There is sufficient evidence at present to support early enteral feeding of low birth weight (LBW) neonates, including those who are sick or very preterm (< 30 weeks). Trophic feeding with human milk initiated within 48 hours of birth at 10-15 ml/kg/day improves later tolerance to graded increment of enteral feeding volumes without increased risk of necrotizing enterocolitis. Trophic feeding supports increments of feeding volumes by 30 ml/kg/day by intermittent gavage feeding. Non-nutritive sucking and spoon-feeding aid earlier transition to exclusive breast-feeding. Human milk promotes adequate growth of most preterm neonates, though many need multivitamin and mineral supplementation. The role of human milk fortifiers to promote growth appears controversial.