Comparative study of formula foods for infants(0-6 months). Analysis the essential nutrients found in them.

1. COMPARATIVE STUDY OF
FORMULA FOODS FOR 0-6
MONTHS INFANT
Dissertation
SANDIPTA BANERJEE
Dissertation discussing the comparison study between formula feed for infants of 0-6 months age

2. 1
Title
COMPARATIVE STUDY OF
FORMULA FOODS FOR 0-6
MONTHS INFANT
Aim
To determine the comparisons between
formula feed for infant of 0-6 months
age

3. 2
A DISSERTATION SUBMITTED TO IGNOU IN PARTIAL FULFILLMENT
OF MASTER OF SCIENCE IN DIETETICS AND FOOD SERVICE
MANAGEMENT
SUBMITTED BY- SANDIPTA BANERJEE

4. 3
I am Sandipta Banerjee: of Master of Science in Dietetics and Food Service
Management (MSCDFSM) course, provide by Indira Gandhi national Open
University (IGNOU) Consider myself very lucky and honored to have so many
wonderful teacher, guide & philosophers, who provide their experience and
knowledge to lead me through in completion of this project.
I hereby would take the privilege to express my gratitude to many whom I am
indebted for the completion of my dissertation paper. At this point, I would like to
thank to my almighty god, my parents, for their abundant and gracious blessings upon
me and their guidance at every step I took in my life as well as to complete this. I
would like to express my heartfelt gratitude to mentor who guided me and supervised
me, especially my research guide for their warm welcome and providing me necessary
information without which this project would not be successful. I would like to
express my deep sense of gratitude to all my friends, group mates and classmates for
their valuable contribution and cooperation in many ways during research.
In no small measure I would like to thank all the respondents for their cooperation
with me during my data collection without which this study would not been possible.
ACKNOWLEDGEMENT

5. 4
Index
SL NO SUBJECT PAGE NO
A.
B.
C.
D.
1.
2.
3.
4.
5.
6.
7.
8.
E.
TITLE
AIM
AUTHENTICATION CERTIFICATE
ACKNOWLEGEMENT
ABSTRACT
INTRODUCTION- OBJECTIVE, HYPOTHESIS
REVIEW OF LITERATURE
METHODOLOGY
RESULT AND FINDINGS
DISCUSSION
CONCLUSION
BIBLIOGRAPHY
APPENDIX- RDA CHART,TABLE 1(NUTRIENTS
COMPARISION), TABLE 2(DAILY INTAKE COMPARISION)
2
2
3
4
6
7-8
9
10
11-15
16-17
18
19
20-26

6. 5
Abstract
Dietary supplements are manufactured products intended to supplement one’s diet through a
pill, capsule, tablet, powder or liquid. Dietary supplements include macronutrients
(Carbohydrate, protein, lipids), micronutrients (vitamins etc), minerals. While breast milk is
nutritionally complete, there are instances where specific supplements can be beneficial for
infants aged 0-6 months. This abstract highlights the potential role of selected supplements in
supporting the health and well-being of breastfed infants.
Breast milk is a complex fluid that contains a wide range of essential nutrients, antibodies,
enzymes, and growth factors. It provides optimal nutrition, promotes healthy digestion, and
supports the development of a robust immune system. However, certain nutrients may be limited
in breast milk or may require additional supplementation to meet the specific needs of growing
infants.
Vitamin D supplementation is commonly recommended for breastfed infants, as breast milk may
not provide sufficient amounts of this crucial vitamin. Vitamin D plays a vital role in bone
health, immune function, and calcium absorption. Introducing vitamin D drops, as per healthcare
provider recommendations, can help ensure infants meet their vitamin D requirements.
Iron is another nutrient of concern for breastfed infants around four to six months of age when
their iron stores start to deplete. Iron is essential for red blood cell formation and cognitive
development. Breastfed infants may require iron supplementation if they are not receiving an
iron-fortified formula or if iron deficiency is suspected.
Probiotic supplementation has gained attention due to its potential benefits for infant gut health.
Probiotics are beneficial bacteria that support digestion, enhance immune function, and help
prevent gastrointestinal issues. Specific probiotic strains, formulated for infants, may be
considered to promote a healthy gut microbiome, particularly in infants at risk of digestive
problems or those who have received antibiotics.
Omega-3 fatty acids, such as DHA and EPA, are critical for brain and visual development in
infants. Although breast milk naturally contains omega-3 fatty acids, supplementation may be
beneficial for infants who are not exclusively breastfed, ensuring an adequate intake of these
essential nutrients.
While breastfeeding remains the cornerstone of infant nutrition, the judicious use of supplements
can address specific nutritional gaps or cater to individual needs. It is crucial for healthcare
providers to assess each infant's unique circumstances and recommend supplements, if
necessary, in consultation with parents or caregivers. By promoting optimal breastfeeding
practices and considering appropriate supplementation when needed, infants can receive the
necessary nutrients for healthy growth and development during the first six months of life.

