In The Lancet Global Health, Anne Lee and colleagues from the Child Health Epidemiology Reference Group (CHERG)1 make an important contribution to our understanding of the global burden of intrauterine growth restriction. What is new in this work is the evidence that the majority of growth-restricted neonates (assessed with the proxy of small-for-gestational-age birth) weigh 2500 g or more at birth, even in low-income and middle-income countries. In high-income countries, most preterm infants—particularly those born at 34—36 completed weeks of gestation—also weigh at least 2500 g. Lee and colleagues show that nearly half of preterm infants from countries of low and middle income also are born above this birthweight threshold. Thus, globally, the traditional maternal and child health indicator of low birthweight (defined as <2500 g) fails to identify most newborn babies who are born either too small or too soon. This fact alone undermines Lee and colleagues’ claim that “low birthweight is an important population indicator for tracking neonatal health”.