This paper explores the relationship between health at birth, academic outcomes  and the potential role for parental investments using administrative panel data from Chile. Twins fixed effects models estimate a persistent effect of birth weight on academic achievement while OLS and siblings fixed effects models find this relationship to decline over time. We make sense of these findings in the context of a model of human capital accumulation where parental investments respond to initial endowments. Using detailed data on parental investments, we find that  investments are compensatory with regard to initial health, but that within twins, parents do not invest differentially. These findings suggest that initial health shocks significantly affect academic outcomes and that parental investments are a potential channel via which the negative impacts of health shocks can be mitigated over the long run.