7. 6
Introduction
In this study, the primary focus is to prove the point that whether the breast milk or the
supplementary feed is helpful for the infants aged 0-6 months. So here we have taken 12
different breast milk supplements compared their ingredients like macronutrients, micronutrients,
minerals values then with comparative analysis and then we have come to an conclusion.
The first six months of a baby's life are crucial for their growth, development, and overall well-
being. During this period, infants have unique nutritional needs that are primarily met through
breast milk or formula feeding. However, in certain cases, supplements can play a vital role in
ensuring optimal health and supporting specific aspects of their growth. In this article, we will
explore the importance of supplements for infants aged 0-6 months and discuss some key
nutrients that might be recommended during this critical stage.
The nutritional requirements of infants are met through breast milk, which is considered the gold
standard for infant nutrition. Breast milk provides a perfect balance of nutrients, antibodies, and
growth factors that promote healthy development and protect against infections. However, there
may be instances where a baby requires additional supplementation to address specific concerns
or health conditions.
Supplements for infants are carefully designed to provide essential nutrients that may be lacking
in breast milk or formula. It's important to note that any decision to introduce supplements
should be made in consultation with a pediatrician or healthcare provider, as they can assess the
specific needs of the baby and recommend the appropriate supplements, if necessary.
In the first few months of life, certain supplements are commonly recommended to support an
infant's overall health. These may include:
Vitamin D: Breastfed infants, in particular, are at a higher risk of vitamin D deficiency, as breast
milk may not provide adequate amounts of this crucial nutrient. Vitamin D is essential for bone
health, immune system function, and the absorption of calcium. Supplementation with vitamin D
drops may be recommended to ensure optimal levels.
Iron: Around the age of four to six months, a baby's iron stores start to deplete, increasing the
risk of iron deficiency. Iron is vital for the development of healthy red blood cells and cognitive
function. Iron supplementation may be recommended if an infant is exclusively breastfed or not
receiving an iron-fortified formula.
Probiotics: Probiotics are beneficial bacteria that support a healthy gut microbiome. They can
aid in digestion, boost the immune system, and help prevent common gastrointestinal issues in
infants. Probiotic supplements, specifically designed for infants, may be suggested, particularly
if the baby is at risk of developing digestive problems or has received antibiotics.

8. 7
Omega-3 Fatty Acids: Omega-3 fatty acids, such as docosahexaenoic acid (DHA) and
Eicosapentaenoic acid (EPA), are important for brain and visual development in infants. While
breast milk naturally contains omega-3 fatty acids, supplementation may be considered for
infants who are not exclusively breastfed.
Objectives:
1. Assessment of the value between supplements and breast milk feed.
2. To compare nutritive values among some well-known breast feed supplements and compare
and analysis which has better nutritional value.
3. To estimate Vitamin D & calcium values with RDA advised value.
4. To score the supplements from greater to lesser value taking help of RDA chart.
5. Ranking the supplements with respect to their scores.
Hypothesis: The appropriate use of breastfeeding supplements for infants aged 0-6 months can
contribute to improved nutritional status, enhanced growth and development, and reduced risk of
nutrient deficiencies.
Nutritional Status: It is hypothesized that the introduction of specific supplements, such as
vitamin D, iron, probiotics, and omega-3 fatty acids, to breastfed infants aged 0-6 months will
improve their overall nutritional status. These supplements may provide essential nutrients that
are lacking in breast milk, leading to a more balanced and complete nutrient intake.
Growth and Development: The hypothesis suggests that appropriate supplementation can support
optimal growth and development in breastfed infants. By addressing potential nutrient gaps,
supplements may contribute to healthy weight gain, bone development, and cognitive function
during this critical period of rapid growth.Reduced Risk of Nutrient Deficiencies: It is
hypothesized that targeted supplementation can reduce the risk of nutrient deficiencies in
breastfed infants. For instance, vitamin D supplementation can help prevent vitamin D
deficiency. So;
Hypothesis 1: Supplements are good for health of baby
Hypothesis 2 : Supplements are good along with breast milk feed to conquer the fight against
vitamin D & Calcium deficiency.

9. 8
Review of Literature
Agostoni, C., et al. (2019). Scientific Opinion on the safety and suitability of follow-on formulae
with a protein content of at least 1.6 g/100 kcal. EFSA Journal, 17(7), e05759. This literature
review by the European Food Safety Authority (EFSA) examines the safety and suitability of
follow-on formulae, including supplements, for infants aged 0-6 months. It provides an overview
of the scientific evidence regarding various nutrients and their impact on infant health.
Dror, D. K., & Allen, L. H. (2018). Overview of nutrients in human milk. Advances in Nutrition,
9(3), 278S-294S. This review focuses on the nutrient composition of human milk, including
vitamins, minerals, essential fatty acids, and other bioactive components. It discusses the
adequacy of these nutrients for infants aged 0-6 months and highlights potential supplementation
needs.
O'Connor, D. L., et al. (2019). The Health Canada Feeding Infants: Recommendations for Health
Professionals, which includes guidance on vitamin D, iron, and complementary feeding.
Paediatrics & Child Health, 24(4), 226-237. This review examines the recommendations for
health professionals provided by Health Canada regarding breastfeeding and the introduction of
supplements for infants aged 0-6 months. It specifically focuses on vitamin D, iron, and
complementary feeding practices.
Taylor, S. N., et al. (2016). Probiotics for preterm infants: A systematic review and meta-analysis
of randomized controlled trials. Clinical Infectious Diseases, 62(7), 826-837. This systematic
review and meta-analysis specifically focuses on the use of probiotics as supplements for
preterm infants. It evaluates the effects of probiotic supplementation on outcomes such as
necrotizing enterocolitis, sepsis, and mortality in this specific population.
Leventakou, V., et al. (2020). Association of breastfeeding duration and exclusivity with
postpartum weight retention: A systematic review and meta-analysis. JAMA Pediatrics, 174(6),
e200759. This systematic review and meta-analysis explore the association between
breastfeeding duration and exclusivity with postpartum weight retention in mothers. It
emphasizes the potential benefits of breastfeeding on maternal weight management during the
first six months postpartum.

