Breast milk contains L-Carnitine, which is required for the transport of long-chain fatty acids and other organic acids across mitochondrial membranes. Young infants fed diets with low L-Carnitine concentrations develop reduced plasma and tissue L-Carnitine levels, and they may further develop disorders related to fatty acid oxidation, metabolism of acyl-CoA compounds, ketogenesis and nitrogen balance. The ESPGHAN Committee on Nutrition (European Society for Paediatric Gastroenterology Hepatology and Nutrition) recommends that infant formula contain L-Carnitine at levels similar to those found in breast milk. L-Carnitine synthesis in newborns is less efficient than in adults, and appears to be insufficient to meet the requirements. Therefore, L-Carnitine is regarded as a conditionally essential nutrient for infants and children.
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