Severe nursing shortage adds to the high mortality of low birthweight babies in developing countries. To study the efficacy of maternal nursing care we conducted a prospective matched case-control study. Outcome was compared in low birthweight babies nursed by mothers (mothers' group, n = 151, cases), versus professional nurses (nurses' group, n = 211, controls). Irrespective of condition on admission, weight gain was significantly higher (p < 0.001) and overall mortality rate significantly lower (p < 0.001) in the mothers' group. Mortality was also lower in the mothers' group for babies with pathological jaundice, skin/umbilical sepsis, and no disease except low birthweight (p < 0.001). Intercurrent diarrhoea, aspiration pneumonia, and septicaemia did not differ. Training mothers to nurse their low birthweight babies can significantly reduce mortality rates and decrease workload on nurses. Policy formulation using this approach can save costs in developing countries.