Survivability of piglets during the neonatal period has been decreasing as genetic selection for highly prolific animals continues across the swine industry. Piglets considered medium weight at birth (1.0-1.3kg) provide the greatest opportunity to improve survival. Colostrum consumption by the neonate after birth aids in thermoregulation and improves survival to weaning as well as provides passive immunity to the piglet from the dam to aid in health pre- and post-weaning. Researchers have studied supplementing piglets with porcine and bovine colostrum or with colostrum-like products rich in energy, protein and immunoglobulins. This chapter reviews current research on a range of types of supplementation to young piglets prior to weaning on growth, immune status and survival.