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Calorie Intake Assessment

The form can be submitted f you would like your calorie intake checked and confirmed. Please complete the following questions, and you will receive feedback via email within 72 hours, Monday to Friday. The more specific you can be, the better I will be able to provide you with accurate feedback.

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Question 1 of 10

Name:

Question 2 of 10

Email:

Question 3 of 10

Age:

Question 4 of 10

Height:

Question 5 of 10

Weight:

Question 6 of 10

Please describe your daily activity level, including how active you are in terms of steps and any structured exercise (such as workout classes or videos) per week:

Question 7 of 10

How many ounces of breast milk do you produce in a 24-hour period?

If you’re unsure, please describe whether your baby receives all their nutrition from you, whether you are combination feeding (breast milk + formula, and how much of each), or breast milk + solid foods.

Question 8 of 10

Please list the calories you calculated from the calorie calculator:

 

If you have not calculated this yet, you can find the calorie calculator here: https://www.postpartumweightlossrd.com/free-calorie-calculator-access

Question 9 of 10

Have you done one full day of calorie tracking to determine your usual intake? If so, please share the total calories you had.

 

Even if you don’t plan on tracking calories long-term, I recommend doing this at least once. It helps us compare your current intake to your estimated needs and make sure there aren’t any dips in your supply.

Question 10 of 10

Anything else you'd like me to know?

Confirm and Submit