Breastfeeding tops the list of effective preventive interventions for child survival. Together with appropriate complementary feeding, this has more impact even than immunisation, safe water and sanitation. There is no food including formula more affordable, beneficial and sustainable than breast milk. Rather formula has several drawbacks when compared to breast milk that might put your baby at risk of developing several diseases and loss of protection given by breastfeeding.
Formula risks for infants:
1. Asthma: Exclusive breastfeeding (EBF) provides protection in early childhood up to age 6.
2. Lethargy: EBF appears to provide some protection in development of allergies in infants, regardless of familial history of allergies.
3. Ear infections: Infants fed formula during the first 6 months of life have more ear infections.
4. High blood pressure and heart disease: Small-for-gestation and normal-weight infants who gained weight quickly on formula had higher risk of developing hypertension later in life than did breastfed infants.
5. Respiratory infections: Formula fed infants suffer more frequently and more severely from respiratory infections, both viral, and bacterial.
6. Reduced IQ & cognitive development: Formula fed infants consistently score lower on IQ and cognitive tests.
7. Obesity: Formula feeding in infancy is associated with increased incidence of childhood and adolescent obesity and higher BMI in adults.
8. Iron deficiency anemia: Formula fed infants have higher rates of iron-deficiency anemia due to low bioavailability of ferrous sulfate in cows milk based formulas.
9. SIDS (Sudden Infant Death Syndrome): Formula feeding increases the risk of dying from SIDS by up to 50% throughout the first year of life.
10. Diabetes (both types 1 & 2): Formula fed infants have greater risk for developing both type 1 and type 2 diabetes irrespective of parents diabetic status.
11. Digestive problems: Diarrhoeal disease is twice as high in formula fed infants, in both industrialised and resource-dependent countries and the increased risk of diarrheal disease when formula fed extends through the first 2 year of life.
12. Childhood cancers: Formula fed infants are at greater risk for developing childhood cancers, and the benefits of breastfeeding are dose-dependent, increasing with length of duration and exclusivity.
13. Sleep apnea: Formula-fed infants are at higher risk for developing sleep-disordered breathing problems.
14. Dental problems: Formula fed children have a significantly higher chance of having dental malocclusions, particularly overbite and cross bite problems.
Risks for mothers:
15. Diabetes: Compared to women who do not have children, women who give birth but do not breastfeed their children have a significantly higher incidence (14%) of developing  type-2 diabetes than women who breastfeed.
16. Overweight and obesity: Formula feeding mothers retain their pregnancy weight longer and are at risk to keep weight gain between pregnancies.
17. Osteoporosis: Formula feeding mothers are at greater risk to experience hip fractures and other problems related to osteoporosis in the postmenopausal period.
18. Breast cancer, ovarian cancer and uterine cancer: Formula feeding mothers have increased risk of developing breast, ovarian and uterine cancers later in life.
19. Hypertension and heart diseases: Formula feeding mothers have higher BP levels in the initial postpartum period. They are also at increased risk to develop hypertension, hyperlipidemia, and cardiovascular disease later in life.
20. Reduced natural child spacing: Formula feeding mothers are at increased risk of having less space between pregnancies, thereby placing both mother and children (already living as well as future pregnancies) at increased risk of mortality, morbidity and malnutrition.

This document has been prepared incorporating evidence based information from the World Alliance for Breastfeeding Action (WABA). The writer is the Director, Institute of Public Health Nutrition and Line Director, National Nutrition Services (NNS).