Low birth weight: exploring an enigma of failure

Low birth weight (LBW) (<=2500g) is universally recognized as a significant health problem, yet there remains a paucity of published evidence concerning how to intervene successfully in a preventative capacity. This article comprises an overview of a ‘review of reviews’ (Ball and Kirkham, 2002), in which high-quality systematic reviews and background literature on preventative intervention were identified. By default, the findings of published research provide a key to the enigma of LBW, and the phenomenon is more readily understood when considered in the context of basic inequalities in health, which are generational in nature and deeply entrenched among families who live in poverty and deprivation. What is needed therefore is a completely radical model of care, which operates outside the traditional boundaries of medical practice. Many excellent initiatives are today embraced into practice (e.g. Sure Start), and their methods and achievements should be placed in the public arena as a matter of priority.