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Raw milk: The benefits don’t outweigh the risks

Pennsylvania had 17 outbreaks related to raw milk from 2007-2012, the highest number in the nation. Children are at a higher risk for serious health problems if raw milk has been contaminated with disease causing bacteria.

As raw milk's popularity increases, debates about its possible benefits and dangers are heating up. Federal laws prohibit interstate sales of raw (unpasteurized) milk products. However, states like Pennsylvania have legalized sales within its borders – and it hasn't been without consequences.

In February, The Pennsylvania Department of Agriculture issued a warning to customers who purchased raw milk from an East Berlin, PA creamery. The warning followed the discovery of Campylobacter in the milk, a bacteria which can cause severe bloody diarrhea, dehydration and sometimes, temporary paralysis.

"A Campaign For Real Milk" is a group whose goal is "universal access to clean raw whole milk from pasture-fed cows, especially access for pregnant and nursing mothers and for babies and growing children." Its founder, Sally Fallon stated, "raw whole milk from pastured cows is the best food there is for growing children. It provides all the nutrition that children need..."

To date, research does not agree with Fallon’s view. John Sheehan, director of the U.S. Food and Drug Administration’s Division of Dairy and Egg Safety has said, “research has shown that there is no significant difference in the nutritional value of pasteurized and unpasteurized milk.” A 2013 review from Belgium agrees that “heating (in particularly ultra high temperature and similar treatments) will not substantially change the nutritional value of raw milk.” While all heating changes food’s chemical structure, the real concern is whether a useful amount of nutritional components are left after heating. For milk, the answer is yes.

Curiously, an issue that seems be completely ignored by raw milk advocates is the universal recommendation to avoid cow's milk of any kind in infants younger than one year. Cow's milk is a poor source of iron, which can lead to significant anemia. It can also cause bleeding in infant intestines, further worsening the anemia. So for the very young, cow's milk in any form, should be avoided (breastmilk or formula should be used instead).

Nutrition aside, there are significant concerns regarding raw milk’s safety. Rates of illness caused by raw milk are on the rise. “The average number of outbreaks caused by raw milk each year was four times higher from 2007-2012 than from 1993-2006,” according to the Centers for Disease Control and Prevention. The CDC also adds “from 2007-2012...these outbreaks caused 979 illnesses and 73 hospitalizations.” Additionally, states which allow raw milk sales experience higher outbreak rates, including Pennsylvania which lead the nation during this period with a whopping 17 outbreaks.

“They did some statistical sleight of hand [to] get these numbers,” Fallon wrote in response. “If a child who drinks raw milk gets intestinal upset, then it is immediately assumed that raw milk is the cause, without looking into the water or any of the other foods that the child has eaten.” In reality, the process is much more involved than this. A child who presents with symptoms of food-related illness will be tested for bacteria that can be found in contaminated milk. If positive, CDC workers may question about raw milk consumption. Water contamination outbreaks tend to make entire populations sick because of its broad use. But raw milk consumption is much more specific because it is not common. Only 1-3 percent of Americans consume raw milk, so raw milk is a likely cause for a child who tests positive and consumed raw milk close to falling ill.

Mistrust of health agencies is not unique to the pro-raw milk movement. Other public health initiatives such as water fluoridation and immunization have produced the same type of skepticism. Before the 1930s, 25 percent of all food borne illnesses were caused by milk products. Since pasteurization, that number decreased to about 1 percent. Raw milk advocates make it a point to say that very few people have died from raw milk, but they fail to mention that very few people actually consume it. Relative to the number of people who drink it in the U.S., raw milk has claimed a concerning numbers of victims. Some simple math reveals that if 100 percent of Americans consumed raw milk products, raw milk products would cause and average 61,000 illnesses, 6,500 hospitalizations and 67 deaths per year (based on 2009 data).

Despite these facts, advocates insist that concerns about raw-milk products are overblown. But in reality, the idea that pasteurization significantly decreases disease is not one created by CDC or FDA. It is a scientific fact, based on copious research. The American Academy of Pediatrics has also made it clear that they oppose the use of raw milk for children.

There are a handful of studies that suggest that children who consume raw milk experience lower rates of allergies, colds, ear infections, and asthma. A common problem in these studies, however, is that children who consume raw milk tend to live on farms. Compared to cities, farms are unique environments, making it hard to pinpoint the exact cause of this apparent reduction in illness.

A recent study also suggests that raw milk may decrease common childhood illnesses such as colds, fevers and ear infections. But the authors themselves make it clear: "raw milk can confer life-threatening infectious diseases." As Sigrid DaVeiga, MD, an allergist and immunologist at Children's Hospital of Philadelphia said, "the study fully acknowledges that the risks of catching a serious infection from drinking raw cow milk vastly outweighs any benefit."  With raw milk offering no special nutritional benefit while increasing potential for disease, it's hard to understand raw milk advocates' convictions.

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