**Abstract**

Genetic selection for higher prolificacy is one of the major causes for a decrease in piglet survival and reproductive health of the sow. Large litters increase farrowing duration and decrease piglet birth weight and therefore have an impact on piglet vitality, colostrum uptake, and piglet survival. Large litters also increase the incidence of postpartum dysgalactia syndrome (PDS) and the probability of the sow to be removed from the herd because of reproductive failure. Therefore, hyperprolificacy challenges the performance of the sow in terms of parturition, colostrum production, neonatal survival, and fertility. In this review, we discuss the tools and protocols for management of parturition, colostrum, and sows' reproductive health. We provide checklists for the prevention of birth complications and PDS as well as for improvement of mammary gland development and colostrum production.

**Keywords:** sow, large litter, parturition, postpartum dysgalactia syndrome, piglet survival, colostrum, risk factors, management
