Few studies support the practice of warming human milk before feeding. No studies have compared the method of warming milk and its effect on growth, particularly in preterm infants. To evaluate growth in preterm infants receiving continuously warmed human milk as compared with infants receiving human milk warmed in a hot water bath before feeding. Forty-four infants less than 32 weeks' gestation admitted to a regional referral level IV neonatal intensive care unit in south central United States were randomly assigned to either the experimental group (continuous warming: n = 22) or the control group (hot water bath: n =22) for 10 days. All infants were on full human milk feedings (120-130 kcal/kg/d) as part of a standardized feeding protocol. Tolerance and weight gain over the 10-day period were used to evaluate the effectiveness of continuous milk warming. There was a significant difference in weight gain for infants receiving continuously warmed milk compared with infants receiving standard warmed milk (203.73 ± 70.71 vs 271.95 ± 67.40, P = .002). The use of continuous milk warming improves weight gain in very low birth-weight infants.