Thomas-Davies, Alaw, Frennesson, Nessie Felicia, Bath, Rachel, Long, Sara Jayne  ORCID: https://orcid.org/0000-0003-1284-9645, Kolovou, Vasiliki and Embling, Rochelle
2026.
Understanding maternal infant feeding decisions in the United Kingdom: a rapid review and qualitative synthesis using the COM-B model and theoretical domains framework.
JAND Global Reports
5
, 100025.
10.1016/j.jaglob.2026.100025
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Abstract
Background: Breastfeeding offers substantial health benefits for mothers and infants, yet breastfeeding rates in the United Kingdom (UK) remain lower than recommended. Understanding which factors influence mothers’ breastfeeding and infant feeding decisions is essential for designing effective interventions. Objective: This review aimed to assess published evidence on the factors that influence mothers’ infant feeding decisions in the UK, focusing on factors that may act as barriers to or facilitators of breastfeeding initiation and continuation up to three years postpartum. Methods: A two-stage search was conducted; stage one screened for qualitative and mix-methods reviews, and stage two identified UK primary studies from the reviews in stage one. Studies were eligible if they explored mothers’ attitudes, values or beliefs relating to breastfeeding or other infant feeding practices. Findings were mapped to the Capability, Opportunity, Motivation, and Behaviour model (COM-B) and the Theoretical Domains Framework (TDF). Results: Of 1319 reviews and 102 studies screened, 26 studies met the inclusion criteria and findings were mapped to all COM-B components and 10 of the 14 TDF domains. Capability barriers included knowledge gaps and unrealistic expectations, while knowledge of breastfeeding benefits and techniques facilitated breastfeeding. Opportunity barriers included limited privacy, not enough access to support and cultural norms while social support and peer networks facilitated breastfeeding. Motivational barriers included guilt and judgement, while beliefs about benefits and intentions to breastfeed acted as facilitators. Conclusions: UK mothers’ infant feeding decisions are shaped by multiple factors. Interventions targeting individuals alone will not sufficiently impact breastfeeding initiation and continuation, and as such, addressing social, environmental and cultural barriers remain essential to public health strategies and interventions.
| Item Type: | Article |
|---|---|
| Date Type: | Publication |
| Status: | Published |
| Schools: | Schools > Social Sciences (Includes Criminology and Education) Schools > School of Social and Spatial Sciences Research Institutes & Centres > Centre For Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer) |
| Publisher: | Elsevier BV |
| ISSN: | 3050-7189 |
| Date of First Compliant Deposit: | 10 August 2026 |
| Date of Acceptance: | 29 July 2026 |
| Last Modified: | 06 Oct 2026 13:10 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/188822 |
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