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