Aim: Exclusive breastfeeding increases survival and optimizes growth of low-birthweight (LBW) infants. If supported, mothers can overcome the unique difficulties associated with breastfeeding from birth to 6 mo. We tested the efficacy of postnatal peer counselling among first-time mothers that aimed to increase exclusive breastfeeding of term LBW infants. Methods: In a Manila hospital, 204 mothers were randomized into three groups. Two intervention groups receiving home-based counselling visits, one by counsellors trained in breastfeeding counselling (n = 68), the other by counsellors trained in general childcare (n = 67), were compared with a control group of mothers (n = 69) who did not receive counselling. Results: Eighty-eight per cent of the participating pairs completed the trial. At 6 mo, 44%of the breastfeeding counselled mothers, 7%childcare-counselled mothers and none of the mothers in the control group were exclusively breastfeeding. More mothers in the breastfeeding counselled group than in the other groups were still breastfeeding at 6 mo. Twenty-four infants who were exclusively breastfed for 6 mo did not have any diarrhoea. All groups had improved mean weight-for-age Z-scores at 6 mo. Conclusion: This study has provided fundamental evidence of successful intervention to achieve 6mo of exclusive breastfeeding among term LBW infants. By improving health outcomes, enhanced breastfeeding offers a distinct possibility of disrupting the intergenerational cycle of undernourished women giving birth to LBW infants. Aim: Exclusive breastfeeding increases survival and optimizes growth of low-birthweight (LBW) infants. If supported, mothers can overcome the unique difficulties associated with breastfeeding from birth to 6 mo. We tested the efficacy of postnatal peer counseling among first-time mothers that Two groups were home-based counseling visits, one by counselor trained in breastfeeding counseling (n = 68), the other by counselors trained in general childcare (n = 67), were compared with a control group of mothers (n = 69) who did not receive counseling. Results: Eighty-eight per cent of the participating pairs completed the trial. At 6 mo, 44% of the breastfeeding counselled mothers, 7% childcare-counselled mothers and none of the mothers in the control group were exclusively breastfeeding. More mothers in the breastfeeding counsel led groups than in the other groups were still breastfeeding at 6 mo. Twenty-four infants who were exclusively breastfed for 6 mo did not have any diarrhea. All groups had improved mean weight-for-age Z-scores at 6 months. Conclusion: This study has provided fundamental evidence of successful intervention to achieve 6mo of exclusive breastfeeding among term LBW infants. By improving health outcomes, enhanced breastfeeding offers a distinct possibility of disrupting the intergenerational cycle of undernourished women giving birth to LBW infants.