Objective: To investigate the effects of early enteral feeding with different nutritional preparations on growth and development, nutrition and feeding tolerance of very low birth weight (VLBW) premature infants. Methods: A total of 100 VLBW premature infants with age <12 h after admission admitted to our hospital from May 2019 to May 2021 were selected and divided into breast feeding group (BF group, n=30), formula milk feeding group (SPF group, n=35) and deep hydrolyzed protein milk feeding group (eHF group, n=35). The growth and development (body weight growth rate, body length growth rate, head circumference growth rate), nutritional biochemical indexes [serum prealbumin (PA), creatinine (Scr), total bilirubin (TB), blood urea nitrogen (BUN), calcium (Ga)] and adverse events were compared among the three groups. Results: There was no significant difference in weight growth rate, length growth rate and head circumference growth rate among the three groups (P>0.05). After feeding, the TB levels in eHF group were significantly lower than those in BF group and SPF group (P<0.05); there was no significant difference in PA, Ga, Scr, BUN level among the three groups (P>0.05). The incidence of feeding intolerance in BF group and eHF group was significantly lower than that in SPF group (P<0.05). There was no significant difference in the incidence of extrauterine growth retardation, infection, necrotizing enterocolitis and cholestasis among the three groups (P>0.05). Conclusion: Breast feeding and formula milk feeding can both promote the growth and development of premature infants with VLBW and improve nutritional and biochemical indexes. Among them, eHF feeding can effectively promote TB metabolism and reduce the incidence of feeding intolerance.