I shared a few posts about the risks associated with consuming raw milk a few days ago on Instagram and had several people who reached out to me promoting common raw milk myths that seem to be floating around. I thought it would be beneficial to share my professional knowledge and recommendations concerning the issue of raw milk consumption and its safety. I’ll also touch on what we know regarding certain nutrition claims.
First, let’s chat about some *important* background information. Then, i’ll discuss the safety aspects of this issue. Lastly, I’ll get into the nutrition claims one by one and share what we know.
Raw Milk vs. Pasteurized Milk?
Raw milk is milk from cows, goats, or sheep milk that has not been pasteurized. Pasteurized milk is milk from cows, goats, or sheep that is pasteurized. Pasteurized milk makes up the large majority of milk available to consumers today. Most, if not all, of the milk available at your grocery store is likely pasteurized milk (depending on what state you live in, raw milk may or may not be legally sold in retail stores.)
What is Pasteurization?
Pasteurization is a simple heat and cool process done to milk to help ensure it is safe to consume. Essentially, chilled raw milk is heated to a specific temperature for a certain amount of time which kills certain harmful bacteria (i.e. E.coli, Salmonella, & Listeria) and slows spoilage of the milk.
If you’d like the nitty gritty details of the pasteurization process, here you go:
- A farmer milks the cow (or goat or sheep) and milk is kept at 39°F
- Milk is taken to a milk plant where it is heated to undergo the pasteurization process.
- There are several different ways to pasteurize milk but each way has a specific temperature and length of time that has been specified to ensure harmful bacteria are killed and the milk is safe to consume for humans.
- HTST – The *most common* process for pasteurized milk in the United States is the HTST (High Temperature Short Time) pasteurization. Here cold raw milk is heated to 161°F for at least 15 seconds. Then, it rapidly gets chilled back to 39°F.
- Ultra-Pasteurization (UT) – Cold raw milk is heated to 280°F for just 2 seconds. This process is used in shelf-stable packaged milk that does not need to be refrigerated.
- Vat Pasteurization – Cold raw milk is heated for at least 30 minutes to 145°F. This is mainly used for starter cultures for cheese, yogurt, buttermilk, and some ice cream mixtures.
What are the potential risks of consuming raw milk?
The most common symptoms associated with illnesses from raw milk consumption are:
-Flu-like symptoms (i.e. fever, headache, body ache)
-Less common (but does still occur): kidney failure, paralysis, long-lasting disorders, and even death.
Honestly, most people who get sick from raw milk consumption will recover (just like when people get better after food poisoning from a random taco stand). However, I’m sure it is not pleasant to go through the symptoms regardless of how serious it is. I’ve never met someone who has gotten a food borne illness and said they would be ok if they went through it again! Usually, they never want to experience that pain and discomfort again!
It’s also important to understand that there is a chance you (or your child) will have serious consequences from drinking contaminated raw milk. I want to share a *few* real life examples of people who have seriously regretted taking the chance on raw milk. Although serious consequences is less common, they do happen.
Here are a few examples of real life people who have gotten sick from consuming contaminated raw milk:
- In 2012, a 2 year old girl consumed raw milk infected with E.coli. She first experienced bloody diarrhea. Next, she developed hemolytic uremic syndrome (a common complication of E.coli infection which was due to her raw milk consumption). Her kidneys eventually shut down and she suffered a stroke while being treated. Less than 2 years later, she had to receive a kidney transplant from her mother. To hear their story, click here.
- In 2008, a woman became sick with a campylobacter infection after drinking raw milk. The infection resulted in her developing Guillain Barre Syndrome (GBS), which is a potentially fatal inflammatory disorder. It got so bad that by the time she was hospitalized, she was essentially paralyzed and had to be intubated and placed on mechanical ventilation. After several months of little improvement and fighting for her life, there was very slow progress. Several months later she was discharged but needed 24 hour care and rehab to re-acquire the ability to speak, breathe, and move her limbs. At the time her story was written, she still could not walk again. If you want to hear her story, click here.
- In 2006, a 7 year old boy was infected with E.coli after consuming raw milk. He also developed hemolytic uremic syndrome (HUS) and was hospitalized. His case was extremely severe resulting in renal failure, pancreatitis, and severe cardiac involvement. While he did survive, renal experts have told him he will likely have severe renal complications in the future and likely have end stage renal disease and need a kidney transplant. To hear his story, click here.
Let’s talk stats for a second.
I talk about this in the next question below but CDC data from 1993 to 2006 enteric outbreak information showed that a person who consumes raw milk was 150 times more likely to be infected with an enteric disease outbreak compared to those who consumed pasteurized milk.
