Linda C. Pugh, associate professor and director of the baccalaureate program at the School of Nursing, received a $2 million grant from the National Institute of Nursing Research to determine the net cost savings of providing breast-feeding support to low-income mothers.

Professional and national health organizations recommend that women breast-feed exclusively for the first six months. While rates of adherence are generally low, disparities exist across socioeconomic lines. Only 20 percent of low-income women breast-feed for six months, compared to almost 41 percent of more affluent women.

"Promoting breast-feeding by all women is a goal, but to reduce these disparities, increasing breast-feeding among low-income women should be a priority," says Pugh, principal investigator of the study. Pugh says nearly 35 percent of low-income women stop breast-feeding within eight days of delivery. Previous research by Pugh concluded that consistent, comprehensive and culturally sensitive support from a nurse and community health worker can increase breast-feeding duration in low-income women. According to Pugh, however, support for low-income women has been neglected by health care providers and information not made available because of generally unsubstantiated claims that the effort is not cost-effective.

"What we have is a realistic strategy to increase breast-feeding among low-income women, who usually lack the resources to get support in the community," Pugh says. "Breast-feeding results in savings from the costs of infant formula and lower health care costs, and it may be less time-consuming. These savings have the potential to offset the costs of breast-feeding promotion."

To determine the actual net cost savings of improved breast-feeding duration, the four-year study will compare a group of mothers receiving standard care with a group receiving in-hospital lactation support, telephone support and home visits from a nurse or community health worker.

Additional members of the multidisciplinary team include co-principal investigators Kevin Frick, associate professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, and Janet Serwint, associate professor of pediatrics at the Johns Hopkins School of Medicine.