 Randomized double blind prospective clinical trial. All infants admitted to University Hospital neonatal intensive care unit with birth weight of 1000 grams, mmore than 24 weeks gestation and with no congenital anomalies will be enrolled in the study. This will include inborn infants and those that are transported from outlying hospitals and admitted at 12 hours of life. After informed consent, infants will be randomized to receive either standard of care nutritional management or nutritional management per study protocol with the addition of protein supplementation. Randomization will take place in the pharmacy. 