SummarySelection for hyperprolific sows, as a means of increasing litter size and profit, has resulted in an increased number of low-birthweight (LBW) piglets. These LBW piglets might suffer from increased morbidity and mortality during the early neonatal period. In addition, they show reduced growth performance, meat and carcass quality, which leads to an important economic loss for the farmer in the post-natal period. Therefore, nutritional interventions can be undertaken to prevent and rear LBW piglets. In the first part of this review, the preventive strategies at the sow level will be discussed. Approaches in preventing LBW piglets are to optimize the intrauterine environment via supplementing the sow during gestation. In the second part of this review, the interventions at the piglet level will be described. To increase the survival and growth rates of LBW piglets, one must focus on ensuring adequate colostrum and milk intake. Interventions include supplementing piglets, split nursing, split weaning and cross-fostering. Additional interventions increasing the probability of optimal post-natal food intake will be discussed.