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Daily Journal

Please fill out the following with as many details as you can.

    Daily Participation Log

    Participation ID

    Date

    What day of the experiment is this?

    Amount of sleep overnight (hours)

    How long did you stay in bed today?

    Food Intake

    Breakfast

    Lunch

    Dinner

    Snacks

    Drinks / Teas

    Daily Activities

    Did you do any physical activity today?

    If yes, please explain

    Did you take any naps today?

    If yes, how long and what time?

    If you are nursing, was it successful today?

    Did you wear your binding today?

    Did you do any warming treatments today?

    If yes, what kind?

    Did you do any other self-care treatments today?

    If yes, what kind?

    Emotional & Physical Wellbeing

    How are you and your little one doing today?

    Please explain

    Did you feel supported at home today?

    Are you experiencing any pain today?

    If yes, please explain

    Did you work today (paid employment)?

    Did you experience stress today?

    If yes, how did you work through it?

    Did you socialize with anyone today (not living with you)?

    If yes, please explain (inside/outside home)

    What was the highlight of your day?

    Any additional thoughts you would like to share today?

    ***Consult your caregiver if you are experiencing pain or emotional distress or overwhelm.

    **** Help Line for Postpartum Support International – call – 1-800-944-4773

    ***** Crisis Hotline – dial 988