title: Breastfeeding preterm infants - a randomized controlled trial of the effectiveness of an Internet-based peer-support group.
abstract: OBJECTIVE
  The aim of this study was to examine whether an Internet-based peer-support intervention has an effect on the duration of breastfeeding or breast milk expression or maternal breastfeeding attitude compared with routine care in the mothers of preterm infants. In addition, the feasibility of the intervention was examined.
  
  
  BACKGROUND
  A few peer-support interventions conducted face-to-face or by telephone have given promising results in promoting breastfeeding in preterm infants.
  
  
  METHODS
  A randomized controlled trial with a 1-year follow-up was conducted in one hospital in Finland in 2011-2015.
  
  
  METHODS
  Altogether 124 mothers of preterm (<35 weeks) infants were recruited; 60 in an experimental and 64 in a control group. The intervention was a closed peer-support group in social media. Data were collected by structured questionnaires. Neonatal and breastfeeding data were collected from patient records.
  
  
  RESULTS
  The duration of overall breastfeeding was on average 3·0 and 4·3 months, in the experimental and control groups respectively. The intervention had no effect on breastfeeding or expressing the breast milk or maternal breastfeeding attitude. A breastfeeding-favourable attitude and at least two previous children predicted longer duration of breastfeeding. Attitude-score decreased during the follow-up. The mothers in the experimental group enjoyed peer support, but only a few reported it as having some impact on breastfeeding.
  
  
  CONCLUSIONS
  Although the Internet-based peer-support intervention had no effect, the importance of breastfeeding attitude for the duration of breastfeeding in mothers of preterm infants was shown. In future, interventions in social media should be studied more and attitude-focused interventions be developed.
authors.affiliation: Department of Nursing Science, University of Turku, Finland.
authors.forename: Hannakaisa
authors.initials: H
authors.lastname: Niela-Vilén
authors.affiliation: Department of Nursing Science, University of Turku, Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: Axelin
authors.affiliation: VAMK University of Applied Sciences, Vaasa, Finland.
authors.forename: Hanna-Leena
authors.initials: HL
authors.lastname: Melender
authors.affiliation: Department of Biostatistics, University of Turku, Finland.
authors.forename: Eliisa
authors.initials: E
authors.lastname: Löyttyniemi
authors.affiliation: Department of Nursing Science, University of Turku, Finland.|Turku University Hospital, Finland.
authors.forename: Sanna
authors.initials: S
authors.lastname: Salanterä
mesh_terms: D000328:Adult; D001942:Breast Feeding; D005260:Female; D005387:Finland; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D009035:Mothers; D012657:Self-Help Groups
keywords: NICU; breastfeeding; breastfeeding attitude; midwives; nursing; peer support; preterm infants; social media