Raw Milk Q&A
Everyone is talking about raw milk!
What are the real benefits and risks?
“… people should be able to buy raw milk if they want to, but we shouldn’t turn a blind eye to some of the food safety concerns,”
Michael Pollan, Author “The Omnivore’s Dilemma”
Seattle Times, March 2010
Click on the links below to find out the answers to commonly asked questions about raw (unpasteurized, unprocessed) milk benefits, safety, and how risks from raw milk compare with other foods like pasteurized milk, fresh fruits and vegetables, and meat/poultry/fish. This information was put together using scientific studies and reports. For some conditions, no scientific literature could be found as shown in the table below.
Q & A Printer Friendly Version available here. (PDF)
Availability of scientific studies on the benefits and risks from raw milk consumption. Click here for larger PDF version
Q: Is raw milk safer today than it was in the 1930s when milk pasteurization became common?
Q: Is pasteurizing milk a guarantee of safety
Q: Does pasteurization destroy all the nutrients and enzymes in milk and make it “dead?”
Q: How many people get sick from raw milk compared to pasteurized milk?
Q: What type of precautions do farmers take to prevent contamination of the milk?
Q: Should babies and children drink raw milk?
Q: Is raw milk from grassfed cows and goats on pasture safer?
Q: Is raw goat milk safer than cow milk?
Q: What is meant by “good” and “bad” bacteria in milk?
Q: Does raw milk have special qualities like enzymes and “good” bacteria that kill pathogens?
Q: Doesn’t raw milk taste better than pasteurized milk?
Q: Is raw milk tested by government or private laboratories safe?
Q: Why is raw milk illegal in some states?
Q: Is raw milk the only way to support a local dairy?
Is raw milk safer today than it was in the 1930s when milk pasteurization became common?
The risks from raw milk in the United States are different today than they were before the 1930’s when raw milk caused 25% of all food and waterborne outbreaks, which resulted in many infant deaths. Two important diseases from raw milk during that time period were bovine tuberculosis and brucellosis. Today, cattle in the United States are virtually free of bovine tuberculosis and brucellosis because of programs to vaccinate and eliminate sick animals. We also have better refrigeration and sanitation for storing and transporting milk. In developing countries like Mexico, bovine tuberculosis and brucellosis still cause many illnesses from contaminated raw milk and cheeses including from those imported illegally into the United States.
In the 21st century, dairy products now cause approximately 1% of reported foodborne outbreaks, but about 70% of reported dairy outbreaks are from raw milk or raw milk cheeses. Because of the way statistics are collected, we do not know how many people get sick from raw milk (or other foods) if they are not part of an outbreak. Despite improvements over the last 100 years, raw milk is still risky because the dairy environment is inherently dirty. Large animals produce large amounts of fecal material. Even with careful sanitation, it is nearly impossible to keep all dirt and fecal matter from getting into the raw milk. In addition, some cows might have udder infections that aren’t obvious to the dairy operator, but still can result in bacteria getting into the milk. The only scientifically proven way to ensure that disease-causing germs are eliminated from the milk that is sold to consumers is to pasteurize the milk.
Modern Day Germs
Campylobacter, E. coli O157:H7, Salmonella (including antibiotic resistant strains), and Listeria are modern-day germs that have spread to dairies and feedlots around the country, even grassfed pasture-based operations. In people, these infections range in severity from mild to severe diarrhea (sometimes bloody) and vomiting to even more serious illnesses including kidney damage, telescoping of the intestine (intussuception) causing a blockage and requiring emergency surgery, and damage to the nervous system (Guillain-Barre syndrome). Listeria can cause injury to unborn babies or miscarriage in pregnant women. All of these infections can result in death, especially in children, older persons, and persons with other illnesses or immune system problems.
Does raw milk build immunity and cure health problems like lactose intolerance, asthma, cancer, and autism?
There is no scientific evidence that raw milk is a “cure-all” for any of the conditions advocates have listed like lactose intolerance, Crohn’s disease, autism, tooth decay, and cancer. These claims are mostly based on testimonials or anecdotal stories. Testimonials are usually solicited from customers by the company producing a product with the goal to increase sales. For example, testimonials are often used to promote diet pills that promise rapid weight loss with no changes in eating and exercise habits. It is a good idea to be skeptical if something sounds too good to be true (remember, raw milk is still simply milk from an animal).
