The Millennium Development Goals (MDGs) has its fourth goal to reduce infant mortality to two thirds the 1990 value by year 2015. Under five and infant mortality rates have been fairly constant over the past 15 years but are still high in the developing countries despite successes in the control of communicable diseases. 40% of under- five deaths and two-thirds of infants deaths occur within the first 28 days of life. According to the United Nations Children’s Fund (UNICEF), more than 50 percent of neonates die at home of which 60% are babies born with birth weight below 2500g. These babies are at increased risk of dying from hypoglycemia, hypothermia, infections and jaundice than normal birth weight babies. A cross sectional analytical study was conducted in the Sekondi sub-metropolis of the Sekondi Takoradi Metropolis, to assess maternal home care practises of neonates. 121 respondents were identified by a snow ball approach and interviewed. The birth weights of babies of 85 mothers were verified at the health centres of birth, 16 of these were low birth weight. 81.82 percent of mothers had a negative perception of low birth weight with higher proportions in women with more than one child. Vulnerability of low birth weight babies was nearly universal with mothers recognizing feeding and access to health care as important but less importantly immunization and warmth provision. Mothers recommended formula feed but less importantly semi solid cereal feed in addition to breastfeeding for low birth weight babies with 26.45 percent recommending herbs. Exclusive breastfeeding within the first month of life was 82.6 percent with higher proportions among educated mothers and mothers 30 years and older. 61.2% of mothers had knowledge of kangaroo mother care (KMC) and 59.5% practised KMC. 97.5% of mothers had their babies vaccinated, 61.2% receiving BCG within the first seven days of life. It was found that 15.7% of mothers administered herbs to their babies during the first month of life for various reasons including prevention and treating certain childhood diseases, emptying bowel and removing “phlegm” from baby. There was no significant difference in the home care practises with respect to exclusive breastfeeding (p= 0.069), KMC practise (p= 0.091), immunization (p= 0.503), and herbal practises (p= 0.734) between low birth weight and normal birth weight babies; despite relatively lower proportions in low birth weight babies. There was however a significant difference with respect to the introduction of semi-solid food during the first month of life between the two groups, p= 0.031, with a high proportion in low birth weight babies. In conclusion, it was found that, the mothers’ knowledge of low birth weight babies and the needed care for these babies is inadequate. It is therefore, recommended that, efforts should be made to improve the level of knowledge of mothers of low birth weight, its complications and the home care required for the survival of these neonates in the metropolis. This could change the perceptions of mothers and improve the home care of all neonates but especially low birth weight neonates.