Babies’ birthweight and other birth outcomes affect their health, development and learning during the early years, which impacts third grade reading outcomes.

Babies born weighing less than 5.5 pounds are at greater risk for physical, developmental and learning problems than infants of normal weight, including:

  • Short- and long-term illness or disability
  • Learning disorders
  • Behavioral problems
  • Enrollment in special education classes
  • Grade retention
  • School failure1

Low birthweight babies generally score lower on reading, passage comprehension, and math achievement tests.2

Low birthweight impacts Black babies at a higher rate than white babies, regardless of mother’s income. Effective strategies to improve healthy birthweight rates focus on pre-pregnancy health, with a particular focus on supporting women of color.

Show 2 footnotes

  1.  Schorr et al, Pathway to Children Ready for School and Succeeding at Third Grade. op cit.
  2.  Michigan News. (2007, June 5). Born to lose: How birthweight affects adult health and success. Retrieved from

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of white babies were born at low birth weight in 2019

State Center for Health Statistics, North Carolina

of Black babies were born at low birth weight in 2019

State Center for Health Statistics, North Carolina

of Hispanic babies were born at low birthweight in 2019

State Center for Health Statistics, North Carolina


What Can We Do About It?

What supports healthy birthweight?

  • Policies and practices that focus on improving women’s general pre-pregnancy health (including addressing unhealthy behaviors) and prenatal and inter-conception care, with particular attention to groups at high risk for low birthweight births.
  • Two-generation approaches and evidence-based programs that support mothers’ health, provide parenting education and support, and support children’s health and learning.

North Carolina’s Perinatal Health Strategic Plan: North Carolina adapted national research to develop a 12-point framework designed to improve health care prenatally and between pregnancies, enhance the coordination of services, and address inequities. The plan is in the implementation phase.1

Improving Community Outcomes for Maternal and Child Health: This initiative within the North Carolina Department of Health and Human Services will fund evidence-based strategies to improve birth outcomes and reduce infant mortality. It will focus on

  • Use of long-acting reversible contraceptives
  • Smoking cessation and prevention
  • Triple P interventions.2 Triple P is a parenting education program that aims to increase the knowledge, skills and confidence of parents and reduce mental health, emotional and behavioral problems in children.

Research-based policies, practices and programs that providers, communities and North Carolina can take to improve healthy birthweight rates.

Show 2 footnotes

  1.  North Carolina’s Perinatal Health Strategic Plan: 2016-2020. (2016). North Carolina Department of Public Health. Retrieved from
  2.  ImprovingCommunity Outcomes for Maternal and Child Health (ICO4MCH). (2017).

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