Standard Operating Procedure for POP Sampling in Breast Milk

Standard Operating Procedure
for POP Sampling in Breast Milk
Page 19 of 20
29: Types of past jobs:
30. Duration in years
a)___________________________________________________________
___________________________________________________________
b)__________________________________________________________
__________________________________________________________
Never worked
31. Was the donor’s mother born in Brazil Yes No
31. Was the donor herself breastfed
Yes No I don’t know
If the answer is yes, how long_________________
32. Was the donor’s house treated with DDT to kill mosquitoes
Yes No I don’t know
If the answer is yes, when_________________
33. Medicines used during the sampling period, for how long and at what dosages (including vitamins and natural
supplements):
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Questionnaire completed by:
(bold types)
Date:
Signature: