Background Umbilical outpouchings (UOs) are common in Danish pigs. Neonatal antibiotics are therefore usedwith the hope of reducing umbilical infections and subsequently UOs. However, the effect of neonatal antibioticson preventing UO has been the subject of mixed conclusions, and secondly, treating all animals with antibioticsmight exacerbate the development of antimicrobial resistance.This study analysed the effects of different treatments on the prevalence of umbilical outpouchings and mortalityfrom birth to nursery unit. All treatment was on the day of birth. The groups were: a negative control group, an anti‑biotic group receiving amoxicillin, and an experimental group where the piglets had their umbilical cord disinfectedwith chlorhexidine, followed by tying and clipping, and lastly, injection with meloxicam. The pigs were examined sixweeks after weaning, and all pigs that died during the study were autopsied.Results There were 5494 pigs divided across the three groups. There were no statistically significant differencesin UO prevalence between the groups: control 3.9%, antibiotic 4.2%, and experimental 4.0% (p = 0.87). The only vari‑able affecting the prevalence of UOs in this study was sex with females being at higher risk. There were no statisti‑cally significant differences in mortality between the groups from birth until departure from the nursery unit: control22.9%, antibiotic 21%, and experimental 21.4% (p = 0.33). The variables affecting mortality were sex, intrauterinegrowth restriction (IUGR), birth weight, and cross fostering. Males had higher odds of dying, as had piglets recordedwith some degree of IUGR. Also, low birth weight increased the odds of dying for all weight quartiles comparedto the fourth (the heaviest piglets > 1.6 kg), as well as cross fostering increased the odds ratio of dying.Conclusions This study found no significant differences in the prevalence of UOs and mortality following differenttreatments at birth. The study showed that the prevalence of UO and mortality was not reduced following the admin‑istration of amoxicillin or meloxicam in combination with disinfection and tying of the umbilical cord.Keywords Umbilical outpouchings, Pigs, Prevention, NSAID, Antibiotics, Disinfection, Amoxicillin, Meloxicam,Chlorhexidine