title: Intervention based on BASNEF model increases exclusive breastfeeding in preterm infants in Iran: a randomized controlled trial.
abstract: BACKGROUND
  The 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.
  
  
  METHODS
  This 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.
  
  
  RESULTS
  Baseline 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.
  
  
  CONCLUSIONS
  Breastfeeding 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.
  
  
  BACKGROUND
  Iranian Registry of Clinical Trials number IRCT2014111013405N6 and date registered, January 5, 2015.
authors.affiliation: Department of Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Sheler
authors.initials: S
authors.lastname: Ahmadi
authors.affiliation: Department of Midwifery &Reproductive Health, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Farideh
authors.initials: F
authors.lastname: Kazemi
authors.affiliation: Research Center for Child & Maternity Care, Midwifery Department, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Seyedeh Zahra
authors.initials: SZ
authors.lastname: Masoumi
authors.affiliation: Chronic Disease Research Center, Midwifery Department, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Parisa
authors.initials: P
authors.lastname: Parsa
authors.affiliation: Department of Biostatistics and Epidemiology, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Ghodratollah
authors.initials: G
authors.lastname: Roshanaei
keywords: Counselling; Exclusive breastfeeding; Premature infant