Rochow N, Fusch G, Ali A, et al. - In this single-center, double-blind, randomized controlled trial, researchers analyzed the effect of target fortification on preterm growth and metabolism by adjusting breast milk macronutrients. The sample consisted of infants < 30 weeks gestational age at birth with an anticipated length of stay > 21 days and receiving fortified breast milk. Baseline features, morbidities, and total fluid intake were not different among groups (intervention n = 52, control n = 51). Infants in the intervention group had higher macronutrient intakes, greater weight gain, and greater body weight. The intervention group infants from mothers with below-average breast milk protein content displayed greatest impact on weight at 36 weeks, length, head circumference, fat, and fat-free mass. Feeding intolerance was also less frequent, blood urea was higher, and triglycerides were lower. Findings suggested that target fortification of breast milk with low macronutrient content improves nutritional quality and growth and is feasible in clinical routine.