Low birth weight in Aboriginal babies has become a persistent quandary as their average birth weight continues to be lower than that of non-Aboriginal babies. Arguments, reviews and research abound to explain this difference which is deemed unacceptable and needing resolution. A précis review of current theories and findings around low birth weight in Aboriginal babies is presented as a background for much needed alternative considerations of this issue. The low birth weight dilemma requires urgent rethinking of Aboriginal women's experiences and feelings of their pregnancies and possible effects on their unborn babies. There is a critical need for empowerment of Aboriginal women that goes beyond rhetoric and dominant ideologies about what is best for them and their babies, and genuinely enables them to assume control and self-determinism in ways that might make a significant difference, including importantly to their babies' birth weights.