Testimonials and anecdotal information can still be helpful in generating “hypotheses” about possible benefits. But until the research is conducted, testimonials are theoretical. Among the various health claims about raw milk, asthma and other allergic conditions are the only diseases that have been studied by scientists. Researchers in Europe suggested that raw milk consumption by children at an early age may have a protective effect against asthma and eczema. However, it is not clear if the protection against allergic conditions was due to raw milk consumption, living in a farm environment, or both. The authors still warn that the risk of pathogens in raw milk outweigh its benefits as a food source to prevent allergies. Before trying raw milk in a child with allergies or other conditions, parents should proceed with caution and talk to their pediatrician or health care provider about the possible risks of serious bacterial infection such as E. coli O157:H7.
“In conclusion…Dietary interventions are an attractive means for primary prevention. However, raw milk may contain pathogens such as salmonella or EHEC, and its consumption may therefore imply serious health risks. A deepened understanding of the relevant “protective” components of farm milk and a better insight into the biological mechanisms underlying the reported epidemiological observation are warranted as a basis for the development of a safe product for prevention. At this stage, consumption of raw farm milk cannot be recommended as a preventive measure.”
Quoted from: Waser, M. et al. 2007. Inverse association of farm milk consumption with asthma and allergy in rural and suburban populations across Europe. Clin Exp Allergy 37:661-70.
What kind of illnesses can you catch from drinking raw milk or eating raw milk products (cheese, ice cream, yogurt, kefir, butter)?
Raw or unpasteurized milk (sometimes called fresh milk, fresh unprocessed milk) is milk that comes directly from cows, goats, sheep, or other animals without any heat treatment to kill germs. Raw milk and cheeses, ice cream, and other dairy products made with raw milk can be contaminated with bacteria including Brucella, Campylobacter, Listeria, Mycobacterium bovis, Salmonella, Shiga toxin-producing E. coli, Shigella, Staphylococcus aureus, Streptococcus pyogenes, and Yersinia enterocolitica. Some people that get sick have a mild illness that lasts a few days, but other people may get very sick, even requiring hospitalization and emergency surgery. Foodborne infections can be much more serious than a “tummy ache,” and have caused long-term health problems sometimes lasting for the rest of the person’s life.
The most commonly found pathogen in raw milk that causes outbreaks is Campylobacter. It usually makes people sick for only a few days with fever, diarrhea (sometimes bloody), and cramps. In rare cases, Campylobacter can lead to paralysis. Hundreds of illnesses from raw milk contaminated with Campylobacter have been reported around the world.
In the last few years, several children have become severely ill and almost died from raw milk contaminated with E. coli O157:H7 . E. coli O157:H7 is probably more common in ground beef than fresh, raw milk, but if it gets into raw milk, the bacteria is very dangerous. No illnesses from E. coli O157:H7 due to pasteurized milk have been reported in the United States.
Is pasteurizing milk a guarantee of safety?
No, processed foods can still become contaminated. In the early 1900’s, pasteurization was introduced to prevent people from getting food poisoning from milk. Pasteurization works by rapidly heating the milk to a certain temperature for a specific period of time to kill disease-causing germs. In contrast, homogenization is the process of passing milk under high pressure through a tiny orifice, which decreases the diameter and increases the number and surface area of the fat globules. This reduces the tendency for creaming of fat globules.
Outbreaks from pasteurized milk products (see Table 2) are very uncommon considering the large number of people who drink them. Pasteurized milk can carry all of the same germs as raw dairy products if they are allowed to get into the milk after pasteurization. In 2007, three men in Massachusetts died after drinking pasteurized milk that was contaminated with Listeria in the bottling area of the facility in which it was produced. Norovirus is the most commonly reported cause of illness from pasteurized milk products. Norovirus is only found in humans, and gets into the milk after the pasteurization process from human hands soiled with feces. It can be easily prevented by good handwashing practices and excluding ill persons from handling milk or other foods.
Pasteurized milk that is appropriately bottled, sealed, and refrigerated after pasteurization, and which is properly handled by the consumer, is extremely unlikely to contain disease-causing germs.
Does pasteurization destroy all the nutrients and enzymes in milk and make it “dead?”
Milk is no different than other foods that we commonly cook. For example, cooked spinach or other fruits and vegetables and meats/poultry/seafood are still full of nutrients even after heating. A comparison of the nutritional labels from a bottle of commercial raw whole milk (left) and a bottle of organic, non-fortified pasteurized whole milk (right) shows that there is little nutritional difference between the two milks.
