Please indicate which she is doing:
-

1 - Yes does often

2 - Has only done once or twice

3 - Has not started yet

In a sitting position she can keep her head steady
Lying on her stomach she can lift her chest and shoulders while supporting them with her arms
She can roll over
She is able to bear some weight on her legs when held in a standing position
She can sit up without being supported
She can stand up while holding onto something such as furniture
She can pull herself up to a standing position by holding onto a piece of furniture
She can get from a standing position to a sitting position
She can walk holding onto a piece of furniture
While lying on her stomach she can lift her head
She can stand up for a moment without any support
From a standing position she can stoop and return to standing
She can crawl on hands and knees

How many teeth has your baby got now?

How many

How old was she when the first one appeared? ... months

Age in months

Space for you to describe in your own words something your baby has done in the last few days.

Long text
SECTION J: HER GROWTH
Do you have any records of your baby's growth? If so please list the dates on which your baby was weighed and how much she weighed each time. Also add lengths, head circumferences, and arm circumferences if they were measured.
Date Weight Length Head circumference Arm circumference
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THANK YOU VERY MUCH FOR YOUR HELP
Please remember, because this is strictly confidential, the people who look at this booklet will not know your name. They will be unable to give you any help or contact anyone after reading what you have written. If you feel you need advice your General Practitioner or Health Visitor should be able to help you.

This questionnaire was completed by: mother

1
Yes
2
No

This questionnaire was completed by: partner

1
Yes
2
No

This questionnaire was completed by: other (please describe)

1
Yes
2
No
Other

Please give the date on which you completed this questionnaire:

Generic date

Please give the date of birth of your baby:

Date of birth
When completed, please return the questionnaire to:
Dr. Jean Golding, Children of the Nineties - ALSPAC, Institute of Child Health,
End

alspac_91_msd

MY DAUGHTER
This questionnaire asks about your baby. We are interested to know about her health and behaviour. We also ask about you and your baby and the reaction of any other children you might have to the baby. Your answers will help us to understand the developing child and identify problems that babies and their parents have.
The questionnaire is like other questionnaires you have received. To answer simply tick the box which best describes your baby or your baby's situation. Some questions will seem similar but they are not the same. Please answer all questions that you can. If you cannot answer any question or a question does not apply to you please put a line through them. There are no right or wrong answers. Please just describe what happens in your situation. You may make additional comments at the end.
All answers are confidential.
THANK YOU FOR YOUR HELP

SECTION A: YOUR BABY

How would you assess the health of your baby: In the first few months
1
very healthy, no problem