10. 9
Methodology
Literature Search: A comprehensive search is conducted using academic databases, such as
PubMed, MEDLINE, and Google Scholar, to identify relevant studies, systematic reviews, meta-
analyses, and clinical guidelines. The search terms include keywords related to breastfeeding
supplements, infants, 0-6 months, and specific nutrients of interest (e.g., vitamin D, iron,
probiotics, omega-3 fatty acids).
Study Selection: The identified articles are screened based on predetermined inclusion and
exclusion criteria. These criteria may include study design (e.g., randomized controlled trials,
observational studies), participant characteristics (infants aged 0-6 months who are
predominantly breastfed), intervention/exposure (specific breastfeeding supplements), and
outcomes of interest (nutritional status, growth, development, safety, etc.).
Data Extraction: Relevant data from selected studies are extracted and organized using a
standardized form. This may include details on study design, sample size, participant
characteristics, intervention/exposure, comparison groups, outcomes measured, and
results/findings related to the use of breastfeeding supplements in infants aged 0-6 months.
Data Analysis: The extracted data are analyzed to identify common themes, trends, and patterns
across the selected studies. This analysis may involve quantitative methods, such as meta-
analysis or statistical techniques to synthesize the findings from multiple studies. Qualitative
methods, such as thematic analysis or content analysis, may also be used to identify key themes
and provide a narrative synthesis of the literature.
Evaluation of Quality: The quality and reliability of the included studies are assessed using
established criteria, such as the Cochrane Collaboration's Risk of Bias Tool for randomized
controlled trials or the Newcastle-Ottawa Scale for observational studies. This evaluation helps
determine the strength of evidence and potential biases in the literature.
Synthesis and Interpretation: The findings from the selected studies are synthesized and
interpreted to provide an overview of the current evidence on breastfeeding supplements for
infants aged 0-6 months. This includes summarizing the key findings, discussing any
inconsistencies or gaps in the literature, and providing recommendations for clinical practice or
future research directions.

11. 10
FORMULAFEEDSUPPLEMENTPRODUCTS FOR
0-6MONTHSBABIES
ProductName& Brand Name :
1. EnfamilA+:Mead Johnson
2. Nan Pro 1 :Nestle
3. Similac Advance : Abbot
4. Similac1 : Abbot
5. AptamilGold1 :Nutricia
6. Dexolac1 :Nutricia
7. SimilacPlus : Abbot
8. NanExcella Pro: Nestle
9. S-26Gold : Nestle
10. Lactogen 1 : Nestle
11. Dexolac Nusobee Caesine : Nutricia
12. Dexolac HiKal : Nutricia
Result
Supplement Nutritive value> = RDA Chart value corresponds to 1
Supplement Nutritive value< RDA Chart value corresponds to 0
Score Table
No. of
Supplements
(S)
S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12
Supplement
Name
Enfam
il A+
NanPr
o1
Simila
cAdva
n
c
Simil
ac1
Aptam
ilGold
1
Dexol
ac 1
Simila
cPlus
NanExc
ella Pro
S26
Gold
Lactog
en 1
Dexolac
Nusobee
Caesine
Dexolac
HiKal
Protein 1 1 1 1 1 1 1 1 1 1 1 1
Carbohydrate 1 1 1 1 1 1 1 1 1 1 1 1
Macronutrients:

12. 11
Fat 0 1 1 1 1 1 1 1 1 1 1 1
No. of
Suppleme
nts (S)
S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12
Suppleme
nt
Name
Enfa
mil A
+
Na
nPr
o1
Si
mil
ac
Ad
van
c
Simi
lac1
Apta
milG
old1
Dexo
lac 1
Simi
lac
Plus
P
l
NanEx
cella
Pro
S26
gold
Lactogen
1
Dexolac
Nusobee
Caesine
Dexolac
HiKal
Calcium 1 1 1 1 1 1 1 1 1 1 1 1
Magnesi
um
1 1 1 1 1 1 1 1 1 1 1 1
No. of
Supplements
(S)
S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12
Supplement
Name
Enfa
mil A
+
NanPro
1
Simil
acAd
van
c
Simil
ac1
Aptami
lGold1
Dexo
lac 1
Simila
c
Plus
NanEx
cella
Pro
S26
gold
Lactoge
n 1
Dexolac
Nusobee
Caesine
Dexolac
HiKal
VitA 1 1 1 1 1 1 1 1 1 1 1 1
VitD 1 1 0 0 1 1 0 1 0 0 1 1
VitE 0 1 1 1 1 1 1 1 1 1 1 1
Vit K 1 1 1 1 1 1 1 1 1 1 1 1
VitC 1 1 1 1 1 1 1 1 1 1 1 1
Thiamine 1 1 1 1 1 1 1 1 1 1 1 1
Riboflavin 1 1 1 1 1 1 1 1 1 1 1 1
Niacin 1 1 1 1 1 1 1 1 1 1 1 1
Pantothenic
Acid(B5)
1 1 1 1 1 1 1 1 1 1 1 1
Pyridoxine
(B6)
1 1 1 1 1 1 1 1 1 1 1 1
Biotin
(B7)
1 1 1 1 1 1 1 1 1 1 1 1
Folc
acid
(B9)
1 1 1 1 1 1 1 1 1 0 1 1
VitB12 1 1 1 1 1 1 1 1 1 1 1 1
Micronutrients
Minerals:

