After her own struggle to breast-feed her daughter, Kimberly Seals Allers began exploring why so many American women opt out of breast-feeding. Why had she been discharged from the hospital with a gift bag full of formula? Why had a pediatrician encouraged her to supplement breast-feeding with formula? And why did she question her body’s ability to produce enough milk for her child?

“It was doubt,” said Allers. “Doubt created by the formula industry. … It’s a very effective marketing tactic.”

Allers’s book “The Big Letdown,” (St. Martin’s Press, 2017) is stacked with research to buttress her claims: formula companies make millions by convincing women they aren’t capable of one of their most basic bodily functions, and have spent millions of marketing dollars aimed at women, doctors, hospitals, scientists and policymakers to hammer this point home for the past century.

Breast-feeding is hard, says Allers. The obstacles are real, and women will need support, education and encouragement to succeed. But rather than seeing breast-feeding as a challenge worth fighting for, women are handed a bottle of formula and “told to give up and not feel bad,” she writes.

Allers says she may be an unlikely face of the breast-feeding conversation: She’s a black woman in a movement she says has been dominated by white, middle-class women. Allers is engaging with communities of color to transform the narrative surrounding breast-feeding into an empowering message.

A lightly edited Q and A with Allers follows:

The Washington Post: Your book cites research that only 5 percent of women aren’t able to produce enough milk. Yet so many women believe they need to supplement or turn to formula to feed their babies. What’s the source of the confusion there?

Allers: We have been told a message that we should not trust our bodies to do what our bodies can do. No one wakes up and worries their kidneys won’t work if there isn’t a reason. When it comes to lactation, it’s something women doubt. It is the messaging we receive when we’re given infant formula “just in case.” Already the seed of doubt is placed in our mind.

As women, we need to start questioning ourselves. Why would I doubt this? Why do I have confidence in my abilities biologically and intellectually, but this is the one thing I am questioning? This doubt was sold to us, as much as anything. … This idea of planting seeds of doubt has historical relevance as a very effective marketing tool.

TWP: Many moms feel the intense pressure to do it, and work, raise kids, keep a clean home, toned body and happy marriage to boot. How can “The Big Letdown” speak to moms who are choosing (or once chose) formula? What bridges can we make to connect parents who already feel a great deal of pressure to do the best for their children, while still promoting breast-feeding as the best option?

Allers: We know formula is necessary in this country. For women who truly choose it, that is their choice and I respect that. But what happens now is that women are not fully informed.

For instance, we have no idea about infant formula’s sugar content. The FDA does not require formula companies to disclose it. For a baby, formula is their sole source of nutrition. If I eat too much sugar today, I can hit an extra Zumba class this week. I have ways to balance out my nutrition, but an infant doesn’t. We all have a right to know what is in our food, especially for our babies.

A true choice means you are given two options, are fully informed on both, and only then are you making a real choice. But women are being misinformed intentionally because there is money to be made from that, and that’s not okay.

Infant formula companies should continue to exist, but they make way too much money for marketing a substitute product which builds their success on women doubting themselves. That should not be a multibillion-dollar industry. We have to start asking what does it take to maintain those numbers and who is really paying the price.

TWP: You write, “women don’t breastfeed, cultures breastfeed.” You’ve chronicled how our society’s expectations and lack of support for mothers contribute to lower breast-feeding rates. Yet you also cite the U.K., which has a far better parental leave policy and still has a low breast-feeding rate. What will it take to change the cultural mind-set and encourage more women to breast-feed?

Allers: Breast-feeding is so complex, it’s not just one thing that holds a woman back. We need to take into account a woman’s idea about her body, the information that she is receiving about food, her relationship with her pediatrician and OB/GYN. Policy alone is not enough. And sometimes policy can be too late and cultural shifts can take generations.

We have to really understand women’s behavior overall for us to really get a handle on how we got to this place.

TWP: Your book highlights the plight of women of color and the historical trauma that accompanies breast-feeding, tracing back to the years of working as an enslaved wet nurse, nursing white children instead of their own. African American babies, in particular, are more likely to be preterm and rely on breast milk as a lifesaving substance. What do you think can change around the culture of breast-feeding within communities of women of color, and do you see that happening anytime soon?

Allers: I’ve been actively working for the past seven years to change that narrative. A big part of it is reclaiming that story and creating a new one that black women do breast-feed. Black women’s bodies have been hypersexualized; the act of them breast-feeding is seen in a much more inflammatory way.

We talk about an empowerment message, that ‘this is the way that we take care of our children.’ There is a terrible lie told about black mothers in this country: We are seen as capable of taking care of other women’s children but incapable of taking care of our own. We use breast-feeding to help change that narrative, and say ‘this is our commitment to the health and nutrition of our children.’

TWP: You write about your own experience breast-feeding and compare that to your experience in the professional world as a black woman. How have you felt in taking the leadership mantle as a breast-feeding advocate, a space that you write has been dominated by white, middle-class women?

Allers: It’s been very interesting working in a white-female-dominated space. There has been some resistance. I travel the country and speak [to communities of color] who say ‘breast-feeding is for white people.’ Without federal paid maternity leave, not everyone can breast-feed. We have to change policies so it’s not just the privileged few who can breast-feed.

[For breastfeeding advocates], you need women who have the time and circumstances to volunteer. Who does that look like? These are the socioeconomic nuances of how this movement has become dominated by white women of some privilege. They have done some amazing work, but for us to move this movement forward it will take a variety of cast of characters.

Rebecca Gale is a journalist and writer and tweets @beckgale.

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