26 ORAL L-CARNITINE SUPPLEMENTATION IN LOW-BIRTH-WEIGHT NEONATES MAINTAINED ON POOLED MILK

As the carnitine /C/ content of human milk declines during lactation, it is doubtful, that its amount is adequate to statisfy the daily needs of premature infants fed with pooled milk. Effects of supplementation have been studied in 20 AGA premature infants /weight at birth 1200 to 1800 g; gest. age 28 to 34 wk/. Throughout 7 days, started at postnatal ages of 10 to 33 days, infants were fed exclusively with pooled human milk containing 300 nmol/ml C as added supplement. Total, free and acyl C were significantly elevated in the plasma at the end of study with an increase in beta hydroxybutyrate /22.9±2.5 vs 38.4±3.9 umol/1, means±SEM, p<0.05/ and a decrease in triglyceride /1.67±0.08 vs 1.29±0.07 nmol/1, p < 0.001/ and urea levels /1.72±0.09 vs 1.36±0.07 nmol/1, p< 0.005/. In the urine both fractions of C significantly increased at the end of study as compared to presupplementary control days. Urinary excretion of total nitrogen /77.3±6.7 vs 62.4±2.4 mg/kg/day, p<0.05/ and urea /1.88±0.11 vs 1.25±0.09 mnol/kg/day, p<0.005/ decreased. The present data suggest, that improved carnitine availability resulted in increased fat oxidation, utilization of amino acids/proteins decreased. It is suggested, that the nutritional value of pooled milk for low-birth-weight infants should be reconsidered because its low carnitine content.