Please enter you or your child's name below

Please describe any difficulty with breastfeeding

If yes, were ties released or are they still present?

If so, what are they?

Digestive problems

If you do not deal with digestive symptoms, or are unsure, select N/A.

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If yes, please explain under "other"

If yes, at what age?

If yes, at what age and did you or your child have this procedure? (answer under "other")

If yes, at what age? (answer under "other")

Expansion typically includes an appliance that is worn, or placed, in the roof of one's mouth.

Please select all that apply.

Please select all of the following that apply:

If yes, please describe the pain level (1-10) and frequency in "other" box.

Please select all answers that apply:

Please select all of the following that apply:

Select all of the following that apply:

If yes, please answer when this study was done under "other"

If yes, how often do you use it? Please answer under "other"

If yes, elaborate answer under "other"

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