| BSQ_1 | Initials of the child |
| BSQ_2 | Field Worker code |
| BSQ_3 | Date of Interview DDMMYY |
| BSQ_4 | Sleeping arrangement: 1=Infant crib in a separate room , 2=Infant crib in parents’ room, 3=In parents’ bed, 4=Infant crib in room with sibling, 5=Other, Specify: |
| BSQ_4i | If others, Specify |
| BSQ_5 | In what position does your child sleep most of the time? 1=On his/her belly, 2=On his/her side, 3=On his/her back |
| BSQ_6 | How much time does your child spend in sleep during the NIGHT (between 7 in the evening and 7 in the morning)? Hours: ______ Minutes: ______ |
| BSQ_7 | How much time does your child spend in sleep during the DAY (between 7 in the morning and 7 in the evening)? Hours: ______ Minutes: _______ |
| BSQ_8 | Average number of night waking per night: |
| BSQ_9 | How much time during the night does your child spend in wakefulness (from 10 in the evening to 6 in the morning)? Hours: ______ Minutes: ______ |
| BSQ_10 | How long does it take to put your baby to sleep in the evening? Hours: ______ Minutes: ______ |
| BSQ_11 | How does your baby fall asleep? 1=While feeding, 2=Being rocked, 3=Being held, 4=In bed alone, 5=In bed near parent |
| BSQ_12 | When does your baby usually fall asleep for the night: Hours: ______ Minutes: ______ |
| BSQ_13 | Do you consider your child’s sleep as a problem? (1=A very serious problem, 2=A small problem, 3=Not a problem at all) |
| BSQ_13i | If yes, Specify |