As shown on the labels, both raw and pasteurized milk contain similar key nutrients (which is also why bacteria grow well in either one). All milk is rich in proteins, carbohydrates, calcium and other nutrients. There are some enzymes that are destroyed by heat, but the enzymes in raw animal milk are not known to be important in human health. Vitamin C is also reduced by heat treatment, but even raw milk is not a good source of vitamin C. Examples of excellent natural sources of vitamin C are oranges, green peppers, watermelon, leafy greens, berries, grapefruit, broccoli, tomatoes, and citrus juices.
How many people get sick from raw milk compared to pasteurized milk?
According to CDC, between 1998 and 2008, there were 85 outbreaks of human infections resulting from consumption of raw milk reported to CDC, including a total of 1,614 reported illnesses, 187 hospitalizations and two deaths. Illnesses and deaths have also been linked to the consumption of fresh cheese made from raw (unpasteurized milk), especially the Mexican-style queso fresco cheeses. Since many millions of people drink pasteurized milk every day in the United States, and only about 1-3% of the population drinks raw milk, the number of illnesses reported show that the actual risk of getting sick from drinking raw milk is tremendously higher than drinking pasteurized milk.
Statistics from the CDC and State Health Departments comparing raw and pasteurized dairy products linked to reported foodborne disease outbreaks (1973-2006) show that raw milk and Mexican-style queso fresco soft cheeses (usually made from raw milk) caused almost 70% of the reported outbreaks even though only 1-3% of the population consumes raw dairy products. If raw and pasteurized milk were equally risky, it would be expected that there would be far more pasteurized outbreaks since the number of people drinking conventional milk is so much higher.
People get sick from all kinds of foods. Is raw milk any different than other foods like deli meats, spinach, beef, peanut butter, and pasteurized milk?
Yes, raw milk is different from other foods marketed as “ready-to-consume.”
“Ready-to-consume” means that you are not expected to have to cook the food or take special precautions when handling it like you would with raw meat or raw poultry, for example. While illness is sometimes caused by ready-to-consume foods like fresh raw fruits and vegetables, deli meats, peanut butter, and pasteurized milk, these events are unusual because these foods are not normally contaminated with fecal bacteria. If there are fecal bacteria in these ready-to-consume foods, it is because of a breakdown in the food safety precautions that are in place to protect these foods from contamination.
However, products including raw milk, raw meat, poultry, and fish products are produced in environments that are unavoidably contaminated with fecal material (milking barns and slaughterhouses). These products should always be thoroughly cooked before consumption to eliminate the disease-causing fecal germs.
Many people who grew-up on a farm drank raw milk from their animals and do not recall ever getting sick. Does this mean that drinking raw milk directly from the farm is safer?
It is true that farm families often drink their own raw milk and usually do not become sick. There is some scientific evidence that they develop immunity to the germs their animals carry. This is not necessarily true for people who don’t live on a farm. Some of the most serious illnesses from raw milk over the last few years have been in adults and children who tried raw milk for the first time. The fact that the farmer and his/her children did not get sick, does not mean that the milk is safe for people in the general population, especially if the milk is intended for pasteurization and not licensed and inspected as a Grade A raw dairy. Children, pregnant women, and people with immune system problems and chronic illnesses are at the highest risk of developing severe illness from contaminated raw dairy products whether they are from a farm or a grocery store.
What type of precautions do farmers take to prevent contamination of the milk?
If you are going to try raw milk where it is legally produced, there are some things you can look for to evaluate if the farmer is taking safety precautions. However, there are many things that you as a non-farmer probably will not be able to check (for example, it would be very hard for a consumer to know if the farmer is using the proper laboratory tests to monitor ongoing quality or detect pathogens, or if the farmer is using the right type of sanitizer).
These videos show fundamental safety standards for a raw dairy where the milk is not intended for pasteurization. These precautions are not a guarantee, but will reduce the risk of the milk being contaminated. If your farmer isn’t following guidelines like these, you should be worried about sanitation problems with their raw milk.
This video was taken as part of a newspaper report on raw dairies in Washington State. While the farmer describes sanitation practices, the video actually shows several points where manure could have entered the raw milk or milking equipment, which is the principal way most kinds of germs get into foods from animals. The report described the experience:
“It’s easy to see potential problems. He doesn’t exactly study the udders to make sure he’s cleaned every last inch. And it’s messy. On a recent visit, one cow, who was sore, fussed as Brown started the milking device. She pooped, splattering Brown’s face, but he didn’t seem to notice. She fussed so much that the device fell to the floor, and the cow stepped on it. When Brown finally got her off it, he sprayed it with a hose. Then he put it on the next cow.”
