This study examined the effects of home fortification of pregnant women’s diets with small-quantity lipid-based nutrient supplement (SQ-LNS) on the birth size of newborns in an African community in Malawi. The women were provided with one daily iron-folic acid (IFA) capsule, one capsule containing multiple micronutrients (MMNs), or one 20-g sachet of SQ-LNS (LNS, containing 118 kcal, protein, carbohydrates, essential fatty acids, and 21 micronutrients). The study findings do not support a hypothesis that the provision of SQ-LNS to all pregnant women would increase the mean birth size in rural Malawi.