Introduction: There is a need for clear guidelines to support adequate nutrition and growth for premature neonates. Unfortunately, we do not have a consensus on the ideal parameters and timing for assessment of growth in these infants. Even though optimal postnatal growth should ideally replicate intrauterine rates, after the initial physiological normal drop, many premature infants follow gains below intrauterine rates. This extrauterine growth restriction (EUGR) can be quantified as lower weight Z-score medians at discharge than those at birth, indicated by a negative difference between birth and discharge (Δ Z-score) below 1 SD. We hypothesized that improved nutrition could reduce the incidence of EUGR in convalescing premature infants. Materials and methods: We reviewed the clinical information from all EpicLatino units in the past 8 years (2015–2022); all infants who were born at ≤32 weeks’ gestational age (GA) and discharged home at ≥34 weeks’ corrected age were included. Statistical comparisons were performed to analyze growth parameters and potential causes of poor nutrition. The weight Δ Z-score from birth to discharge was used as a surrogate for adequacy of nutrition. Birth weight medians and interquartile ranges were correlated with weight Δ Z-score, GA, and head circumference (HC) at discharge. Results: We reviewed 480 cases that met the established criteria. Gestational age at birth, necrotizing enterocolitis, unit of origin, rupture of membranes >24 hours, temperature at admission, and intraventricular hemorrhage were significantly different. There was a negative correlation between the Δ Z-score and corrected GA at discharge. Head circumference at discharge also correlated with weight Δ Z-score. Conclusion: The frequency of EUGR varied between units. There were some clinical associations, but our sample size was not large enough to establish causality. The risk of EUGR may increase with severity of illness or could be higher in some specific populations. Quality improvement programs to optimize nutrition policies and practices may help.