A low birth weight (LBW) baby is one whose birth weight is less than 2,500 grams, irrespective of gestational age. LBW babies are at increased risk of hypothermia, hypoglycaemia, infection, feeding difficulties, respiratory problems and poor growth. The midwife has an important role in providing immediate, continuous and skilled care to maintain the baby's physiological stability, promote growth and development, prevent complications and support the mother in caring for her baby. The midwife begins care by assessing the baby immediately after birth. The baby's birth weight, gestational age, temperature, respiratory rate, heart rate, colour, muscle tone and general condition should be assessed and documented. Particular attention should be given to signs of respiratory distress, such as rapid breathing, grunting, chest indrawing, nasal flaring or cyanosis. The midwife should identify babies who require immediate referral or additional neonatal care. Prevention of heat loss is one of the most important responsibilities of the midwife because LBW babies have little subcutaneous fat and a relatively large surface area, making them highly vulnerable to hypothermia. The baby should be dried thoroughly immediately after birth, wet linen should be removed and the baby should be kept in a warm environment. Skin-to-skin contact with the mother should be encouraged as soon as the baby's condition permits. The baby may be placed between the mother's breasts and covered with a warm cloth or blanket, with the head covered appropriately. Temperature should be monitored regularly. If the baby cannot maintain body temperature through skin-to-skin care, an appropriate radiant warmer or incubator may be required. The midwife plays a central role in establishing and maintaining breastfeeding. Breast milk is the ideal food for an LBW baby because it provides easily digestible nutrients, antibodies and other protective factors. Breastfeeding should be