Long-term breastfeeding mothers’ perspectives on the warm chain’s support

Although breastfeeding provides many benefits for infants as well as mothers, the UK has one of the lowest breastfeeding rates worldwide. While 54.3% of mothers start breastfeeding after birth, only 1% exclusively breastfeed for the first six months and less than 0.5% continue for up to two years as recommended by the World Health Organization and UNICEF. This study aimed to understand what encourages mothers to initiate and sustain breastfeeding, and how society can support them in their breastfeeding journey despite the obstacles they face. A qualitative study using reflexive thematic analysis explored the experiences and attitudes of breastfeeding mothers regarding the support they received. Eight interviews were conducted with mothers aged 38–52 who breastfed for at least twelve months of their lives. Participants had diverse ethnic backgrounds but similar educations levels, partnership statuses while breastfeeding, and lived in East London at the time of the study. Four themes emerged from the data: “Breastfeeding is hard”, “Breastfeeding is magical”, “Breastfeeding is an emotional rollercoaster”, and “Support is everything”. Participants described physical challenges, social stigma, and exhaustion, while simultaneously experiencing deep bonding, pride, and fulfilment. Support from healthcare professionals, family, and peers is essential for breastfeeding success. Interventions should focus on building self-efficacy and providing consistent, accessible support, for example via video conference. Education about realistic expectations and practical aspects of breastfeeding better prepares mothers and reduces anxiety related to perceived insufficient milk supply. At a policy level, strengthening implementation of the warm chain may support longer breastfeeding duration and reduce avoidable early cessation. These findings align with WHO and UNICEF recommendations supported through the Baby-Friendly Hospital Initiative and community-based peer support networks. The small, homogeneous sample (highly educated, middle-class mothers in East London) and recruitment through convenience sampling limit generalisability. Findings may differ among younger mothers, lower socioeconomic groups, or more diverse populations.