Becoming a mother is terrifying. You doubt yourself with every decision, and you research online and text friends for advice before making any moves. No matter what choice you end up making, there is always someone there to confirm that it was the wrong one, to make you feel like an incompetent parent — an article on a mothering blog, a know-it-all friend, a well-meaning mother-in-law. The one place where you should be able to count on not being made to feel like an awful parent is your recovery room. Unfortunately, not all hospitals have realized that.

A friend of mine delivered her first child at Jefferson University Hospital. She shared a picture on Facebook of the paperwork that she received in the hospital.

My friend posted on Facebook when she saw the flier.
Handout
My friend posted on Facebook when she saw the flier.

The handout she posted was titled "What if I give my baby some formula?" and listed five terrible things that would happen to a baby if fed formula, chock-full of exclamation marks and bold words. Sick visits to the doctor! Overweight children! Recalls!

Top half of a breast-feeding flier given to new moms.
Handout
Top half of a breast-feeding flier given to new moms.

It then listed four negative things that would happen to the mother. Not losing the baby weight! Ovarian and breast cancer! The sheet ended with, "You can nurse your baby without giving formula!" The tone of the handout was neither supportive nor informative. It was threatening, and the final statement is demonstrably false for some mothers, as in the case of women with insufficient glandular tissue, who are physically incapable of producing sufficient milk.

Bottom half of a flier given to new moms.
Handout
Bottom half of a flier given to new moms.

My friend explained that when she had her baby, he nursed incessantly for several hours — to the point that her nipples were bleeding — yet still he screamed whenever she stopped nursing. She knew instinctively that she was not providing enough colostrum to satisfy him, but she was scared to ask the nurses for formula because, throughout her pregnancy, she had been told repeatedly by her doctors that formula was bad. When she finally did tell them, she broke down crying because of how ashamed she was, because of how ashamed her health-care providers made her feel for needing it, with all of the antiformula comments they had made.

What's truly unforgivable in this scenario isn't that my friend used formula to satiate her child, but that she felt she couldn't do so without being judged by the very people who are employed to help her.

While each of the claims on this handout may be true, healthcare providers should prioritize informing patients rather than bullying them with scare tactics. After all, no one chooses to use wildly expensive formula without a reason.

Mothers use formula because they don't make enough milk on their own, or because they have to work and can't pump enough to last throughout the day while their child is in someone else's care, or because breast-feeding is actually detrimental to their bonding with their baby rather than fostering it. They may use formula because they are sick or on medication that would make breast milk unsuitable for their baby.

At the end of the day, what is most important is not what the baby is being fed, but that the baby is being fed.

Just ask any of the mothers whose children died, or were put on life-support, due to dehydration from insufficient breastmilk. The blog from the organization Fed is Best is full of these stories, of women who lament having tried to breast-feed exclusively, who were therefore unable to monitor just how much food their babies were actually getting.

Wesley Culp, the Pennsylvania Department of Health's deputy press secretary, says that the department — in conjunction with WIC — provides educational brochures such as this one no matter how the mother chooses to feed her baby and that the department "understands that breast-feeding may not be an option for all families or for all new parents." He also clarified that the brochure in question was intended for mothers who already breast-feed, but were considering either stopping or supplementing with formula before the baby was six months old.

Jason Griffith, a spokesperson for Abington Hospital, which is part of the Jefferson Health network, said Jefferson Hospital provided the handout as part of its dedication to being recognized by the Baby-Friendly Hospital Initiative, a program that encourages hospitals and birth centers to promote breast-feeding. Griffith said the purpose of the brochure was "to encourage successful breast-feeding and to provide information about what can happen to a nursing mother's milk supply when formula is introduced." Griffith also said that the handout was supposed to be given only  to mothers who mention supplementing with formula and that nurses were to discuss the flier with patients.

For my friend, the flier was included in her discharge papers without explanation.

This flier is problematic because it doesn't just explain what happens to the mother's milk supply; it threatens mothers with the shame of making the wrong choices for their newborn babies. In the words of my friend, "This is not education. This is shaming, and no one needs that, whether they are breast-feeding or bottle-feeding formula."

My friend’s Facebook post about her reaction to this flier.
Handout
My friend’s Facebook post about her reaction to this flier.

In 2015, formula company Similac made a commercial that went viral that was called "The Mother 'Hood." In the video, the "breast police" confront mothers who bottle feed, the moms who use cloth diapers confront the moms who use disposable, and so on. While the mothers are busy fighting, a baby in a stroller starts rolling down a hill, and all the parents race to save it. In that moment, they realize that they've lost track of what's important — the babies.

And that's a lesson everyone — including health-care professionals —  should keep in mind before they judge new moms about the choices they make for their kids.

Rachel Lodge teaches at a middle school in Delaware. She has two daughters, neither of whom would be here today were it not for the help of formula. You can reach her @rbtinytruths