Maternal overweight and obesity are associated with failure to initiate breastfeeding successfully and to sustain breastfeeding adequately. The purpose of this study was to describe how health care providers counsel obese mothers about breastfeeding. The authors surveyed (by telephone or in-person interview) health care providers who counsel mothers about breastfeeding in rural upstate New York (n = 89). They also surveyed lactation consultants (n = 31) from New York, New Jersey, Florida, Nebraska, California, and Texas by e-mail. The authors found that the majority of health care providers surveyed neither believed that there was a difference in the success rate between obese mothers and normal-weight mothers nor advised obese mothers differently about breastfeeding. Given the excess risk for premature lactation failure among obese women, these findings suggest that those who care for such women need to be made aware of this risk so that they can develop and provide appropriate services. J Hum Lact. 22(3):322–327.