It really comes down to this: If you drink raw milk does it mean you will get sick? No. Some people obviously do drink it and have not gotten sick. But, do the potential risks outweigh the benefits? I hope this article helps you decide what’s best for you and your family. We do know that you are more likely to get sick by consuming raw milk (and it can potentially be very dangerous and life threatening if you do).
Who is most at risk of getting sick from raw milk?
Anyone is at risk for getting sick but the groups that are especially at risk for contracting serious illness are children, the elderly, pregnant women, and people with a weakened immune system (i.e. cancer).
A study done by the CDC in 2012 found that children were most at risk for illness from raw milk. Between 2007-2012, 59% of outbreaks involved at least one child younger than 5.
This website shares more devastating stories of real kids/adults who have had to fight for their life after complications from consuming raw milk.
Is pasteurized milk safer than raw milk?
The CDC (Centers for Disease Control and Prevention) conducted a study from 1993 to 2006 that examined outbreaks caused by raw milk products vs. pasteurized milk products. During this time, only about 1% of the entire U.S. population consumed raw milk. However, the number of enteric disease outbreaks associated with dairy products was greater in raw milk products than pasteurized milk products. Using data from this study, a person who consumed raw milk was 150 times more likely to be infected with an enteric disease outbreak compared to those who consumed pasteurized milk.
Additionally, the hospitalization rate for patients in outbreaks linked to raw milk was 13 times higher (13% vs 1%) than the rate for people in outbreaks linked to pasteurized milk. Professionals believe this is partly due to the fact that outbreaks linked to raw milk were all caused by bacterial infections which can be more severe than the mild viral infections and toxins linked to the pasteurized milk. To be more clear: out of all the people who were hospitalized due to enteric disease from the consumption of either raw or pasteurized milk, those who consumed raw milk tended to have more severe disease compared to those who drank pasteurized milk.
The reality is, pasteurized milk does significantly reduce your risk of getting sick from harmful bacteria that can contaminate and grow in raw milk.
Is it legal to sell raw milk in the United States?
Due to federal law, it is illegal for anyone to distribute and sell raw milk across state lines.
However, it’s up to individual states to decide if raw milk can be legally sold within their state or not. In Utah, the law states that raw milk sales are only allowed on the farm that the milk comes from. If they are sold in a store, the store must be owned by the producer (which can be located off the farm). So essentially, the raw milk you buy has to come from the actual dairy farm/producer it was gathered from.
To check your state’s laws on raw milk click here.
What guidelines do farmers have to maintain in order to sell raw milk?
If you live in a state that allows the selling of raw milk, you must have a permit to sell raw milk. In Utah, sellers have to get an approved permit by the Utah Department of Agriculture and Food (UDAF) to sell it. Guidelines can vary based on state. To check your state’s laws on raw milk, click here.
In Utah, raw milk must be tested for bacteria and pathogens. They must contain zero pathogens; bacteria <20K/mL; coliform <10mL. Animals must be tested before production and every 6 months after. Lastly, bottles of raw milk must be labeled raw and contain a warning label.
Sounds like raw milk is raw then right? Here is where things get more complicated.
These requirements do help make raw milk “safer” but, ultimately, Farmers cannot guarantee that their raw milk and the products made from it are free of harmful germs – even if tests indicate the raw milk does not contain harmful germs. I’ll share more in the next paragraph but some bacteria are actually very difficult to detect in raw milk through certain testing and can result in a false negative test (the bacteria tests negative even though it is actually present).
Here is an interesting example that actually happened in Utah in 2014. Between May and November 2014 the Utah Department of Health (UDOH) found a large spike of people sick with a rare strain of Campylobacter (an infectious disease caused by bacteria). After investigation, they found that over half of these people consumed raw milk from the same dairy. Following protocol, the UDOH then went to the dairy to test their raw milk for Campylobacter. Surprisingly, the initial testing for Campylobacter in this dairy’s raw milk came back negative. However, after consulting professionals, microbiologists from the Utah Public Health Laboratory found that when they used a specific sampling method of the raw milk, they were able to detect the same strain of Campylobacter making people sick in this dairy’s raw milk. This dairy had to halt the selling of raw milk temporarily but eventually was reinstated to sell raw milk a few months later. Shortly after the dairy’s permit was reinstated to sell raw milk in October 2014, new Campylobacter cases infected with the same rare strain were reported to UDOH. The dairy’s permit was revoked indefinitely and since then, no cases of campylobacter with that outbreak strain has been reported. There is still risk when consuming raw milk even when farmers do testing for pathogens. Campylobacter is known for being particularly difficult to detect in raw milk (even with common testing procedures).