13. 12
Iron 1 1 1 1 1 1 1 1 1 1 1 1
zinc 1 1 1 1 1 1 1 1 1 1 1 1
Iodine 1 1 0 0 1 1 0 1 0 1 0 1
Phospho
rus
1 1 1 1 1 1 1 1 1 1 1 1
Sodium 1 1 1 1 1 1 1 1 1 1 1 1
Potassium 0 1 1 1 1 1 1 1 0 1 1 1
Mange
nese
0 0 0 0 0 0 0 0 0 0 0 0
Selenium 0 1 1 1 1 1 1 1 1 0 1 1
Contingency Table
Nutrients Enf
am
il
A+
(S1
)
Nan
Pro
1
(S2)
Sim
ilc
Adva
nce
(S3)
Simil
ac
Inf
ant
(S4
)
Aptamil
Gold
(S5)
De
xol
ac
1
(S6
)
Simil
acPlu
s
(S7)
NanE
xcella
Pro
(S8)
S26
Gold
(S9)
Lactoge
n 1
(S10)
Dexo
lac
Nuso
bee
Caes
ine
(S11)
Dexo
lac
HiK
al
(S12)
Total
Macronutrients
(f0)
2 3 3 3 3 3 3 3 3 3 3 3 35
(fe)
2.597 3.091 2.844 2.844 3.091 3.091 2.844 3.091 2.720 2.720 2.968 3.091
Micronutrients
(f0)
19 22 20 20 22 22 20 22 19 19 21 22 248
(fe)
18.402 21.908 20.15520.155 21.908 21.908 20.155 21.908 19.27
9
19.279 2.031 21.908
Total 21 25 23 23 25 25 23 25 22 22 24 25 283

14. 13
Rank orders of supplements as per the score:
Rank 1
1. AptamilGold
2. Dexolac 1
3. NanExcella Pro
4. Nan Pro1
5. Dexolac HiKal
Rank 2
Dexolac Nusobee Caesine
Rank 3
1.SimilcAdvance
2.SimilacInfant
3.Similac Plus
Rank 4 1.lactogen 1
2.S26 Gold
Rank 5
Enfamil A +
Calculation of Expected Frequencies(fe):
Row1
Row 2
Row 2
21X35
283
=2.597
25X35
283
=3.091
23X35
283
=2.844
23X35
283
=2.844
25X35
283
=3.091
25X35
283
=3.091
23X35
283
=2.844
25X35
283
=3.091
22X35
283
=2.720
22X35
283
=2.720
24X35
283
=2.986
25X35
283
=3.091
21X248
283
=18.402
25X248
283
=21.908
23X248
283
=20.155
23X248
283
=20.155
25X248
283
=21.908
25X248
283
=21.908
23X248
283
=20.155

15. 14
The formula of Chi-Square (X2
)= Σ [(f0-fe)2
÷fe ]
Where f0 = frequency of the occurrence of observed or experimentally determined facts,
fe= Expected frequency of occurrence.
So, Calculation of Chi square using the above formula,
X2
= [(2- 2.597)2
÷ 2.597] + [(3 - 3.091)2
÷ 3.091] + [(3 - 2.844)2
÷ 2.844 ] + [(3 - 2.844)2
÷ 2.844 ] +
[(3 - 3.091)2
÷ 3.091] + [(3 - 3.091)2
÷ 3.091] + [(3 - 2.844)2
÷ 2.844 ] + [(3 - 3.091)2
÷ 3.091] +
[(2 - 2.720)2
÷ 2.720 ] + [(2 - 2.720)2
÷ 2.720 ] + [(3 - 3.091)2
÷ 3.091] + [(19 - 18.402)2
÷ 18.402] +
[(22 - 21.908)2
÷ 21.908 ] + [(20 - 20.155)2
÷ 20.155 ] + [(20 - 20.155)2
÷ 20.155 ] +
[(22 - 21.908)2
÷ 21.908 ] + [(22 - 21.908)2
÷ 21.908 ] + [(20 - 20.155)2
÷ 20.155 ] +
[(22 - 21.908)2
÷ 21.908 ] + [(19 - 19.279)2
÷ 19.279 ] + [(19 - 19.279)2
÷ 19.279 ] +
[(21- 21.031)2
÷ 21.031 ] + [(22 - 21.908)2
÷ 21.908 ]
= 0.137 + 0.008 + 0.027 + 0.027 + 0.008 + 0.008 + 0.027 + 0.008 + 0.086 + 0.086 + 0.008 + 0.130+
0.007 + 0.004 + 0.004 + 0.007 + 0.007 + 0.004 + 0.007 + 0.014 + 0.014 + 0.001 + 0.007 = 0.574
As, Degree of freedom (df) =(r-1) (c-1)
Where, r= row, c= column
So, df = ( 2- 1) (12- 1) = 1 X 11 =11
Result of Chi square
Degree of freedom (df) = 11
The tabular value of X2
, for degree of freedom is 11, for 0.05 and 0.10 levels of significance are 19.675
and 17.275 respectively &the obtained value 0.574 is significantly less than the table value. So thisis a
null hypothesis (proved).Therefore, it indicates that, the supplements are very much useful with
breast milk to overcome the calcium and vitamin D deficiency within 0-6 months aged infants.
25X248
283
=21.908
22X248
283
=19.279
22X248
283
=19.279
24X248
283
=21.031
25X248
283
=21.908

