Objective. This survey was conducted to identify factors affecting early initiation of breastfeeding and exclusive breast-feeding among mothers in peri-urban Guatemala Conclusions. Our findings suggest that global efforts must be continued to improve breastfeeding practices in delivery hospitals. In addition, community-based support of breast-feeding is needed well after delivery. Mothers who work outside the home should be provided with options to maintain exclusive breast-feeding when they are physically separated from their infants due to the demands of work.Breast-feeding, infant nutrition, child development, health promotion, health education. ABSTRACTBreast-feeding is critical for sustaining the health and well-being of newborns and infants. Infants who are properly breast-fed grow better and experience less sickness and fewer deaths than do infants who are not breast-fed (1-5). Globally, breast-feeding is on the rise (6). However, in most countries a relatively small percentage of mothers practice optimal breastfeeding behaviors that reduce infants' risk of morbidity and mortality, including initiation of breast-feeding in the first hour after birth and exclusive breast-feeding for the first 6 months of life.Guatemala has the highest rate of childhood malnutrition in Latin America: 42% of children less than 3 years of age are chronically malnourished. Growth faltering in Guatemala begins in the first 6 months of life and accelerates shortly thereafter (7). Globally, efforts to address malnutrition in children may begin too late. Recent analyses using information from Africa, Asia, and Latin America indicate that virtually all deterioration in weight-

Objective. To assess the impact that a mother-to-mother support program operated by La Leche League Guatemala had on early initiation of breast-feeding and on exclusive breast-feeding in peri-urban GuatemalaBreast-feeding, infant nutrition, social support, health education, health promotion.