This photo shows an extreme example of unsanitary conditions at an illegal herdshare (cowshare) dairy in Washington. It was taken during a 2005 outbreak investigation where several children developed HUS from grassfed raw milk. This report also shows examples of unsanitary conditions that probably contributed to an outbreak of Campylobacter that sickened 81 people in Colorado in 2009.
The Chicago Tribune recently published a video from a farm in Illinois that documents similar problems with dirty animals and potential for manure contamination of the raw milk.
Should babies and children drink raw milk?
No, because a baby’s or child’s immune system is still developing, they are least prepared to fight off a bad infection if given contaminated raw milk. It is proven that infants do best if breastfed by their mother whenever possible. If breastfeeding is not possible, a safe source of formula is critically important.
Human breast milk is “raw” and should never be over-heated if fed in a bottle. The risk of pathogen transfer between a mother and her baby is extremely low. Similarly, baby calves and baby goats rarely get sick from their mother’s milk. However, giving raw animal milk to human babies is risky because the milk bought on the farm or in a store is often pooled from multiple animals that can carry germs. You cannot see or smell germs in raw milk, so the risk of accidently using contaminated raw milk is simply too high to recommend it for babies.
Raw milk is also risky for children, especially those under 5 years old. According to CDC statistics, the majority of illnesses from raw milk outbreaks are among children younger than 18 years, but adults also become ill. Although rare, several children around the country have experienced life-threatening illnesses and permanent kidney damage after drinking contaminated raw milk.
Is raw milk from grassfed cows and goats on pasture safer?
Some studies have shown that cattle in feedlots have higher rates of E. coli O157:H7 in their feces than pastured cattle. However, pathogens are still found in cows and goats fed only grass or kept on pasture as shown in the table below. Several recent E. coli O157:H7 and Campylobacter outbreaks in the US were linked to grassfed cows, and pathogens have been cultured from grassfed farm animals and raw milk. Click here for a larger PDF version with Links.
Is raw goat milk safer than cow milk?
There is no evidence that raw milk is safer from a particular species of animal. Goats may be easier to keep clean because they produce less manure compared with cows and a goat’s fecal material is firmer and less likely to splash compared to cows who have liquid feces. But, people have been sickened by both goat’s and cow’s milk if it gets contaminated. In 2008, a young boy and girl became severely ill after drinking raw goats milk contaminated with E. coli O157:H7 from a farm in Missouri.
What is meant by “good” and “bad” bacteria in milk?
Raw milk is a complex food full of bacteria and other microorganisms like yeasts that come from the animal’s skin and teat canal. Microorganisms can also be carried into raw milk by flies, human hands, and fecal material on the milking or bottling equipment.
Most of the bacteria in raw milk are harmless, and some even help in the process of cheese making (for example, lactic acid bacteria). There are species of bacteria that are classified as “probiotic”, or bacteria that have healthful effects for the body. For, example, if present in enough numbers, these bacteria may help the digestive system. However, since the lactic acid bacteria do not grow well under refrigeration, the numbers of these bacteria in raw milk is expected to be fairly low or variable. In addition, we cannot be sure whether the lactic acid bacteria that may be present are, in fact, probiotic.
Pathogens such as Campylobacter, E. coli O157:H7, Listeria, and Salmonella come from the same place as the “good bacteria.” Unless the animal is sick with mastitis (infection of the udder), the “bad bacteria” are usually present in much lower numbers than the harmless bacteria. However, only a tiny amount of these pathogens need to be swallowed to make someone sick, especially a child or a person with a compromised immune system (for example, someone with HIV/AIDS or on chemotherapy).
There are many other foods that contain “good bacteria” and are less risky than raw milk. For example, there are dairy foods with probiotic bacteria added (milk, yogurt and kefir made from pasteurized milk). There are also unprocessed foods that may contain lactic acid bacteria including fermented vegetables (sauerkraut, kimchi), but the number and type of bacteria is less predictable. There are also high quality nutritional supplements that can be used to add probiotic bacteria into one’s diet. It seems more logical, and certainly of less potential risk, to obtain dietary probiotic flora from sources with known activity and where these bacteria are present in sufficient numbers to be effective, than to rely on raw milk where the levels are low and variable.
