The North American pork industry has substantially increased the number of piglets born per litter. Improvement in litter size was achieved through better management and implementation of effective genetic selection programs for litter size. However, the increase in number of piglets born per litter is associated with more piglets with low birth weight, increased preweaning mortality of piglets, and a greater demand placed on the sow to produce more milk. There are people who have stated concerns about the welfare of the animals. The health and welfare concerns can be minimized by using proper management procedures and excellent caretakers.

Some of the management aspects that can help increase preweaning survival include: understanding the complex interaction between the sow, piglet, environment and caretaker; managing to correct for number of non-functional mammary glands and nipples; effective management of colostrum when sows have a large number of piglets; effective use of cross-fostering procedures; managing lactation feed intake for genetically lean sows with large litters; utilization of a detailed procedure for training and supervising new employee.