I Chose Formula Feeding—Am I a Bad Mother? Breastfeeding vs Formula Explained

I’ve chosen to give my baby formula. Does that make me a bad mother? Few topics in parenting carry as much pressure, judgment, and confusion as feeding decisions.

In this episode of Healthy Beginnings, Dr. Edgar Kalimba explores the realities of breastfeeding and formula feeding—what the science says, what matters most for your child, and how parents can make informed decisions without guilt.

Healthy Beginnings offers clear and evidence-based conversations about children’s health, family wellbeing, and the systems that shape our lives. 

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Produced by LF Media

Transcript

SPEAKER_01 0:00

I have chosen to give my child formula. Am I a bad mother? Welcome back to our podcast. Nutrition, especially in the early phases of life, is a very important consideration, especially because the first couple of months, the first year of life, is a phase of rapid growth. This is where the child grows the most. This is where the foundations of health are laid. Brain development, immune system development, and even long-term eating habits. Often, parents receive conflicting advice, and I hope that today we can unpack this and be able to empower you on these choices. If I go back to the question that has been asked, the answer is no. You are definitely not a bad mother, you're not a bad parent for choosing to give your baby formula. It must be said that the natural and most recommended option is breast milk, breastfeeding, and I'll get back to this in a moment. However, it is not always possible or feasible or doable for some mothers to actually be able to breastfeed. And as such, formula actually provides a healthy option when breastfeeding is not a possibility. Formula that is appropriate, is safe, and is nutritionally complete as an alternative. And it is designed to mimic breast milk as closely as possible. It does provide consistent content that is nutritionally required. And it is important to note that for you to choose the appropriate formula for your infant, first of all, it needs to be age appropriate because all formulas have different categories that are age-based. And that's why we have number one for the first six months, we have number two for the six to twelve months. And we even have the pre-formula for babies who were born early, who are born preterm, who have got low birth weight, and have increased nutritional and caloric requirements. A key component to consider when you're choosing your baby's formula is also to make sure that it is fortified. Key nutritional elements that should be considered when you're checking for your formula include fortification with iron and the key vitamins that are required to ensure that your child receives a balanced protein and caloric, plus vitamins and stress elements that are all important for healthy growth. A frequent question that I get from parents is should I go for the more expensive one, for example? Is cost equivalent to quality? And the answer is no. In fact, often we have brands of formula that are well established, that are fully licensed, that are fortified, and have all the nutritional requirements, and they are not always the most expensive. So the answer is no. Cost is not necessarily a guarantee for quality or the best choice. So a good baby formula tries to mimic breast milk by using lactose as the primary carbohydrate. It contains iron, it includes essential fatty acids, which are important for brain development, and also uses easily digestible proteins, particularly which is what we call whey and casein. These are the two protein ingredients that are usually adapted to make the formula digestible and appropriate for the infant. So these are the key things that you would look out for in terms of the content and in terms of the nutritional elements that are key for your infant. Now, I would like to go back to speaking a little bit about breast milk and breastfeeding and why this is usually the number one choice, understandably. This is the natural way. This is the most complete way that's appropriate to feed the infant. And all parents, most parents, have good understanding that we always recommend breast milk as a first choice. And I'll just talk about a few important components that make breast milk the first choice, keeping in mind that not all mothers are able to breastfeed, but whenever it's possible and feasible, this should naturally be the first choice. Breast milk contains antibodies and immune modulatory elements that help to protect against infections. Now, these are natural, naturally occurring antibodies from the mother's system. And these are actually not available in formula. So breast milk from early on, the first milk which we call colostrum also triggers an important biological process. So the moment the mother starts to breastfeed their newborn, adaptation starts to happen, especially in the immune system. And the first milk actually works like a gut primer, almost like a vaccine, the first vaccine. And this sets in motion a couple of biological processes and metabolic processes that actually have a lifelong impact. And so breast milk is associated with a lower risk of, for example, infections, whether it's ear infections, respiratory infections, gut infections like diarrhea. It is also well established that it actually reduces the risk for allergies like eczema and other allergic diseases. It is also well known that it sets a child on a good metabolic course and actually reduces risk for long-term adult metabolic diseases, particularly non-communicable diseases, including obesity later on in life. The other thing to mention is that breast milk is actually easier to digest for babies. And I'll give an example. When babies are born preterm, we almost entirely want to give them breast milk because formula, as good an alternative as it is, it is not as easy to digest as breast milk is. And often we run into problems when small and premature babies feed on non-breast milk. Now, in this part of the world, in Africa, we do not yet have well-established breast milk banks. But this is one of the reasons why in developed countries, breast milk banks are actually well established, where mothers that have extra breast milk can donate, have the milk tested, and can be given to the most vulnerable babies and infants. Another interesting element is that breast milk actually adapts to the baby's needs as they grow. So what the breast milk is in the first week of life is different to what it is in the second month of life, in the fourth month of life, in the sixth month of life. Because as the baby grows, the body needs change in terms of the caloric needs, the protein needs, as well as the quantity, understandably, and breast milk actually adapts to these changes and the growth. I often get a question from mothers worried that they might not be having enough breast milk or they might not be feeding their child enough. So the two things I always tell them is one, uh almost every mother is able to breastfeed. There are very few exceptions, whether it's for medical reasons or other reasons. And often because of the exhaustion and the stress around taking care of a small infant, it's easy to feel like you're not able to satisfy your baby and also visibly have insufficient amounts of breast milk. And so we always encourage mothers, first of all, to hydrate because it takes a lot out of the mother to make sure you hydrate sufficiently. And the second very important element is to rest. Often, when the mother gets sufficient rest and support, when they get a good sleep, even if it's for three to four hours, they will frequently wake up with a good amount of supply of breast milk. So with a few changes and awareness and effort, most mothers are actually able to breastfeed or to provide breast milk. And one way to track that you're giving sufficient amounts and you don't need to add formula or to change to formula is obviously your child's growth, which is important to monitor. Are they gaining enough weight? To do they actually have sufficient wet dappers. So when a child is getting good amounts of nutrition, they'll have regular wet dappers, they'll have a regular uh rhythm of passing stool, and they'll grow and gain weight. Usually the first few weeks and months of life, they gain about 200 grams per week. And this is why we always check regularly, especially the first few months, to see how they're growing. Are they actually gaining a sufficient amount of grams per week, per month, and so on and so forth. With the pace of life and busy working mothers having to balance between taking care of the children, taking care of their family, and getting to work and earning a living, often mothers have to leave their babies quite early within the first few months of life. One very practical element that I appreciate and I've seen many mothers doing is actually expressing breast milk so that even while they are away, while they're at work, their baby, their infant can still be fed on their mother's milk and still get all the benefits that come with breastfeeding. That being said, I know you're doing your best. I know you want your child to grow well, to thrive, and to be healthy. And even if you're not able to breastfeed, which happens frequently, whether it's biological, whether it's circumstantial, or for any other reasons, you are still a good mother. And formula will provide uh sufficient nutrition for your child to grow, to thrive, to adapt, to do well in school, and be smart in life. You do not need to blame yourself. Your baby will do well, and you should not be worried. Before I go, I would like to answer some of your questions.

