Post Discharge Human Milk Fortifier in Preterm Infants

Inclusion Criteria:

• Birth Weight between 750-1800 g
• Gestational Age at birth between 26 and 32 weeks
• Singleton or twin birth (for twins to be eligible, both must meet eligibility criteria)
• Small for Gestational age or appropriate for gestational age
• ≥ 80% energy received from human milk in the previous three days
• ≥ 25% of human milk consumed orally in the previous three days
• Mother agrees to exclusively feed her infant human nilk after discharge
• If so randomized, parents agree to supplement ~1/2 or the human milk provided to her infant as powdered human milk fortifier for 12 weeks after hospital discharge
• Subject's parents have voluntarily signed an informed consent form

Exclusion Criteria:

• Serious congenital or chromosomal anomalies that will affect growth
• Grade III or IV periventricular/intraventricular hemorrhage
• Received steroids within 14 days o randomization
• Asphyxia (hypoxia or ischemia) es evident by severe and permanent neurological data
• Maternal incapacity, including maternal cocaine or alcohol abuse dring pregnancy, or concurrent, or mother or infant has tested positive for HIV
• Principal residence of study family outside GTA
• Mother unable to verbally communicate in English
• A single feeding must be fortified > 24 kcal/oz or >50% of feeds need to be fortified