Increasing litter size has led to introduction of so-called nurse sows in several EU countries. A nurse sow is a sow receiving piglets after having weaned her own piglets and thereby experiencing an extended lactation. In order to analyse whether nurse sows have more welfare problems than non-nurse sows a cross-sectional study was conducted in 57 sow herds in Denmark. Clinical observations were made on nurse and non-nurse sows and their litters. The clinical observations were dichotomized and the effect of being a nurse sow was analysed based on eight parameters: thin (body condition score<2.5), swollen bursae on legs, dew claw wounds, vulva lesions, poor hygiene, poor skin condition, shoulder lesions and cuts and wounds on the udder. Explanatory variables included in the eight models were: nurse sow (yes=1/no=0), age of piglets (weeks old, 1 to 7), parity (1 to 8+) and all first order interactions between these three variables. The effect of using nurse sows on piglet welfare was analysed with five models. The outcomes were: huddling, poor hygiene, lameness, snout cuts and carpal abrasions. The explanatory variables included in the five models were: nurse sow (yes=1/no=0), age of piglets (weeks old, 1 to 7), parity (1 to 8+) and all first order interactions between these three variables. Herd identity was included as a random factor in all models. The nurse sows had a significantly higher risk of swollen bursae on legs (P=0.038) and udder wounds (P=0.001). No differences in risk of being thin or having shoulder lesions were found. Foster litters had significantly higher risk of being dirty (P=0.026) and getting carpal abrasions (P=0.024) than non-foster litters. There was a tendency for higher lameness in foster litters than in non-foster litters (P=0.052). The results show that nurse sows and their piglets to some extent experience more welfare problems than non-nurse sows with piglets at a similar age.