• Change from baseline in body weight (g) at 3 months [ Time Frame: Baseline and Month 3 ] [ Designated as safety issue: No ]
• Body weight at 12 months' corrected age [ Time Frame: 12 months´ corrected age ] [ Designated as safety issue: No ]
• Change from baseline in total body length (mm) at 4 weeks [ Time Frame: Baseline and Day 29 ] [ Designated as safety issue: No ]
• Change from baseline in total body length (mm) at 3 months [ Time Frame: Baseline and Month 3 ] [ Designated as safety issue: No ]
• Time to readiness for discharge. [ Time Frame: Baseline to time point when readiness for discharge ] [ Designated as safety issue: No ]
• Time to discharge. [ Time Frame: Baseline to time for discharge ] [ Designated as safety issue: No ]
• Change from baseline in head circumference (mm) at 4 weeks. [ Time Frame: Baseline and Day 29 ] [ Designated as safety issue: No ]
• Head circumference (mm) at 3 months. [ Time Frame: Month 3 ] [ Designated as safety issue: No ]
• Head circumference at 12 months' corrected age. [ Time Frame: 12 months´ corrected age ] [ Designated as safety issue: No ]
• Number and percentage of patients with treatment emergent AE, SAE and AE leading to discontinuation by system organ class and preferred term (coded by MedDRA) [ Time Frame: Baseline to Month 3 ] [ Designated as safety issue: Yes ]
• Change from baseline in Systolic Blood Pressure, Diastolic Blood Pressure and Heart Rate at 4 weeks [ Time Frame: Baseline and Day 29 ] [ Designated as safety issue: Yes ]
• Systolic Blood Pressure, Diastolic Blood Pressure and Heart Rate at 4 weeks [ Time Frame: Day 29 ] [ Designated as safety issue: Yes ]
• Number and percentage of patients with a clinically significant abnormal laboratory assessment during treatment [ Time Frame: Baseline to Day 29 ] [ Designated as safety issue: Yes ]

• Change from baseline in body weight (g) at 3 months [ Time Frame: Baseline and Month 3 ] [ Designated as safety issue: No ]
• Body weight at 12 months' corrected age [ Time Frame: 12 months´ corrected age ] [ Designated as safety issue: No ]
• Change from baseline in total body length (mm) at 4 weeks [ Time Frame: Bseline and Day 29 ] [ Designated as safety issue: No ]
• Change from baseline in total body length (mm) at 3 months [ Time Frame: Baseline and Month 3 ] [ Designated as safety issue: No ]
• Time to readiness for discharge. [ Time Frame: Baseline to time point when readiness for discharge ] [ Designated as safety issue: No ]
• Time to discharge. [ Time Frame: Baseline to time for discharge ] [ Designated as safety issue: No ]
• Change from baseline in head circumference (mm) at 4 weeks. [ Time Frame: Baseline and Day 29 ] [ Designated as safety issue: No ]
• Head circumference (mm) at 3 months. [ Time Frame: Month 3 ] [ Designated as safety issue: No ]
• Head circumference at 12 months' corrected age. [ Time Frame: 12 months´ corrected age ] [ Designated as safety issue: No ]
• Number of Adverse Events [ Time Frame: Baseline and 12 months´ corrected age ] [ Designated as safety issue: Yes ]

The purpose of this study is to demonstrate that rhBSSL improves growth in preterm infants as compared with placebo.

The purpose of this study is to demonstrate that rhBSSL improves growth in preterm infants as compared with placebo. The infants should be born before week 32 of gestational age.

The study drug, rhBSSL or placebo, will be administered during a 4 week treatment period by adding it to either infant formula or pasteurized breast milk.

The study will also evaluate the safety and tolerability of rhBSSL.

Eligible patients will be randomized in a ratio of 1:1 (rhBSSL:placebo). The study consists of maximum 1 week screening period, a 4-week treatment period and a 1 year follow-up period.

• Experimental: rhBSSL
  Intervention: Drug: rhBSSL (recombinant human bile-salt-stimulated lipase)
• Placebo Comparator: Placebo
  Intervention: Drug: rhBSSL (recombinant human bile-salt-stimulated lipase)

Inclusion Criteria:

• Preterm infants born before week 32 of gestation.
• Preterm infant who is less than 33 weeks postmenstrual age at the time of randomization.
• Preterm infant who is appropriate for gestational age (AGA) or small for gestational age (SGA) at birth.
• Preterm infant who is receiving food enterally (bottle or gavage tube) at a level of at least 100 ml/kg/day at randomization.
• Preterm infant whose enteral feeding consists of only infant formula or only pasteurized breast milk at the time of inclusion, and who are expected to remain on only infant formula for 4 weeks, or only pasteurized breast milk for at least 2 weeks following treatment initiation.
• Preterm infant who is expected not to receive any fresh breast milk for 4 weeks following treatment initiation.
• Informed consent is obtained.

Exclusion Criteria:

• Expected stay in the hospital is less than 4 weeks from the first dose of study drug.
• Criteria to ensure no disease or treatment affecting growth or development, e.g. brain disease, necrotizing enterocolitis.
• Enrolled in another concurrent clinical intervention study.