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[3] L-carnitine transports long-chain fatty acids across the inner mitochondrial membrane as acyl-carnitine esters, permitting -oxidation and ATP generation while simultaneously buffering toxic acyl-CoA accumulation

However, it may not be suitable for individuals sensitive to cyanide or those with kidney problems, as the body must detoxify even the small amounts of cyanide

The benzyl alcohol preservative has been linked to severe toxicity in this population, including a potentially fatal condition known as gasping syndrome. Newborns have immature metabolic pathways and cannot efficiently metabolize benzyl alcohol, leading to its accumulation and metabolic acidosis with respiratory failure in severe cases

And honestly, they have a point