ABSTRACT. The effect of maternal milk feeding during the first 4 weeks of life on neurodevelopmental outcomes at 20 months corrected age (CA) of singleton very low birth weight (VLBW) (<1.5 kg) infants was examined. Ninety-eight VLBW infants born from January 1997 to February 1999 were followed to 20 months CA (mean birth weight, 1012 g; gestational age, 27 weeks). Maternal milk intake was calculated as both mean milliliters per kilogram per day and graded doses. Outcomes included the Bayley Mental Development Index (MDI) and Psychomotor Development Index (PDI), and rates of cerebral palsy (CP) and of overall neurodevelopmental impairment. After adjusting for neonatal and social risk, results revealed no effect of maternal milk on outcomes. MDI was predicted by both social and neonatal risk, and PDI, CP, and neurodevelopmental impairment were predicted by neonatal risk. In this small, high-risk group of VLBW infants, the effects of social and neonatal risk appear to outweigh any possible benefits of maternal milk on neurodevelopmental outcome.