Human milk is the optimal feeding for preterm infants due to its nutritional and bioactive factors, supporting not only growth and development, but also the immune and gastrointestinal systems. However, questions remain regarding the optimal approach to human milk feeding in the NICU, including selection among fortification types, fortification timing, supplementation strategies, and the role of bioactives. Amidst these uncertainties, interprofessional collaboration and practical solutions to common preterm infant feeding challenges are urgently needed.