Wellness Wednesday: Raw Milk Risks and Realities

Raw milk has become one of the most polarizing nutrition topics I encounter today. As a registered dietitian with a background in public health, I understand exactly why people are curious—there’s nostalgia, there’s distrust of large food systems, and there’s the belief that “natural” automatically means better. But I also know the data, the outbreaks, and the historical reasons pasteurization exists in the first place.

My goal here isn’t to shame anyone’s choices. It’s to give you the full picture so you can make informed decisions for yourself or your family—grounded in history, microbiology, and real-world health outcomes.

Why Pasteurization Exist

Before industrialization, people consumed milk from animals they raised themselves or sourced locally. But the conditions weren’t always idyllic. In the 19th and early 20th centuries, milkborne diseases such as tuberculosis, brucellosis, typhoid fever, and diphtheria were leading causes of death in children.

When Louis Pasteur’s heating method—pasteurization—was adopted widely in the early 1900s, rates of milkborne illness dropped dramatically. Public records from the early 20th century show milk-related infectious disease deaths in the U.S. plummeted by an estimated 90% after pasteurization became standard in commercial dairy production.

As someone trained in public health, I see pasteurization as one of the most successful food-safety interventions ever implemented.

What Pasteurization Does

Pasteurization simply means heating milk enough to kill harmful pathogens without affecting nutritional value.

Common methods:

• HTST (High-Temp Short Time): 161°F for 15 seconds

• UHT (Ultra-High Temperature): 280°F for 2 seconds

• Vat/Low-Temp Pasteurization: 145°F for 30 minutes

What pasteurization does:

• eliminates dangerous bacteria and viruses

• extends shelf life

• prevents outbreaks

What pasteurization does not do:

• meaningfully reduce vitamin or mineral content

• destroy protein quality

• remove beneficial fatty acids

• cause lactose intolerance

• alter milk’s safety in ways that “weaken the immune system” (a common myth)

Multiple controlled trials show no clinically significant nutrient loss.

Raw vs. Pasteurized Milk

From a dietitian’s perspective, this is often where clients are most surprised.

Nutrient Retention

Studies show:

• Vitamin A, D, calcium, protein, and fats remain stable after pasteurization.

• B vitamins decrease slightly (5–10%), but the amount lost is nutritionally negligible.

• Enzymes destroyed in pasteurization (e.g., lipase) are not needed for human digestion—our bodies produce their own digestive enzymes.

Probiotics? Not Exactly.

Raw milk enthusiasts often claim it contains beneficial probiotics.
However:

• The bacteria present in raw milk are not standardized probiotic strains.

• “Wild” bacteria can include organisms that cause severe illness.

• To be considered a probiotic, a microbe must be clinically tested for benefit and safety.

If you want therapeutic bacteria, fermented dairy products like yogurt or kefir are far more reliable.

What Pathogens Are We Actually Talking About?

From a public health RD perspective, this is the core issue.

Milk can harbor:

• Listeria monocytogenes – causes miscarriage, stillbirth, and severe newborn infections

• Campylobacter – common cause of diarrhea, fever, and Guillain-Barré syndrome

• E. coli O157:H7 – can lead to kidney failure, especially in children

• Salmonella – causes severe gastrointestinal illness

• Brucella – causes chronic fever and joint damage

• Staphylococcus aureus – causes toxin-mediated vomiting

• Mycobacterium bovis – tuberculosis transmitted via milk (still seen globally)

Even healthy cows can shed pathogens intermittently.
Even spotless milking facilities cannot guarantee sterility.

Testing reduces—but does not eliminate—risk.

Global Perspective: How Other Countries Handle Raw Milk

The U.S. isn’t alone in this debate.

• Canada: Raw milk sales banned; pasteurization mandatory.

• Australia: Strict prohibitions except for cosmetic/non-edible “bath milk.”

• EU countries: Some allow raw drinking milk, often from regulated vending machines with onsite testing.

• France & Italy: Raw-milk cheeses are common, but fluid raw milk is still regulated due to safety risks.

Distinguish: Raw Milk vs. Raw-Milk Cheese

Raw-milk cheese aged ≥60 days is substantially safer because:

• acidity

• salt

• time

• controlled fermentation

all suppress pathogens.

Raw fluid milk lacks these protections.

Why Raw Milk Outbreaks Still Happen-Even on “Clean” Farms

Farms that market raw milk often emphasize:

• grass-fed cows

• small herd size

• antibiotic-free production

• “clean milking practices”

These are good agricultural virtues.
But they are not food safety guarantees.

Reasons:

• Pathogen shedding is unpredictable (a healthy cow can shed bacteria one day and not the next).

• Contamination can occur at any step from udder to bottle.

• Refrigeration slows—but does not stop—pathogen growth.

• Some pathogens (like Listeria) grow even at refrigerator temperatures.

A 2023 multi-state outbreak linked to raw milk occurred in a farm with excellent sanitation scores—and dozens were hospitalized.

Safety and Risk: Who Is Most Vulnerable?

From a public health perspective, risk stratification is essential.

Highest Risk (avoid raw milk entirely)

• Pregnant individuals

• Infants

• Children under 5

• Older adults

• Individuals with chronic illnesses

• Immunocompromised individuals

These groups are disproportionately represented in hospitalizations and deaths from raw dairy outbreaks.

Moderate Risk

• Healthy adults aged 18–59
  Risk is lower but not zero. Most U.S. outbreaks involve this group.

Lower Risk (but not no-risk)

• No population group has “no risk”—raw milk contains pathogens that do not discriminate.

Why Some People Believe Raw Milk Is Safer or Healthier

Natural = Safe Fallacy

People equate “natural” with “healthy,” even when nature includes deadly pathogens.

Mistrust of institutions

After decades of mixed nutrition messaging, distrust in government dietary guidance has grown.

Identity-driven health choices

Choosing raw milk often becomes tied to:

• self-sufficiency

• wellness culture identity

• alternative-health narratives

• contrarianism

Influence of social media

Charismatic influencers often share personal anecdotes that feel more compelling than statistics.

Understanding these psychological roots helps people make grounded decisions.

An Evidence-Based Conclusion

Pasteurized milk:

• matches raw milk in protein, fat, carbs, vitamins, and minerals

• is safer

• is more accessible

• is more consistent nutritionally

Raw milk:

• has no demonstrated nutritional advantage

• carries significantly higher microbiological risk

• offers no clinically validated probiotic benefits

• remains unsafe for vulnerable groups

Making an Informed Decision

A registered dietitian’s role is not to shame, but to guide.

If a reader still chooses raw milk:

• Understand the risks clearly.

• Discuss with a pediatrician before giving to children.

• Ask the farm about microbial testing frequency, storage procedures, and animal health protocols.

• Never consume raw milk when pregnant, immunocompromised, or serving children.

If safety is the priority, pasteurized milk—or fermented dairy—is the evidence-based choice.

What You Decide Should Be Grounded in Evidence, Not Fear or Myth

Raw milk has become a cultural symbol, but milk is also a food with a long, complicated safety history. The science is clear:

Pasteurization protects public health without diminishing nutrition.
Raw milk increases risk without providing unique benefits.

Understanding the full context—historical, microbiological, psychological, global, and nutritional—allows consumers to choose from a place of clarity, not ideology.