Protocol - Consumption of Sweet Beverages

Please complete the following table by circling YES or NO for each of the beverages that your child may have consumed during the past week. For beverages that your child drank, write the number of servings (per day or week) that your child drank, and the amount drank per serving during the past week.

Please check the best response to the following questions.

1. If your child drinks cows milk, what type of cows milk does your child usually drink?

1[ ]Whole milk

2[ ]2% milk

3[ ]1% milk

4[ ]Chocolate milk

5[ ]Other flavored milk (e.g., strawberry, vanilla)

6[ ]Doesnt drink milk

2. What type of container does your child most often use for beverages?

1[ ]Infant bottle

2[ ]Open cup

3[ ]Closed cup (sippy cup)

4[ ]Cup with nonspilling, straw mechanism

5[ ]Water bottle

6[ ]Product container (e.g., juice box, pop can, or bottle)

3. What beverage does your child most often consume at meals?

1[ ]Cows milk

2[ ]Juice or juice drinks

3[ ]Water

4[ ]Regular soda pop or other sugared beverages

5[ ]Diet soda pop or other sugar-free beverages

4. What beverage does your child most often consume between meals?

1[ ]Cows milk

2[ ]Juice or juice drinks

3[ ]Water

4[ ]Regular soda pop or other sugared beverages

5[ ]Diet soda pop or other sugar-free beverages

6[ ]Other: _______________

5. Which statement best describes your childs nighttime feedings?

1[ ]My child falls asleep with a bottle.

2[ ]My child has a bottle in the middle of the night.

3[ ]My child has a snack at bedtime.

4[ ]My child has a snack in the middle of the night.

5[ ]None of the above.

Kool-Aid® is a registered trademark, Kraft Foods Global Brands, LLC; Crystal Light® is a registered trademark owned and licensed from KF Holdings, Inc.; Pepsi® is a registered trademark, PepsiCo, Inc.; Coca-Cola® is a registered trademark, The Coca-Cola Company; Gatorade® is a registered trademark, PepsiCo, Inc.; Powerade® is a registered trademark, The Coca-Cola Company.