Abstract Across the globe, the well-being of newborns is greatly influenced by the knowledge and practices of family members, yet global policies and interventions primarily focus on strengthening health services to save newborn lives. Predominant approaches to promote newborn survival in non-western cultures across the Global South, based on a western, nuclear family model, ignore the role of family caregivers, whose attitudes and practices are influenced by culturally prescribed strategies embedded in family systems. This paper is an argumentative review of the literature which provides evidence of a neglected facet of newborn care, the role and influence of grandmothers. Based on a family systems frame, over the past ten years I identified research conducted in Africa, Asia and Latin America that examines family roles related to newborn care, specifically that of grandmothers. I identified numerous studies, from published and grey literatures, in English, French and Spanish, which provide evidence of grandmothers’ role as culturally-designated and influential newborn advisors and caregivers. Research from all three continents reveals that grandmothers play similar core roles in newborn care while their culturally-specific practices vary. Review findings support two conclusions. First, the conceptual basis for future newborn research should manifest a family systems framework, grounded in the structure and dynamics of non-western collectivist cultures. Second, newborn interventions should aim not only to strengthen health services but also influential family caregivers, namely grandmothers, and the indigenous social support networks of which they are a part, in order to improve family-level newborn practices and save newborn lives.