Intervention based on BASNEF model increases exclusive breastfeeding in preterm infants in Iran: a randomized controlled trial

Abstract

BackgroundThe objective of this study is to determine the effect of a consultation model, Beliefs, Attitudes, Subjective Norms and Enabling Factors (BASNEF), and the counselling steps using GATHER-Greet clients, Ask clients about themselves, Tell clients about their choices, Help clients choose, Explain what to do, and Return for follow-up-on the continuation rates of exclusive breastfeeding in mothers of premature infants.MethodsThis is a randomized controlled clinical trial carried out on 124 mothers with premature infants hospitalized in Fatemieh Hospital, city of Hamadan, in 2014. Participants were randomly assigned to either the intervention or control groups. The initial demographic questionnaire carried out in both groups included three questions about the continuation of exclusive breastfeeding, BASNEF, a checklist related to the lactation performance documented by mothers and the weight gain of their infants. Five breastfeeding consultation sessions based on the BASNEF model and counselling steps using GATHER, were held for the mothers in the intervention group for five consecutive days. Then follow-up weight gain and the questionnaire completion were performed in both groups at 1, 2, 3 and 4 months after the intervention.ResultsBaseline characteristics were similar in the two groups. There were no significant differences between both groups in the rate of exclusive breastfeeding, lactation performance and infant weight at baseline. The intervention group had significantly higher rates of exclusive breastfeeding, 72.6% versus the control group of 16.1%, at the end of the 4 month follow-up. Also the intervention group had significantly higher mean scores of lactation performance (8.62 ± 2.08 vs 6.40 ± 1.84 in the control group) and infant weight (5694.80 ± 779.43 vs 4760.17 ± 859.12 in the control group) at the end of the 4 month follow-up.ConclusionBreastfeeding consultation of mothers based on the BASNEF model and using GATHER counselling steps increased the rate of exclusive breastfeeding, lactation performance and weight gain of premature infants. Therefore, breastfeeding counselling sessions are recommended for all mothers of premature infants.Trial registrationIranian Registry of Clinical Trials number IRCT2014111013405N6 and date registered, January 5, 2015.

Explaining breastfeeding experiences and assessing factors affecting breastfeeding self-efficacy in mothers of premature infants: a mixed method study protocol

“…5) The breastfeeding self-efficacy questionnaire: It was designed by Dennis (2003). This questionnaire is a 33-item scale and is scored by a 5-point Likert scale from always confident (5) to not at all confident (1). Scores range from 33 to 165, with 33-76 considered low self-efficacy, 77-120 average self-efficacy, and 121-165 regarded as high self-efficacy.…”

“…Given the results of these studies, it seems that any of these factors as social determinants of health can have a positive or negative effect on breastfeeding [8,16,17]. These factors are especially highlighted in mothers of preterm infants since they face additional obstacles leading to the delayed onset of breastfeeding [1]. Furthermore, studies show that mothers of preterm infants have lower socioeconomic status, compared to mothers of term infants which, in turn, can have negative effects on breastfeeding [16,18].…”

“…Breast milk protects one's health in childhood [1,2] and also provides health and wellness for the rest of one's life [3]. The importance of breastfeeding in various respects has been well recognized [4] It has protective effects on maternal and neonatal health, prevents multiple diseases and complications, and as a result reduces healthcare costs [2,5], Moreover, it helps establish an attachment between a mother and her infant and is a good strategy for the reduction of infant mortality [6].…”

“…Therefore, it can be said that a number of different factors contribute to breastfeeding success [10,19]. One of the strategies for achieving breastfeeding success is focusing on the affective factors; however, the experience of breastfeeding after preterm delivery has not been studied well [1,10]. Addressing this knowledge gap is very important in the context of caring and support planning.…”

Effect of Consultation on Adherence to Clinical Breast Examination and Mammography in Iranian Women: A Randomized Control Trial

“…GATHER was developed by Rinehart and his colleagues in 1998 as a guideline to for consulting with clients based on their needs (Rinehart et al, 1998). It was used as a guide strategy in several studies for enhancing breastfeeding, providers' compliance to family counseling and cervical cancer screening (León et al, 2005, Ahmadi et al, 2016Shobeiri et al, 2016). The role of the midwife is to act her activities according to the female need in particular of breast cancer prevention.…”