Does raw milk have special qualities like enzymes and “good” bacteria that kill pathogens?
There are natural enzymes in milk (for example, lactoperoxidase) that are toxic to bacteria including pathogens. These enzymes will kill some of the germs, but not all of them. The technical term for this phenomenon is “Competitive Exclusion” or “Competitive Inhibition.” In areas of developing countries that don’t have pasteurization or good refrigeration systems, these enzymes and competing bacteria help to make the raw milk safer.
The World Health Organization published an extensive review of the risks and benefits of using the lactoperoxidase system to control germs in raw milk in the third world. However, lactoperoxidase is not dependable in its natural state, and they recommend adding hydrogen peroxide. This approach to keeping raw milk safe is not ideal, and their report concludes:
“It is obvious that the science behind competitive exclusion remains incomplete, and certainly does not warrant a broad conclusion that raw milk is consistently safer than pasteurized milk based on “good bacteria” out-competing pathogens.”
Quoted from the World Health Organization, “Benefits and Potential Risks
of the Lactoperoxidase System of Raw Milk Preservation.”
Doesn’t raw milk taste better than pasteurized milk?
Taste is subjective and different products (e.g., soft drinks) have claimed to taste better than rival products for as long as there has been advertising. Impartial researchers who conduct blind taste tests have not compared raw milk and pasteurized milk, in part because it would not be ethical to intentionally expose research participants to a high-risk product such as raw milk.
The richer, creamier taste may be related to nonhomogenized milk rather than the milk being raw. Homogenization is the process of breaking up the fat globules in milk so that the cream does not separate from the rest of the milk (eliminating the need to shake up the milk before drinking). For those who prefer a richer, creamier taste and texture, nonhomogenized, but still pasteurized, milk can often be found in specialty stores and farmers markets.
Is raw milk tested by government or private laboratories safe?
Testing is not a guarantee of safety, but helps the government and industry catch problems early before they get out of control. Where raw milk is sold legally in the United States, most states require licensing, inspections, and testing of dairies. But, since not every batch can be tested (and the tests are not perfect), outbreaks from legal and “certified” raw dairy farms continue to sometimes occur around the country. This is the case for all regulated foods, not just raw milk.
Testing may not be perfect, but it is still important. Consumers should avoid any dairy products sold illegally, especially “black market” raw milk/cheeses, and soft Mexican-style cheeses such as queso fresco sold by unlicensed vendors, or imported illegally into the US.
Why is raw milk illegal in some states?
There is a long history and debate surrounding the legalization of raw milk in the United States. Michigan was the first state to require pasteurization of all dairy products sold to the public. A 2009 review of raw milk consumption found that 29 states allow some form of on- or off-farm raw milk sales, but only a few allow sales in grocery stores. CDC has documented fewer illnesses and outbreaks from raw milk in states that prohibit sales.
In 1987, the FDA mandated pasteurization of all milk and milk products for human consumption effectively banning the shipment of raw milk in interstate commerce with the exception of cheese made from raw milk, provided the cheese has been aged a minimum of 60 days and is clearly labeled as unpasteurized. This action was prompted by Federal Judge Norma Holloway who ordered the US Department of Health and Human Services to ban interstate shipment of raw milk and raw milk products. She stated:
“It is undisputed that all types of raw milk are unsafe for human consumption and pose a significant health risk. The appropriate remedy in this case is therefore, an order compelling the agency to promote a regulation prohibiting interstate sale.”
Quoted from Public Citizen v. Heckler, 653 F. Supp. 1229, 1241 (1987).
Is raw milk the only way to support a local dairy?
Raw milk is not the only way to enjoy fresh, wholesome dairy products and support local farms. Many dairy farmers avoid selling raw milk despite a demand for it because of the liability and because public health agencies recommend against it. If someone gets sick, it can cost millions of dollars to help with the medical costs. Insurance rates are very high and some companies will not insure a dairy that sells raw milk.
There are more and more local dairies around the country finding success in producing niche products such as local, organic, hormone-free, grassfed milk and cheeses that have been treated with the lowest recommended amount of heat to kill pathogens. There are also many delicious artisan cheeses made from pasteurized milk.
Another alternative is to home pasteurize raw milk as described in this information sheet:
There are also some excellent recipes to make your own cheese safely such as this one for soft, Mexican-style cheese:
