The American Academy of Pediatrics on Monday warned that pregnant women and children should not drink raw milk and said it supports a nationwide ban on the sale of raw milk because of the danger of bacterial illnesses.
The group’s statement said it supports federal health authorities “in endorsing the consumption of only pasteurized milk and milk products for pregnant women, infants and children.”
The academy also “endorses a ban on the sale of raw or unpasteurized milk and milk products throughout the United States, including the sale of certain raw milk cheeses, such as fresh cheese, soft cheeses and soft-ripened cheeses.”
Thirty states allow the sale of raw milk. The U.S. Food and Drug Administration prohibits the interstate shipment of raw milk for human consumption, though it allows transport of some clearly labeled raw cheeses.
Advocates say raw milk is delicious and provides health benefits, including protection against asthma and lactose intolerance. And when the animals are raised properly and the milk is treated carefully, they say, raw milk poses little danger to human health.
Health officials in Minnesota this month warned that raw milk could be making more people sick than previously recognized, based on a 10-year study. They estimated that more than 17 percent of the state’s residents who drank raw milk got sick.
There are many reasons why some people are thinking about drinking raw milk these days. (Raw milk is milk that has not been pasteurized to kill harmful germs.) Some people want to eat less processed food. Others have heard that raw milk contains more of certain nutrients than pasteurized milk, or that it can prevent or even solve various health problems. Still others think of buying raw milk as one way to support local farmers and sustainable agriculture.
As a public health epidemiologist and veterinarian, I know firsthand how animals and their germs can contaminate all kinds of food, including milk. Also, in my job in the Outbreak Response and Prevention Branch at CDC, I help investigate outbreaks caused by contaminated food and contact with infected animals.
If you’re thinking about adding raw milk to your diet (or your family’s diet), it’s important for you to understand the risks of drinking raw milk.
Why raw milk is dangerous
Raw milk can carry harmful bacteria and other germs that can make you very sick or kill you. Yes, it’s true that it’s possible to get “food poisoning” or foodborne illnesses from many foods, but raw milk is one of the riskiest of all. Raw milk and products made from raw milk (such as cheeses and yogurts) can cause serious infections, such as Salmonella, Listeria, and E. coli.
By LCDR Casey Barton Behravesh, DVM, DrPH, US Public Health Service
Raw milk has long been identified as a source of food-borne-illness outbreaks, but it is also responsible for uncounted sporadic illnesses, the Minnesota officials said.
And, in another study, scientists who looked at hundreds of samples found that organic whole milk offered more of the fatty acids good for the heart than conventional milk. “We were quite surprised to see the magnitude of difference in milk from organic farms,” said Charles Benbrook, lead author of that study and a program leader at the Center for Sustaining Agriculture and Natural Resources at Washington State University.
Raw milk from cows, sheep and goats is a source of pathogens such as listeria, salmonella and E. coli — which can cause serious, even fatal, illness, the pediatricians’ policy statement said. And it contends that the benefits of raw milk “have not been clearly demonstrated in evidence-based studies” and do not outweigh the risks.
That assessment is confusing, said Mark McAfee, head of a raw milk dairy with products sold in 625 stores. “I could not disagree with them more profoundly. And it’s based on science,” he said.
What he sells “is not the raw milk we saw 50 to 75 to 100 years ago,” he said. Raw milk that’s regulated by state officials and produced under strict standards is safe and beneficial to people, he said.
A statement released from the American Academy of Pediatrics (AAP) states that although people may think raw milk is healthier and more nutritious than pasteurized milk, those health claims are unfounded. In recent years, advocates have pushed raw milk’s benefits for the body since it does not contain antibiotics or hormones sometimes found in pasteurized milk, which is heated and then rapidly cooled to kill potentially harmful bacteria. Some have even argued that drinking raw milk may prevent lactose intolerance, although no independent studies have backed this up.
The authors of the statement, led by Dr. Yvonne Maldonado, a professor of pediatrics at the Stanford University School of Medicine in California, note that from 1998 to 2009, there were 93 recorded cases of disease outbreaks associated with raw milk or raw-milk products that caused 1,837 illnesses, 195 hospitalizations and two deaths. The majority of the infections were caused by E. coli, salmonella or campylobacter infection. A survey from 2011 concluded that raw milk and its byproducts are legal in 30 states, but only a few states allow them in grocery stores (California is one). “We invented pasteurization to prevent these horrible diseases,” said Maldonado in a statement. “There is really no good reason to drink unpasteurized milk.” Pasteurized milk has the same nutrients, proteins, vitamins and calcium, and is less likely to cause these types of infections.
Pasteurization, introduced in the U.S. in the 1920s, kills bacteria by heating milk. Before that time, the pediatricians’ statement said, raw dairy products were responsible for hundreds of outbreaks of infection.
“Pasteurized milk and milk products are extraordinarily healthy, nutritious and safe for children,” said Dr. Mary Glode, a co-author of the policy statement. The academy’s statement supports the position of the FDA, the American Medical Association and others.
Maureen Bligh, a registered dietitian nutritionist, said she agreed “wholeheartedly” with the American Academy of Pediatrics’ stand. “They instituted pasteurization for a reason — to ensure safety for the entire population, and it’s especially important for children and anyone else who is vulnerable.”
To her, the risks are not worth any benefits that advocates say come from raw milk.
The pediatricians estimate that 1 percent to 3 percent of dairy products consumed in the U.S. are not pasteurized. From 1998 to 2009, that led to 1,837 illnesses, two resulting in death.
The popularity of raw milk products, including soft cheeses, has been on the rise.
“We have no scientific evidence that consuming raw milk provides any advantages of pasteurized milk and milk products,” Dr. Yvonne Maldonado, lead author of the policy statement, a professor of pediatrics at Stanford University School of Medicine and an infectious-disease expert, said in a statement. “But relative to the amount of raw milk products on the market, we do see a disproportionately large number of disease and illnesses from raw milk.”
McAfee does not dispute that some raw milk is risky. And that, he said, is why all states need regulations. In Minnesota, for example, raw milk is illegal, so there’s no way to make sure it gets processed safely. In California, he said, there have been very few cases of illness. He said he’s not surprised there are infections in places where raw milk is unregulated because “it’s a black market, a free-for-all.”
Infection from raw milk can occur through contact with animal feces, through organisms on the hide, or through infections the animals have.
McAfee also sees business motivations. He said milk processors oppose the sale of raw milk because they are in the business of processing it.
Los Angeles Times