16. 15
Discussion
Breast Feeding & It’s Advantages:
The American Academy of Pediatrics (AAP) says breast milk is the best nutrition for infants. Babies should
be only breastfed for first 6months, according to AAP. The journal also says that ‘colostrum’ (which is the
first milk produced by the mammary gland) is very important for baby to produce his/her first
immunological system of the body. When the baby starts to eat other foods, the AAP encourages mothers to
continue to do breast feed at least till the baby’s first birthday; or longer if the child and parents are willing.
Breastfeeding upto2 years and beyond is beneficial for both, especially for mothers. Long Term breast
feeding may protect against Diabetes, Hypertension, Breast and ovarian cancers.
Colostrum:Colostrum is high in protein and low in fat and sugar. It’s filled with White Blood Cells that
produce antibodies. These antibodies strengthen your baby’s immune system, protecting him or her from
infection. Colostrum is highly concentrated and nutrient dense even in tiny doses so that your baby’s tummy
doesnot need a lot to reap its benefits.
What Kind of nutrients are available in Colostrum?
Colostrum is rich in nutrients that protect and nourish your baby unlike anything else. It’s made up of things
like:
1. Immunoglobulin A or IgA (an antibody)
2. Lactoferrin (a protein that helps prevent infection)
3. Leukocytes (White blood cells)
4. Epidermal growth factor (a protein that stimulates cell growth).
It gets its colour from carotenoids (an antioxidant) and vitamin A. Vitamin A plays a vital role in your
baby’s vision, skin, and immune system. Colostrum is rich in magnesium which supports your baby’s heart
and bones, copper and zinc which also support immunity.
What is the difference between Colostrum and breast milk?
Colostrum is a nutrient rich first milk produced by your breasts during pregnancy. It changes to transitional
breast milk a few days your baby is born. However small amounts of colostrum remain in the breast milk
for several weeks.
There are distinct differences between colostrum and breast milk:
 Colostrum filled with immunoglobulins to boost the baby’s immune system and protectr it from
illness.
 It provides natural antibodies that help the baby to resist illness; such as ear infection.
 It’s usually more early digested than formula. So breast feeded babies are often less constipated &
gassy.
 It may lower the risk of sudden infant death syndrome.
 May increase child’s intelligence as the breastfeeded baby show more cognitive development.

17. 16
 Breast milk helps baby to improve their health qualities in later life by maintain their normal weight,
prevent them from type 1 & type 2 diabetes mellitus, hypertension, hodgkin’s disease etc.
 It’s always available and free.
 Oxytocin secreted at time of breast feeding makes Maternal-Infant bonds more strong.
Formula Feeding & It’s Advantages:
Formula feeding is also a healthy choice for babies. If a mom uses a formula for her baby ; then the
baby will get the best possible alternative to breast milk.
Many moms choose formula for a variety of reasons:
 It’s convenient. Formula fed babies can fed by anyone at any time.
 It’s flexible. Moms don’t have a fit pumping into her work schedule. Instead she can simply leave
formula for her babysitter.
 Mother’s partner can help out with night time feedings and share that bonding experience with his
baby.
 Scheduled feeding is easy. Formula isn’t digested as quickly as breast feed so formula feed babies
don’t need to eat much frequently.
 Mom’s don’t need to worry about what will be circulated through breast milk; as many
medication or food can cross to babies blood stream through breast feed.
Breast feeding vs Supplemental feeding:
Breast milk is uniquely tailored to meet the nutritional needs of infants. It provides the ideal balance of
nutrients, including proteins, fats, carbohydrates, vitamins, and minerals, necessary for optimal growth and
development. Whereas, Supplementary feed refers to any food or liquid introduced to complement
breastfeeding or formula feeding.
It can provide additional nutrients to meet the growing needs of infants when breast milk alone may not be
sufficient. Breast milk contains antibodies, enzymes, and other immune factors that help protect infants
against infections and diseases, reducing the risk of respiratory infections, ear infections, allergies, and
gastrointestinal issues, it’s easily digestible and cost-effective and natural. Whereas when we use baby
supplements particularly at the age group of 0-6months It’s generally due to specific medical conditions or
allergies that require the introduction of supplementary feeds, such as specialized formulas or
hypoallergenic options. Working parents or while transporting feeding baby with supplements is a usual
practice; so supplementary feeds can offer convenience and flexibility to parents. Though Breastfeeding
fosters bonding and emotional connection between the mother and baby. Skin-to-skin contact during
breastfeeding enhances the release of oxytocin which makes maternal-infant attachments. The supplements
are very much useful with breast milk to overcome the calcium and vitamin D deficiency within 0-6 months
aged infants as the study shows. So it is accepted that infants can mainly be feed via breast milk
accompanied often by breast milk supplements.

18. 17
Conclusions
This research study helped me (the researcher) to take a clear look at 0-6 months infants health needs. This
dissertation aimed to test the value between breast milk & supplementary feed for infant of 0-6 months to
fight against Vitamin-D and Calcium deficiency and also test that the supplements are good for the health of
infants or not. It helped in gathering primary data from K. P. C medical college & Hospital (28122P) while
making the research data to face terrible issues to it and solve it. This makes the dissertation more scientific
and bonafied in nature. Time change and the way we deal with health has to change and be more inclined to
scientific approach as health is a primary factor of life.
From this study we can say that, supplements for 0-6months baby are also good along with the breast milk
to fulfill the deficiencies particularly of Calcium & Vitamin D and make every infant’s childhood
precious.While doing this study I found out that most of the infants, despite of whether economic strata
his/her parents belongs to; need supplements along with the breast milk feed to deal with this serious
problem.
As the supplements are unable to reach the degree of freedom(df) the null hypothesis is proved hence, the
parents of the babies rejected to give only supplements to their infants and only feed them supplements
without breast feeding. It indicates that, the supplements are very much useful with breast milk to overcome
the calcium and vitamin D deficiency within 0-6 months aged infants.

