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Plasma carnitine and breast milk carnitine intake in premature infants
Insights
Premature infants receiving breast milk maintained stable plasma carnitine levels. Carnitine intake increased in the second week, with higher urinary excretion, but did not correlate with plasma levels.
Area of Science:
- Neonatal Nutrition
- Biochemistry
Background:
- Premature infants are at risk for carnitine deficiency.
- Carnitine is essential for fatty acid metabolism.
Purpose of the Study:
- To assess carnitine intake and plasma levels in premature infants fed breast milk.
- To investigate the relationship between breast milk carnitine and plasma carnitine status.
Main Methods:
- Studied 10 premature infants (gestational age 27-32 weeks) for 14 days.
- Measured daily breast milk carnitine intake and concentration.
- Monitored plasma carnitine, its derivatives, and urinary excretion.
Main Results:
- Daily carnitine intake increased from week 1 to week 2.
- Plasma carnitine levels remained stable throughout the study.
- No correlation found between breast milk intake and plasma carnitine levels.
- Urinary carnitine excretion increased in the second week.
Conclusions:
- Premature infants without complications can maintain plasma carnitine levels with breast milk feeding.
- Breast milk provides adequate carnitine for stable plasma levels in this population.
Abstract:
Ten premature infants with a mean gestational age of 29 weeks (range, 27-32) and a mean birth weight of 1,294 g (range, 930-2,300) and without complications at birth were studied during the first 14 days after birth. Their breast milk intake was recorded and the carnitine content determined in each daily portion. During the first week, the daily mean carnitine intake was low and increased to 6-7 mumoles/kg and day during the second week. Breast milk carnitine concentration ranged from 17 to 148 mumoles/L. Plasma carnitine and its derivatives did not change during the observation period. No relationship was found between the individual cumulative breast milk carnitine intake and total plasma carnitine levels or between carnitine and its derivatives and nonesterified fatty acids or 3-OH-butyrate. The urinary carnitine excretion, in millimoles of carnitine per mole of creatinine, was higher during the second week. In other studies, declining plasma carnitine levels have been observed in premature infants on total parenteral nutrition. The results from this study indicated that premature infants without complicating disorders were able to maintain their plasma carnitine levels.