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My Kota Bear's New Jersey

Community Baby Shower

Registration Form

Saturday, June 28, 2025 | 12pm-4pm

I'm bringing a plus one
Baby's Gender (if known)
Male
Female
Unknown
How old is your baby? (Note: Your baby should be unborn - 3 months older during this event. (If you have a need & your child is 3 months or older, please contact My Kota Bear for assistance at: info@mykotabear.com.)
Unborn
Newborn (0 months)
1-3 months
Do you have or expect multiples? (If you have multiples that are mixed boys & girls, please let us know how many boys & how many are girls in the "Comments" Section)
Twins
Triplets
Other
No
May we add you to our email list?
Yes
No

Survey

Please take this brief survey by filling out the information below:

1. Is your baby a NICU baby?
Pregnant
Baby is in the NICU
Baby was in the NICU
Never was in the NICU
2. What is your level of awareness about the ABCDE's of sleep? I am:
fully aware of the ABCDEs of sleep.
aware of the ABCDEs of sleep.
somewhat aware of the ABCDEs of sleep.
not aware of the ABCDEs of sleep.
unsure of what the ABCDEs of sleep.
3. How often do you make sure that your baby’s crib is firm & free of stuffed animals, bumpers, and other objects?
Always
Often
Sometimes
Never
4. How often does your baby sleep in its crib near its caregiver, not IN the bed with its caregiver?
Always
Often
Sometimes
Never
5. Do you plan on breastfeeding your baby?
Yes - I plan to breastfeed/I am breastfeeding.
No - I do not plan to/did not breastfeed.
I am unsure if I will breastfeed.
6. How often do you eat foods that promote healthy breast milk such as leafy greens and proteins?
I eat those foods every day.
I eat those foods often (more than 2 times per week).
I eat those foods sometimes (1 time per week).
I never eat those foods.
I am unsure of what those foods are and/or how often to eat them.
7. What is your level of awareness about the effect of wine, hard liquors, coffee, and tea on breast milk contents?
Fully aware of the effect of substances on breast milk contents.
Aware of the effect of substances on breast milk contents.
Somewhat aware of the effect of substances on breast milk contents.
not aware of the effect of substances on breast milk contents.
unsure of the effect of substances on breast milk contents.
8. What is your level of awareness about the effects of secondhand smoke on your baby’s health?
Fully aware of the effects of secondhand smoke
Aware of the effects of secondhand smoke
Somewhat aware of the effects of secondhand smoke
Not aware of the effects of secondhand smoke
Unsure of the effects of secondhand smoke
10. Which category best describes your race?
White
African American/Black
Asian
Hispanic/Latino
Other
11. Which of the following is a possible sign of postpartum depression?
Feeling very sad or worried
Laughing all the time
Feeling confident
12. Unwanted thoughts can be increased by stress and anxiety.
13. Who should a birthing person speak to if they are struggling with their mental health?
A health care provider or therapist
A stranger in the park
No one, they should handle it alone
14. Breastfeeding is easy because it is natural.
15. What can a birthing person do to help take care of themselves emotionally?
Join a support group to talk with others
Focus only on taking care of the baby
Avoid talking about their feelings
16. When should a birthing individual seek help when experiencing postpartum depression symptoms?
One year postpartum, if symptoms still appear
Wait at least 6 months to see if symptoms go away
As soon as possible

Our Mission:

My Kota Bear is a global company that provides services and goods for, primarily, NICU (Neonatal Intensive Care Unit) families by bringing awareness, and education to prevent pre-term labor and births and overall wellness including post-partum depression (mental health) and health equity for women and children, including maternal and infant mortality prevention.

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Community Baby Showers

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