More States Are Making Raw Milk Legal. Is It Safe? - Verywell Health

Key Takeaways

• More than two dozen states have legalized the sale of raw dairy products.
• Raw milk enthusiasts say that pasteurization—the process of heating milk just enough to kill harmful bacteria—reduces the nutritional value of milk.
• Experts say raw milk is not a meaningful source of "good" probiotic bacteria, and it can carry pathogens including Listeria, Campylobacter, Salmonella, and E. coli.

This month, Iowa joined more than two dozen states in legalizing the sale of raw, unpasteurized milk and other dairy products, like cheese, yogurt, and ice cream.

Most milk in the United States is treated through a process called pasteurization, which involves heating milk just enough to kill harmful pathogens.

Raw milk enthusiasts say that pasteurization reduces the nutritional value of milk and claim that raw dairy can improve allergies and lactose intolerance. But food safety experts say these claims are largely unfounded and the risk of serious infection from untreated milk far outweighs the benefits.

"I think people are doing this for many reasons—trying to find healthy, natural ways to address their health problems. But you need to listen to a need to read the evidence-based information," Francisco Diez-Gonzalez, PhD, a professor and Director for the Center for Food Safety at the University of Georgia, told Verywell. "There's a lot of misinformation out there about what things are really good for you or not."

"The bottom line is that it's really hard to control the presence of pathogens in raw milk because the product is not subjected to a kill step, like pasteurization," Diez-Gonzalez said.

Across the western U.S., people can buy raw dairy from retailers. In the Midwest and in states including New York, Georgia, and Vermont, farmers can sell raw dairy directly to consumers. In Colorado, Tennessee, North Carolina, and several other states, raw dairy is available through herd share programs.

Research from the Centers for Disease Control and Prevention (CDC) shows that as more states have legalized raw milk, the number of related outbreaks has also increased. Between 1998 and 2018, outbreaks linked to raw milk caused more than 2,600 illnesses and more than 200 hospitalizations. In states where raw milk is legal, there were more than three times as many outbreaks than in states where it's illegal.

What Types of Raw Dairy Products Are Allowed?

Raw milk laws typically apply to all dairy products, including those made from goat's and sheep's milk. The FDA allows raw milk cheeses to be sold, as long as they've fermented for 60 days or more.

What Is the Purpose of Pasteurization?

Pasteurization involves heating milk to the lowest possible temperature necessary to kill pathogens that cause disease. Depending on the product and the type of pasteurization, that could mean heating it at a temperature of 145 degrees to 280 degrees Fahrenheit for as long as 30 minutes or as short as 0.01 seconds.

Before pasteurization became mandatory in U.S. states in the mid-1900s, bacteria in milk was a leading cause of tuberculosis, brucellosis, diphtheria, scarlet fever, and Q-fever. In 1938, a quarter of foodborne illnesses were linked to milk. Today, milk-related outbreaks account for 1% of all foodborne illness outbreaks, and 70% of those cases are linked to raw milk.  

"Milk and dairy have gone from the poster child for a major causative agent for foodborne illnesses to almost a footnote," John Lucey, PhD, director of the Center for Dairy Research at the University of Wisconsin, Madison, told Verywell.

Today, untreated milk can carry pathogens including Listeria, Campylobacter, Salmonella, and E. coli. Getting sick with these bacteria can cause vomiting, diarrhea, and other uncomfortable, but not life-threatening symptoms.

But sometimes, an infection can progress to a severe disease. Campylobacter infections, for instance, primarily cause diarrhea but can sometimes progress to the autoimmune disorder Guillain-Barré syndrome. Since 1987, there have been 143 reported outbreaks of illness linked to raw milk, according to the FDA. Some of these resulted in miscarriages, stillbirths, kidney failures, and deaths.

Is Raw Milk Safe?

Many microorganisms that can be harmful to humans exist naturally in dairy animals' intestines. Even the cleanest dairy farms can't totally control where bacteria-laden manure lands.

Dairy producers can decrease the risk of contamination by cleaning machinery and tanks, cleaning animals' udders, and storing milk at low temperatures. But cleanliness alone won't ensure that dairy products are safe, Lucey said.

Some states require that dairy farmers use antibiotics and routinely test their products for harmful bacteria. Others require producers to have permits, prohibit people from reselling raw milk bought from the producer, and forbid sales more than seven days after production.

"Sanitation and cleaning and temperatures all contribute to safety, but we would consider pasteurization to be the critical one. If, if all else fails, as long as it pasteurized, I know I killed all the pathogens," Lucey said.

Some people who live on farms or have been exposed to dairy for a long time may have some immune resistance to the pathogens in raw milk.

"The trouble is when you make this available to city folk or somebody who has never been on a farm, you're increasing their risk," Lucey said. "They are not as familiar with the flora in the raw milk, and they're at much higher risk than you are."

For most people with a healthy immune system, drinking contaminated raw milk may cause diarrhea and vomiting. But for vulnerable groups, like children and people with weak immune systems, who often have little control over what they eat, the consequences can be life-threatening or life-altering. About 48% of people who get sick from raw milk consumption are younger than 20 years old, according to a CDC study.

Does Pasteurization Make Milk Less Nutritious?

Proteins, fats, lactose, and other major components of milk generally stay intact during the pasteurization process.

Whey proteins tend to denature a bit during pasteurization. However, slightly denaturing whey protein actually improves how easily the body can digest it and make use of its nutrients, according to Lucey. The heat isn't enough to destroy key minerals in milk, such as calcium, riboflavin, and potassium.

"Some of the vitamins are partly sensitive, but you're talking about maybe a 10% reduction in those. And to be honest, if you drink milk in a glass bottle versus milk in a carton, you would have more destruction of vitamins because of the clear glass and light causing some oxidation of the vitamins than pasteurization ever would," Lucey said.

Some raw milk advocacy groups, such as the Weston Price Foundation, claim that lactose intolerant people can comfortably drink raw milk. But both pasteurized and unpasteurized milk contain lactose, the sugar that leads to diarrhea and bloating in people who lack the enzyme to digest it fully.

Raw milk is also not a meaningful source of "good" probiotic bacteria, Lucey said, since the bacteria naturally present in milk that produce lactic acid will outgrow them. If a milk product tests positive for probiotic bacteria, it's probably an indication that it's infected with manure, he said.

Diez-Gonzalez said that the raw milk trend is mainly driven by the belief that it has more nutritional properties that are lacking in pasteurized milk, but "the evidence is very, very questionable."

"If you have a young child, would you risk to have your kids sick for a potential benefit that is not even being fully confirmed?" he said.

What This Means For You

The most fail-safe way to ensure the safety of milk is to heat it to a temperature high enough to kill contaminants. Bringing raw milk to a boil before drinking it should kill most bacteria.

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