Human milk feedings during the critical periods of early life for premature infants contribute to both short and long-term benefits. The potent benefits of human milk are such that all preterm infants should receive human milk. (AAP, 2012) Additionally, all preterm infants should receive fortified human milk to ensure optimal intake of protein, minerals, and vitamins. Now, fortification can be achieved by using human milk-based fortifiers. This program will evaluate strategies on optimizing enteral nutrition to improve growth outcomes in very low birth weight (VLBW) infants.