This is just one real life example showing how even “testing” done by local dairies cannot guarantee that the milk is not contaminated.
If a farmer states exceptional cleanliness and bacteria prevention practices can I trust their raw milk?
After reading numerous reports from the Utah State Health Department, I think it’s safe to say there are farms that do more than others to encourage cleanliness and bacteria prevention practices. I know there are several farmers near me that take pride in their work and are people with integrity. However, as a dietitian it really comes down to this: a farm is still a farm. While following good hygienic practices during milking can reduce the chance of milk contamination, it cannot completely eliminate it. Even the most hygienic dairy farms are still exposed to dirt, rodents, feces, etc. which means any dairy farm is still a breeding ground for bacteria to grow. There will always be potential risk for contamination in raw milk.
Some of the most common ways milk may be contaminated with bacteria through the milk collection process:
- Cow feces coming into direct contact with the milk
- Infection of the cow’s udder (mastitis)
- Cow diseases (i.e. bovine tuberculosis)
- Bacteria that live on the cow’s skin
- Environment (i.e. dirt, processing equipment)
- Insects, rodents, and other animal vectors
- Humans, for example, by cross contamination from soiled clothing and boots.
After reading this list, even though some farmers may do “rigorous” testing and do their best to promote cleanliness, farms are farms. There are a lot of different ways milk can be contaminated with bacteria that could easily go unnoticed during the milk collecting process. Farmers cannot guarantee that their raw milk and the products made from it are free of harmful germs – even if tests indicate the raw milk does not contain harmful germs.
Is local raw milk safer than non-local raw milk?
Well, remember that it’s illegal to distribute and sell raw milk across state lines. So, the selling of non-local raw milk isn’t legally possible. However, if you lived near a state’s border or traveled to a different states that sells raw milk, you could technically buy it there and consume it.
Aside from that, I would never consider buying or consuming raw milk that is not local and has been distributed across state lines. It is illegal and it has more potential situations of becoming contaminated and more opportunities for bacteria to grow before you consume it. However, as mentioned throughout this article several times, no farmer can guarantee that their raw milk and the products made from it are free of harmful germs – no matter if they are local or not.
How often do people get sick from drinking raw milk?
According to the CDC, the average number of enteric outbreaks linked to raw milk between 2007 and 2012 was four times higher than 1993 to 2006.
In 2007-2012, there were 81 reported outbreaks in the United States linked to raw milk consumption, 979 illnesses and 73 hospitalizations.
It’s also important to remember that the reported outbreaks are likely just a small fraction of the actual number of people who develop illnesses. A lot of illnesses are not reported. It’s safe to say there are even more outbreaks than what these statistics show.
What do professional health organizations say about raw milk?
Virtually all national and international advisory and regulatory committees related to food safety have strongly endorsed consuming only pasteurized milk and milk products. These include the American Medical Association, The Academy of Nutrition and Dietetics, The American Academy of Pediatrics, the American Veterinary Medical Association, the International Association for Food Protection, the National Environmental Health Association, the FDA, and the World Health Association.
Is raw milk from grass-fed cows and goats safer? What about organic?
There have been outbreaks traced back to grass-fed animals and grain fed animals. So, no, it is not “safer” just because the animal is grass fed. Also, regardless if the milk is organic or not, it can still be contaminated with bacteria. Remember that any farm is a breeding ground for bacteria because any farm is exposed to feces, dirt, rodents, insects, etc.
Can I tell raw milk is contaminated by smelling it or looking at it?
No. You can’t tell if raw milk is contaminated by tasting, looking, or smelling it.
Coming soon 🙂References
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3. Costard S, Espejo L, Groenendaal H, et al. Outbreak-related disease burden associated with consumption of unpasteurized cow’s milk and cheese, United States, 2009–2014. Emerg Infect Dis. 2017;23(6):957–964
4. Center for Disease Control And Prevention. Raw Milk Questions and Answers. https://www.cdc.gov/foodsafety/rawmilk/raw-milk-questions-and-answers.html. Accessed July 15, 2021.
5. U.S. Food and Drug Administration. Raw Milk Misconceptions and the Danger of Raw Milk Consumption. https://www.fda.gov/food/buy-store-serve-safe-food/raw-milk-misconceptions-and-danger-raw-milk-consumption. Accessed July 14, 2021.
6. Real Raw Milk Facts. https://realrawmilkfacts.com/real-life-stories. Accessed July 15, 2021.