Raw Milk Is Being Legalized in More States. Is It Safe?

On July 1, Iowa officially became one of more than two dozen states that have legalized the sale of raw milk, or milk that has not been pasteurized.

Over the past decade, a growing number of states have made raw milk more accessible, said Dennis D’Amico, an associate professor of animal science at the University of Connecticut. Some of those states, including Iowa, allow raw milk producers to sell their products directly to consumers; others allow grocery stores to sell such products, and some states allow raw milk to be sold only as pet food.

But federal health experts have linked those new laws with increasing foodborne illness outbreaks associated with raw milk. Between 1998 and 2018, for instance, the Centers for Disease Control and Prevention reported that the average number of raw milk-associated outbreaks across the United States increased. Outbreaks during those years sickened 2,645 people and caused 228 hospitalizations and three deaths.

Between 2013 and 2018, the agency reported, states that had legalized the sale of raw milk at retail stores had three times as many outbreaks as states that prohibited such sales.

The Food and Drug Administration classifies raw milk, which can come from cows, sheep or goats, as higher risk than pasteurized milk because of the potential for contamination with harmful germs. Children, older adults, people with compromised immune systems and those who are pregnant are especially vulnerable to severe infection, the agency says.

Some raw milk proponents argue that pasteurization zaps the nutrients from milk, or that raw milk can fight off viruses on its own, said Nicole Helen Martin, a dairy microbiologist at Cornell University.

“We’re seeing this a lot post-pandemic, people turning to ‘local’ or ‘natural’ — I’m using air quotes — foods,” Martin said.

But there is no evidence that raw milk is healthier for you than pasteurized milk, she added. Under the most commonly used pasteurization method in the United States, Martin said, certain vitamins are only reduced by around less than 10%. “The claim that these components are ‘destroyed’ by pasteurization is simply untrue,” she said.

The growing availability of raw milk is “a loss for public health,” said Marion Nestle, a professor of nutrition, food studies and public health at New York University.

Raw milk, along with other raw dairy products including unpasteurized ice creams, yogurts and cheeses, can harbor bacteria that cause common foodborne illnesses — such as salmonella, listeria, campylobacter and E. coli. Germs may linger on a cow’s udders or in the dirt around them, or on the hands of people who milk them, which can then contaminate the milk, said Dr. Yvonne Maldonado, a professor of pediatrics, infectious diseases and epidemiology at Stanford Medicine.

Without pasteurization, which involves heating milk to kill harmful microbes, “it’s kind of like if you don’t wash your hands and you just lick them” instead, she said.

The risk of bacteria being present in raw milk remains even when dairy facilities appear to take precautions, Martin said. Many people say, “‘Oh, this is my neighborhood farm, I’ve spent time there, the animals are super clean, I would eat in that parlor,’” she said. “The reality of the situation is, that doesn’t matter.”

If bacteria are present, even a small amount of raw milk can make you sick. The symptoms typically include nausea, vomiting, stomach pain, fever, headache and body aches.

Depending on the virus, most healthy people recover within a few days or weeks, D’Amico said, but as with many foodborne illnesses, the symptoms can be severe and even life-threatening, especially if you’re in a higher risk group.

People can get so dehydrated from severe vomiting and diarrhea that in rare cases, their kidneys fail, said Beth Czerwony, a registered dietitian at the Cleveland Clinic. If raw milk is contaminated with campylobacter bacteria, there is a small risk — about one in 1,000, D’Amico said — that a person who becomes infected with it can develop Guillain-Barré syndrome. This can cause muscle weakness and sometimes paralysis, according to the CDC, although most people recover fully.

“There are people who say, ‘I’ve been drinking raw milk my whole life,’” Maldonado said. “Well, yeah, you can also drive around without a seat belt or ride your motorcycle without a helmet.” But eventually, she said, that behavior can catch up with you.

In many states where you can legally purchase raw milk, producers are required to do extra testing for viruses. The odds of any one batch testing positive is fairly low, Martin said. But according to the CDC, those tests can’t always detect low levels of contamination, so a negative test does not guarantee that raw milk is safe to drink.

“Pasteurization is one of the great advances in public health,” Nestle said. “Why not just do it?”

This article originally appeared in <a href="https://www.nytimes.com/2023/07/11/well/eat/raw-milk-risks.html">The New York Times</a>.