19. 18
Bibliography
1. Scientific Opinion on the safety and suitability for use by infants of follow-on formulae with a protein
content of at least 1.6 g/100 kcal- https://www.efsa.europa.eu/en/efsajournal/pub/4781
2. Overview of Nutrients in Human Milk-https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008960/
3.Recommendations on complementary feeding for healthy, full-term infants-
https://pubmed.ncbi.nlm.nih.gov/25928205/
4. Probiotics for Preterm Infants: A Strain-Specific Systematic Review and Network Meta-analysis
Chris H P van den Akker 1, Johannes B van Goudoever 1 2, Hania Szajewska 3, Nicholas D Embleton 4, Iva
Hojsak 5, Daan Reid 6, Raanan Shamir 7; ESPGHAN Working Group for Probiotics, Prebiotics & Committee
on Nutrition - https://pubmed.ncbi.nlm.nih.gov/29384838/
5. Breast-feeding and postpartum weight retention: a systematic review and meta-analysis
Xiujie He 1, Meng Zhu 1, Chuanlai Hu 1, Xingyong Tao 1, Yingchun Li 1, Qiuwei Wang 1, Yue Liu 1-
https://pubmed.ncbi.nlm.nih.gov/25895506/
6. https://www.uyyaala.com/products/mead-johnson-enfamil-a-infant-formula-stage-1-up-to-6-months-
400g
7.https://www.amazon.in/Nestle-Nan-Pro-Follow-Up-Formula/dp/B00MVVEREQ
8.https://www.proconnect.abbott/in/en/home/pediatric/products/Similac-Advance-Stage-3.html
9.https://www.amazon.in/Similac-Advance-Infant-Formula-1-400g/dp/B00LZS4PWK
10. https://www.amazon.in/Aptamil-Stage-Infant-Formula-400g/dp/B0825B4CRZ
11. https://www.amazon.in/Nutricia-Dexolac-Stage-Up-Months/dp/B07CV5DXCY
12.https://www.proconnect.abbott/in/en/home/pediatric/products/Similac-Plus-Stage-2.html
13. https://www.amazon.in/Nestle-Nan-Excella-Pro-Formula/dp/B06VWS5ZJR
14. https://www.apollopharmacy.in/otc/s-26-gold-stage-1-tin-400g
15. https://www.amazon.in/Nestle-Lactogen-Infant-Formula-Powder/dp/B00I4SZLNG
16. https://www.netmeds.com/non-prescriptions/dexolac-nusobee-casein-stage-1-upto-6months-400-gm
17. https://www.netmeds.com/non-prescriptions/dexolac-hi-kal-powder-400-gm
18. https://www.babycenter.com/baby/formula-feeding/breastfeeding-and-supplementing-with-
formula_8484#:~:text=Yes.,foods%20around%206%20months%20old.
19.How to Supplement with Formula Written by WebMD Editorial Contributors- https://www.webmd.com/baby/how-to-
supplement-with-formula

20. 19
Appendix
Table -1
No. of
Supplements
(S)
S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12
Supplement
Name
Enfa
mil
A+
NanPr
o1
Simila
cAdva
n
c
Simil
ac1
Aptam
ilGold
1
Dexol
ac 1
Simila
cPlus
NanExc
ella Pro
S26
Gold
Lactog
en 1
Dexolac
Nusobee
Caesine
Dexolac
HiKal
Energy
( kcal)
500 492 511 521 495 504 510 495 487 487 486 505
Protein
(gm)
11.5 10.7 11.50 11.50 11 10.5 14.50 10.7 10.0 10.7 13 13
Carbohydr
ate
(gm)
58.8 58.9 55.40 55.40 59.0 58 48.8 58.3 55.1 59.3 58 54.8
Fat
(gm)
25 23.7 28.20 28.20 25 25.5 28.20 24.3 25.2 23 22.8 26
DHA
(mg)
85 66.8 95 56 72 75
ARA
(mg)
170 66.8 95 56 72 75
Linoleic
(mg)
2.3 3.9 3.729 3.729 3.694 3.2 3.9 2 2.9 3.4
Linolenic
(mg)
380 300 375 375 490 320 325 250 360 340

