Nutrition support of the premature infant must be designed to compensate for metabolic and gastrointestinal immaturity, immunologic insufficiency, and the demands of associated medical conditions. The beneficial effects of human milk extend to the feeding of premature infants. While human milk enhances immunity, nutritional concerns arise because the milk may not meet the expanded nutrient requirements of the very low birth weight (VLBW, less than 1500 g) premature infant. Human milk fortifiers are available to provide optimum nutrition. This review summarizes the benefits and limitations of human milk for the premature infant.