In 1990, a lactation management clinic was established at Children’s Hospital in Islamabad, Pakistan, with the goal of promoting exclusive breast feeding for 4-6 months. Mothers who are experiencing problems breast feeding are referred to this specialized service from other units of the hospital. The clinic is staffed by two public health nurses. At intake, both mother and infant are examined and the attempt to breast feed is observed. Where appropriate, guidance is provided about how to position the infant during breast feeding. In addition, a social history that seeks information on the attitudes toward breast feeding on the part of the husband and extended family is taken to detect any psychosocial obstacles to a successful nursing experience. In some cases, breast feeding is prematurely terminated due to women’s concerns that their breast milk is of poor quality or the insistence of significant others that the infant is not gaining enough weight. To date, the clinic has counseled over 4000 mothers. A follow-up survey of 273 of these women indicated that 67% had resolved their breast feeding problem. Three months after the initial consultation, 61% of these mothers were still exclusively breast feeding, 25% were providing both breast milk and supplemental fluids, and only 9% had weaned their infant.