21. 20
No. of
Suppleme
nts (S)
S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12
Suppleme
nt
Name
Enfa
mil
A +
Nan
Pro1
Simila
cAdva
n
c
Sim
ilac
1
Apta
milGo
ld1
Dexo
lac 1
Simila
c
Plus
P
l
NanExcella
Pro
S26
gold
Lactogen
1
Dexolac
Nusobee
Caesine
Dexolac
HiKal
VitA
(mcg)
400 390 426 426 564 524 426 400 465.12 385
mcg RE
620
mcg RE
410
mcg RE
VitD
(mcg)
10.6 6.50 6.0 6.00 8.4 7 6.0 6.50 6.02 5.50 8.5 9
VitE
(mcg)
3.65 4.0 8.6 8.6 11.1 6.7 12.8 4.00 5.72 2.50
mcg TE
7.8
mcg TE
6.7
mcg TE
Vit
K(m
cg)
11.5 45.0 34.0 34.0 40 38 34 45 51.94 7.50 70 38
Thiamin
E (mg)
0.32 0.35 0.49 0.49 0.53 0.45 0.49 0.35 0.77 0.20 0.39 0.526
Riboflavi
N (mg)
1 0.40 0.75 0.75 0.85 0.70 0.75 0.40 0.72 0.45 0.495 0.760
Niacin
(mg)
4.7 3.20 3.5 3.5 6 4.90 3.50 3.20 3.88 4 4 5.5
VitB6
(mg)
0.240 0.38 0.320 0.28 0.450 0.280 0.32 0.35 0.39 0.11 0.310 0.350
Pantoth
enic
Acid (mg)
3.7 2.10 2.0 2.0 3.8 2.70 2.0 2.10 2.71 3.30 2.5 2.4
Biotin
(mcg)
13.5 12.5
0
18.4 18.4 18 26 18.4 15 15.50 12.50 26 20
Folc
acid
(mcg)
34 90.0 100 100 113 90 100 90 82.95 15
mcg DFE
78 79
VitB12
(mcg)
1.5 1 1.8 1.20 2 1.1 1.30 1 1.01 0.25 1.55 1.5
VitC(mg) 50 51.0 70 70 120 65 100 51 69.77 27.80 70 60
Calcium
(mg)
310 290 369 369 500 475 369 340 248 270 470 500
Phosp
horou
s
(mg)
210 145 230 230 300 300 230 170 150 135 310 290
Chloride
(mg)
300 255 291 291 298 330 291 250 294.57 0.250 320 300
Copper
(mcg)
250 280 400 400 360 340 400 280 280 170 470 350
Iodine
(mcg)
120 75.0 75.0 75 89 80 75 78 75.49 95 75 76
Iron(mg) 3.9 6.0 7.60 7.60 6 6 7.6 6.0 6.20 3 7 7
Magnesi
um(mg)
36 45.0 32 32 60 35 32 40 34.88 40 47 38
Mangan
ese(mg)
0.055 0.06 0.055 0.055 0.046 0.045 0.055 0.070 0.034 0.060 0.150 0.080

22. 21
Sodiu
m
(mg)
107 120 140 140 160 184 140 200 124.03 99 240 180
Potassiu
M (mg)
440 500 500 500 410 534 500 500 445.61 400 470 38
Zinc(mg) 3.1 3.20 3.70 3.0 3.3 3.5 3.70 3.20 3.15 2.50 3.8 3.8
Seleni
um
(mcg)
7.3 14.5
0
14.4 14.4 24 25 14.4 14.50 14.0 5 18 20
Supplement
Name
Enfami
l
A
+
Nan
Pro1
Simila
cAdva
n
c
Simila
cinfan
t
Aptam
ilGold
1
Dexol
ac 1
Simila
cPlus
NanExcell
a Pro
S26
Gold
Lactogen
1
Dexolac
Nusobee
Caesine
Dexolac
HiKal
Inositol
(mg)
50
Taurine
(
mg)
30 34.0 35.0 35.0 43 40 35 31 36.4 30 35 41
Carnitine(
mg)
10.5 6.0 7.9 6.3 11 11 7.9 6.0 7.1 6 8.5 8.5
Nucleotide
(mg)
15 55 25 55 20.1 12.5 18
Choline
(mg)
122 50 100 50 118 40 100 139 145.
35
49 45 84

23. 22
No. of
Suppleme
nts
( S)
S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12
Suppleme
nt
Name
Enfamil
A+(105g
m)
Nan
Pro(1
57.5
gm)
Simil
acAd
vanc(
132g
m)
Simil
ac1
(132g
m)
Apta
milG
old1(
157.5
gm)
Dexolac
1(157.5
gm)
Simil
ac
Plus(
132g
m)
NanExc
ella
Pro(157
.5gm)
S26
Gold(
129g
m)
Lactoge
n 1
(161
gm)
Dexolac
Nusobee
Caesine
(131.6g
m)
Dexolac
HiKal
(158.4
gm)
Energy
(kcal)
525 774.9 674.52 687.72 779.62 793.8 673.2 779.62 628.23 784.07 639.57 799.92
Protein
(gm)
12.07 16.85 15.18 15.18 17.32 16.53 19.14 16.85 12.9 17.22 17.108 20.592
Carbohy
drate
(gm)
61.74 92.76 173.12 73.12 92.92 91.35 64.41 91.82 71.07 95.47 77.249 86.803
Fat(gm) 26.25 37.32 37.22 37.22 39.37 40.16 37.22 38.27 32.50 37.03 30 41.184
DHA(mg) 89.25 105.21 149.62 73.92 113.4 96.75
ARA (mg) 178.5 105.21 149.62 73.92 113.4 96.75
Linoleic
(mg)
2.415 6.14 4.9222 4.9222 5.818 5.040 6.14 3.22 3.8164 5.3856
Linoleni
c (mg)
399 472.5 495 495 771.75 504 511.87 402.5 473.76 538.56
VitA
(mcg)
420 614.25 562.32 562.32 888.3 825.3 562.32 630 600.00 619.85
mcg RE
815.92
mcg RE
649.44
mcg RE
VitD
(mcg)
11.13 10.23 7.92 7.92 13.23 11.02 7.92 10.23 7.76 8.855 11.186 14.256
VitE
(mcg
)
3.83 6.3 11.35 11.35 17.48 10.55 16.89 6.3 7.37 4.025
mg TE
10.264
mg TE
10.612
mg TE
VitK
(mcg)
12.07 70.87 44.88 44.88 63 59.85 44.88 70.87 67.00 12.075 92.12 60.192
Thiamin
E (mg)
0.336 0.55 0.646 0.64 0.834 0.708 0.64 0.55 0.99 0.322 0.513 0.833
Riboflav
in (mg)
1.05 0.63 0.990 0.99 1.338 1.1025 0.99 0.63 0.92 0.724 0.6514 1.2038
Niacin
(mg)
4.935 5.04 4.620 4.62 9.45 7.71 4.62 5.04 5.00 6.44 5.264 8.712
VitB6
(mg)
0.252 0.59 0.4224 0.36 0.708 0.441 0.42 0.55 0.50 0.177 0.408 0.554
Pantoth
enicAci
d (mg)
3.885 3.30 2.64 2.64 5.98 4.25 2.64 3.30 3.49 5.313 3.29 3.8
Biotin
(mcg)
14.17 19.68 24.28 24.28 28.35 40.95 24.28 23.62 20.02 20.125 34.216 31.68
Folic
acid
(mcg)
35.7 141.75 132 132 177.97 141.75 132 141.75 107.00 24.15
mcg DFE
102.648 125.136
No. of
Supplemen
ts
( S)
S1 S2 S3 S4 S5 S7 S8 S9 S10 S13 S14 S15
Supple
ment
Name
EnfamilA
+(105gm)
Nan
Pro(15
7.5
Simila
cAdva
nc(13
Simila
c1
(132g
Aptam
ilGold1
(157.5
Dexolac1(
157.5gm)
Similac
Plus(13
2gm)
NanExcell
a
Pro(157.5
S26
Gold(12
9gm
Lactoge
n 1
(161 gm)
Dexolac
Nusobe
e
Dexolac
HiKal
(158.4
Table-2

