Objective:To determine whether peer counselors impacted breastfeeding duration among premature infants in an urban population. Design:This was a randomized controlled clinical trial. Setting:The trial was conducted in the Newborn Intensive Care Unit at Boston Medical Center,an innercity teaching hospital with approximately 2000 births per year. Participants:One hundred eight mother-infant pairs were enrolled between 2001 and 2004. Pairs were eligible if the mother intended and was eligible to breastfeed per the 1997 guidelines from the American Academy of Pediatrics and if the infant was 26 to 37 weeks’ gestational age and otherwise healthy. Intervention:Subjects were randomized to either a peer counselor who saw the mother weekly for 6 weeks or to standard of care. Main Outcome Measure:The main outcome measure was any breastmilk feeding at 12 weeks postpartum. Results:Intervention and control groups were similar on all measured sociodemographic factors. The average gestational age of infants was 32 weeks(range,26.3-37 weeks) with a mean birth weight of 1875 g(range,682-3005 g). At 12 weeks postpartum,women with a peer counselor had odds of providing any amount of breastmilk 181%greater than women without a peer counselor (odds ratio,2.81 95%confidence interval,1.11-7.14 ; P=0.01). Conclusions:Peer counselors increased breastfeeding duration among premature infants born in an innercity hospital and admitted to the neonatal intensive care unit. Peer counseling programs can help to increase breastfeeding in this vulnerable population. Objective: To determine whether peer counselors impacted breastfeeding duration among premature infants in an urban population. Setting: The trial was conducted in the Newborn Intensive Care Unit at Boston Medical Center, an innercity teaching hospital with approximately 2000 births per year. Participants: One hundred eight mother-infant pairs were enrolled between 2001 and 2004. Pairs were eligible if the mother intended and was eligible to breastfeed the 1997 guidelines from the American Academy of Pediatrics and if the infant was 26 to 37 weeks’ gestational age and otherwise healthy. Intervention: Subjects were randomized to either a peer counselor who saw the mother weekly for 6 weeks or to standard of care. Main Outcome Measure: The main outcome measure was any breastmilk feeding at 12 weeks postpartum Results: Intervention and control groups were similar on all measured sociodemographic factors. The average gestational age of infants was 32 weeks (range, 26.3-37 weeks) with a mean birth weight of 1875 g (range, 682-3005 g). At 12 weeks postpartum, women with a peer counselor had odds of providing any amount of breast milk 181% greater than women without a peer counselor (odds ratio, 2.81 95% confidence interval, 1.11-7.14; P = 0.01). Conclusions: Peer counselors increased breastfeeding duration among premature infants born in an inner city hospital and admitted to the neonatal intensive care unit. Peer counseling programs can help to increase breastfeeding in this vulnerable population.