Is Drinking Raw Milk Risky?

For a growing number of people, deciding what milk to buy doesn’t just involve picking between whole, 2% and skim varieties found on store shelves. It’s also about choosing between pasteurized milk and raw milk.

Access to raw (or unpasteurized) milk continues to grow, as government regulations change in response to consumer demand, particularly in the United States. And people are buying it, too, with sales surging.

But at the same time, public health agencies continue to warn about the safety of raw milk.

So, that leads to an obvious question: Is it dangerous to drink raw milk?

Let’s look at the potential risks with registered dietitian Erin Rossi, RD, LD.

What is raw milk?

Raw milk is milk from cows, sheep, goats or other animals that hasn’t gone through pasteurization, a heat-driven process for killing bacteria. Basically, it’s what comes straight from the animal.

Consumers who seek out raw milk often do so because of:

• Personal choice
• Traditional food practices
• Distrust of large-scale food regulation

Many proponents of raw milk also see pasteurization as a negative. They say the heating process strips milk of key nutrients and undermines some of its health-boosting power. (More on that in a bit.)

How does pasteurization work?

So, what makes milk pasteurized? “Pasteurizing milk means you’re heating it to 161 degrees Fahrenheit [71.66 degrees Celsius] for just 20 seconds,” explains Rossi. “This kills any bacteria.”

Pasteurization was developed in the 1800s to help reduce the transmission of germs and disease. Historians credit milk pasteurization guidelines with reducing once common disease outbreaks.

Today, most U.S. milk that’s poured into glasses or used in dairy products has been pasteurized.

The risks of drinking raw milk

Raw milk that comes straight from the farm is more likely than pasteurized milk to carry harmful bacteria, cautions Rossi. These bacteria can increase your risk for food poisoning and the complications that come with it.

The risks are highest for pregnant women, young children, older adults and those with compromised immune systems. (Healthy adults may evaluate those risks differently.)

Most large public health organizations — including the U.S. Food and Drug Administration (FDA) and the U.S. Centers for Disease Control and Prevention (CDC) — consider pasteurized milk a safer choice than raw milk.

“Pasteurization goes a long way in preventing the illnesses associated with raw milk,” says Rossi.

That includes illnesses related to:

• Escherichia coli (E. coli): Certain strains of E. coli can cause severe abdominal cramps, diarrhea (often bloody) and vomiting. In some cases, it can lead to hemolytic uremic syndrome (HUS), a serious condition affecting the kidneys.
• Salmonella: Diarrhea, fever and abdominal cramps can follow consumption of food tainted with Salmonella. In severe cases, it can lead to hospitalization, especially in young children, older people and those with weakened immune systems.
• Listeria: This bacterium is especially dangerous for pregnant women, as it can lead to miscarriage, stillbirth, premature delivery or life-threatening infections in newborns. Listeria is also a concern for older adults and people with weakened immune systems.

Drinking raw milk can also expose you to highly pathogenic avian influenza (HPAI), also known as bird or avian flu. There’s evidence that the virus has been passed from wild birds to dairy cattle. Milk from infected cows can carry the HPAI virus.

In a review of food illness outbreaks linked to dairy consumption between 2007 and 2020, researchers found more cases involving raw milk than pasteurized milk. Raw milk accounts for less than 5% of all milk sales.

Some dairy products, including many soft cheeses, are also made with raw milk and bring an elevated risk.

U.S. states that allow raw milk sales to consumers generally require some testing of the product for bacteria, but regulations vary widely. Check with your state for specific guidelines if you have questions.

Are there benefits to raw milk?

While many advocates of raw milk say it’s healthier, there’s a lack of scientific research supporting the claim, says Rossi. Let’s address a few of the more common benefit questions using studies and information compiled by the FDA.

• Does raw milk contain more nutrients? “The nutritional value is the same for all milk across the board,” says Rossi. “Pasteurization doesn’t reduce nutrients. It reduces bacteria.”
• Will raw milk relieve lactose intolerance? When it comes to lactose, raw and pasteurized are the same. Both contain proteins that trigger lactose intolerance in people with lactose sensitivities.
• Can raw milk limit asthma or allergic reactions? Researchers haven’t found a difference between raw milk and pasteurized milk when it comes to allergic reactions or asthma.
• Is raw milk better at preventing osteoporosis? This doesn’t appear to be so, as current studies haven’t found evidence that pasteurization affects the concentration or absorption of calcium.
• Can bacteria in raw milk boost gut health? While your gut does benefit from some good bacteria, that’s not the type found in raw milk.

Final thoughts

Milk is a household staple for many reasons. It’s packed with 18 of 22 essential nutrients, making it a simple and efficient way to address your body’s needs for certain vitamins and minerals.

But just because it has a lot of good stuff doesn’t mean it can’t have some bad, too. Drinking raw milk brings an increased chance of bacterial exposure and uncomfortable or even life-threatening complications.

“There are risks in any food supply,” notes Rossi. “But foodborne illnesses are often preventable with proper handling and processing. That includes pasteurization, which minimizes risks while preserving vital nutrients.”