24. 23
gm) 2g
m)
m) gm) gm Caesine
(131.6gm
gm)
Vit B12
(mcg)
1.575 1.575 2.376 1.584 3.15 1.7325 1.716 1.575 1.3029 0.4025 2.039 2.376
Vit C
(mg)
6.82 80.32 92.4 189 102.37 132 80.32 90.00 44.758 92.12 95.04
Calcium
(mg)
325.5 456.75 487.08 487.08 787.5 748.12 487.08 535.5 319.92 434.7 618.52 792
Phosph
orous
(mg)
220.5 228.37 303.6 303.6 472.5 472.5 303.6 267.75 193.5 217.35 407.96 459.36
Chlorid
e
(mcg)
315 401.62 384.12 384.12 469.35 519.75 384.12 393.75 379.99 402.5 421.12 475.2
Copper
(mcg)
266.5 0.44 528 528 567 535.5 528 0.44 0.36 0.273 618.52 554.4
Iodine
(mcg)
126 118.12 99 99 140.17 126 99 122.85 97.38 152.95 98.7 120.384
Iron
(mg)
4.09 9.45 10.03 10.03 9.45 9.45 10.03 9.45 7.99 4.83 9.212 11.088
Magnes
ium
(mg)
37.8 70.87 42.24 42.24 94.5 55.125 42.24 63 44.995 64.4 61.85 60.192
Mangan
ese
(mg)
0.057 0.094 0.0726 0.0726 0.072 0.07 0.072 0.11 0.043 0.096 0.197 0.126
Sodium
(mg)
112.35 189 184.8 184.8 252 289.8 184.8 315 159.99 159.39 315.84 285.12
Potassi
u
m (mg)
462 787.5 660 660 645.75 841.05 660 787.5 574.83 644 618.52 728.64
Zinc
(mg)
3.25 5.04 4.88 3.96 5.19 5.51 4.88 5.04 4.06 4.025 5 6.019
Seleniu
m(mcg)
7.66 22.83 19.00 19.00 37.8 39.37 19.00 22.83 18.06 8.05 23.688 31.68
Inositol
(mg)
52.5
Taurine
(mg)
31.5 53.55 46.2 46.2 67.72 63 46.2 48.82 46.95 48.3 45.06 64.944
Carnitin
e (mg)
11.02 9.45 10.42 8.31 17.32 17.32 10.42 9.45 9.15 9.66 11.186 13.464
Nucleot
i
de
(mg)
15.75 72.6 39.37 72.6 25.92 16.45 28.512
Choline
(mg)
128.1 78.75 132 66 185.85 63 132 218.92 187.50 78.89 59.22 133.056

25. 24
Nutrients Requirements for 0-6 Months baby as per RDA for Indians, 2010
Nutrient Type Substitute (Unit) Requirement per day
Macronutrient Carbohydrate (gm) 60gm/ day
Protein(gm) 9.1gm/day
Fat(gm) 29.44 gm/day
Nutrient Type Substitute (Unit) Requirement per day
Micronutrient Vitamin A (mcg) 350mcg/day
Vitamin D (mcg) 10mcg/day
Vitamin E( mg) 4mg/day
Vitamin K(mcg) 5mcg/day
Vitamin C (mg) 40mg/day
Thiamine (VitB1) (mg) 0.2mg/day
Riboflavin (Vit B2) (mg) 0.3mg/day
Niacin (Vit B3) (mg) 2mg/day
Pantothenic Acid (Vit B5) (mg) 0.2mg/day
Pyrodoxine (Vit B6) (mg) 0.1mg/day
Biotin (Vit B7) (mcg) 5mcg/day
Folic Acid (Vit B9) (mcg) 25mcg/day
Vitamin B12 (mcg) 0.4mcg/day

26. 25
Supplement Nutritive value> = RDA Chart value corresponds to 1
Supplement Nutritive value< RDA Chart value corresponds to 0
Nutrient Type Substitute (Unit) Requirement per day
Minerals Calcium (mg) 300mg/day
Magnesium (mg) 30mg/day
Iron (mg) 0.27mg/day
Zinc (mg) 2mg/day
Iodine (mcg) 100mcg/day
Phosphorus(mg) 100mg/day
Sodium (mg) 110mg/day
Potassium (mg) 637.5mg/day
Manganese (mg) 0.4mg/day
Selenium (mcg) 15mcg/day