SPEAKER_00 13:36

First question from Alice in Kigali. My daughter is six and only wants rice, fries, and bread. If I cook vegetables or beans, she refuses to eat and would rather sleep hungry. I grew up being told you must finish what's on your plate, but I don't want food to become trauma for her. How do I handle picky eating without turning dinner into a daily war?

SPEAKER_01 13:57

Very interesting and practical question. Often, children will be choosy. They'll choose this over that, they'll prefer this over that. Some things are easier, some things are sweeter, and yet we still need to make sure that our children actually get a balanced diet. Now, there's no easy approach to that, but there's a couple of practical things that you can do. Off the bat, I need to say that for picky or fussy eaters or difficult eaters, the more you fight, the worse it becomes. So you're right, you don't need to turn it into a battle zone. When a child associates eating with fighting, it actually makes the situation worse, not better. So I often tell parents that the first thing to do is to make sure that your child understands why this is important. Now, this is a six-year-old, so you can actually have a conversation. I have a five-year-old in my own house, and uh we've had these conversations over and over again. One, it's always recommended to have meals together with your with your children, parents and the children, as a family, because first of all, they get to see that you're also eating vegetables. You're not just making them eat vegetables, but you're also eating them because they're important. The second thing is do not let them off the hook. You could, for example, mix it with their preferred food if they prefer to eat rice or potatoes or something else. You need to come up with creative ways of including these vegetables in what they like to eat. The other option that you could do is um to creatively come up with um uh smoothies. So, more and more mothers, for example, are doing a combination of fruits and vegetables and come up with um a meal that is easy to take. It could be taken as a snack, could be taken as part of a main meal, but one way or the other, these key comp key components and food groups, whether it's vegetables, whether it's fruits, should be part of your child's diet.

