Aim: To evaluate the somatic growth of very low birth weight (VLBW) infants through individualized nutritional and medical interventions, tracking growth progress until 40 weeks postmenstrual age. Materials and Methods: This prospective observational study included 100 VLBW infants (<1500 g), admitted within the first 72 hours of life and discharged alive. Infants with major congenital anomalies or syndromes were excluded. Anthropometric measurements (weight, length, and head circumference) were recorded at birth, discharge, and 40 weeks postmenstrual age. Feeding protocols were tailored based on birth weight and clinical stability. Z-scores for anthropometric parameters were calculated to assess growth patterns over time. Statistical comparisons identified significant differences in growth outcomes. Results: The cohort included 55% males, with most infants (45%) born between 28–32 weeks of gestation. Forty percent were classified as small for gestational age (SGA). Weight increased from 1200 ± 200 g at birth to 2600 ± 250 g at 40 weeks. Length improved from 35.5 ± 3.2 cm at birth to 48.2 ± 3.1 cm, and head circumference increased from 26.5 ± 2.5 cm to 33.8 ± 2.4 cm. Maximum weight loss occurred within 5 ± 2 days after birth, with infants regaining birth weight in 15 ± 5 days. Feeding practices varied by birth weight, with infants <600 g taking longer to reach full feeds (14 ± 2 days). Z-scores for weight (-1.8 to -0.8), length (-1.5 to -0.7), and head circumference (-1.6 to -0.9) demonstrated significant catch-up growth. Conclusion: Tailored nutritional and medical strategies significantly improved somatic growth in VLBW infants, with notable catch-up in weight, length, and head circumference. However, disparities in weight gain compared to length and head circumference suggest the need for enhanced nutritional interventions, particularly for SGA infants. Individualized feeding practices effectively minimized complications and promoted optimal growth.