Understanding the barriers and enablers of babywearing using the COM-B model and the theoretical domains framework

• Mothers actively negotiated multiple, interrelated barriers and enablers related to the capability, opportunity, and motivation to engage in babywearing. • Developing a strong identity as a ‘babywearer’ was one of the strongest motivational enablers of babywearing. • Physical capability to carry their child was a significant barrier to babywearing. • Enablers could be harnessed more, and barriers reduced, with support from healthcare professionals. Research suggests that ‘babywearing’ (the use of slings, wraps, and carriers) can have beneficial effects on the quality of parent-child attachment, maternal well-being, paternal responsiveness, breastfeeding behaviour, child mood, and child sleeping patterns. Recently, there has been a growth in the popularity of babywearing, but reports suggest there are significant challenges in engaging and maintaining the practice. This research used qualitative methods and concepts from behavioural science (the Theoretical Domains Framework and the COM-B model) to investigate the psychological, social, cultural, economic, and logistic factors that mothers perceive as barriers and enablers in relation to babywearing. Seventeen mothers with experience of babywearing were interviewed. They reported both positive and negative aspects of babywearing, and many factors that made babywearing easier or more difficult. Notable issues including access to babywearing equipment, access to training and support, difficulty/ease of use, convenience/empowerment relative to other baby transport solutions, physical capacity, and social pressure/support. The findings provide a rich social, motivational, and behavioural description of the factors that influence people’s decision to babywear and suggest several approaches that baby-wearing advocates could use to support their work.