SPEAKER_00 16:42

Second question from Peter. I pay for a gym membership every year and barely go. Then I feel guilty and ashamed. Is walking enough? Do we really need intense workouts to be considered healthy?

SPEAKER_01 16:55

I'm guilty of the same thing. It has happened to me over and over again. And I always come up with excuses. I'm busy, my days are long, I'm tired. Um, and most of us are busy. People are busy, you have to work, you have to balance many things and fit them in your day. And what is important is that you need to do something. You need to have some consistent physical activity. Walking is great. It's actually well established with research, published research, that if you walk for 30 to 45 minutes a day, if you can do it every day, that's great. If you can do it three to five times a week, that's still very, very useful. Of course, it would it gives much more benefit if you make it a brisk walk and sort of make it a moderate intensity as compared to a leisure walk. If it's a leisure walk, uh you probably wouldn't benefit as much as if it's a brisk intentional walk. But it doesn't have to be the gym, it doesn't have to be intense, it needs to be intentional and regular because the cost of not doing that is quite high.

SPEAKER_00 18:21

Finally, our last question from Vanessa living in Kampala. My 15-year-old used to tell me everything. Now it's one-word answers and lock doors. I'm scared to push too hard, but I'm also scared to lose connection. How do I rebuild communication without invading her space?

SPEAKER_01 18:38

So when it comes to teenagers and adolescents, it's a particular group, it's a particular season, it's a particular age range that comes with its challenges. One thing I've noticed is that we expect our teenagers and adolescents to be superhuman beings. If you look at it, for example, if you look at 14 to 18-year-old, they're in high school, they are going through physical, biological, hormonal growth and development. And that takes a toll on them. Their body is changing. They have to adopt, adapt to this. They also are going through an intense phase of relationships and peer pressure. They want to fit in, they want to have friends, they want to be cool, they want to be accepted and be part of the community and their friends. An additional element is that that is a busy school season. So they are, depending on the programs, there's many intense academic programs nowadays, you know, whether it's Cambridge or IB or all these school programs or the national program, there's a huge demand on them academically. And then on top of that, often as parents, we are on their necks. You need to clean your room, you need to arrange everything, you need to be on time, you need to behave well, you need to be clean, you need to participate in chores in the house. So when you put all of this together, it's often quite overwhelming, to be honest. And uh what I tell parents, and I try this myself as a parent, is one, do not make everything a battlefield. At the end of the day, slow down, ask them how they are. If they are under the weather or if they're emotionally, psychologically not feeling well that day, give them a break. Don't fight unnecessarily. The second thing is often parents are busy and absent, and when they show up, they just want to fix problems. Do this, do that, and there's actually no strong trust and relationship. And your teenager, your adolescent can see that you're emotionally absent. So it's very important to work on the emotional connection and the trust. And as a parent, it's imperative that your teenager, your adolescent knows without a shadow of a doubt that you actually love them. That's one. Two, you want the best for them. Three, they can trust you. They can fall on you. When things are overwhelming, they should have that reassurance that they can actually come to you and have a conversation and be vulnerable with you. Often, what We do actually breaks this or pushes them away, and I think it's a learning curve. So I would say that take a moment, find slots where you can actually sit down without any tension and have conversations and build rapport and build trust and actually get to know what's happening in their lives. And based on that, they will be more keen and willing to open up instead of shutting you out completely. Thank you for listening to Healthy Beginnings. If you have any questions you'd like answered in the next episode, you can submit them to our email, HealthyBeginningspodcast at gmail.com. You can also follow us on all social media platforms. You can find us on YouTube as well as the audio platforms of your choice. See you next week.

SPEAKER_00 23:01

This podcast is for general informational and educational purposes only. Do not make health decisions without consulting your doctor. This podcast is brought to you by LF Media, home of great African podcasts.