Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

Do you believe your child has any dental problems? __ Y __ N
If yes, what do you believe is the problem? _____________________________________
Has your child been to the dentist? __ Y __ N
If yes, what was the reason? ________________________________________________
Have you started to clean your child’s teeth? __ Y __ N
If yes, at what age did you start, and how do you clean?
Age: ______________________
How do you clean? __________________________________________________
Do you use tooth paste? ___ Y ___ N
Who usually cleans the teeth? ___ Mom ___ Dad ___ Other:___________
Did you give fluoride drops to your infant? ___ Y ___ N
Infant Feeding Pr<strong>of</strong>ile:
Did you breastfeed your infant? ___ Y ___ N
If yes, are you still breastfeeding? ___ Y ___ N
If no, when did you stop breastfeeding? _______________________________________
Did you give your infant vitamin D drops while breastfeeding? ___ Y ___ N
If yes, how <strong>of</strong>ten?________ Starting at age?________ Until____________
If no, why not? ___________________________________________________________
After breastfeeding do/did you clean your child’s teeth? ___ Y ___ N
Have you ever breast fed your baby to sleep? ___ Y ___ N
If yes, how <strong>of</strong>ten have you done this?
___ Usually ___ Now and then ___ Not <strong>of</strong>ten
Does child have breast whenever child wants it? ___ Y ___ N
Did you bottle-feed your infant? ___ Y ___ N
If yes, when did you start using the bottle? _____________________________________
If yes, are you still giving your infant the bottle? ___ Y ___ N
If no, when did you stop giving your child the bottle? ____________________________
Have you ever added the following to your child’s bottle (check all that apply)?
___ breast milk ___ cow milk ___ water
___ juice ___ pop ___ sugar
___ formula ___ tea ___ cornstarch
___ molasses
___ other: ________________
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