I grew up in a household where raw fruits and vegetables were forced upon me starting shortly after I was transitioned from baby formula to solid foods.  Along the way, I was informally schooled on the added nutrition that accompanies the consumption of fruits and vegetables in their raw state.  My parents’ pushy food choices must have worked because now, as a fully independent adult able to pick and choose my own meals, I select raw fruits and vegetables whenever possible.

If raw is generally considered to be the preferred state to consume most fruits and vegetables, the same should be true of other food products, right?

When it comes to animal products, the answer generally is “no.”  Uncooked beef, poultry, even fish, pose significant health risks of which most people are (or should be) aware.  But for other animal products, like raw milk, the dangers of “raw” are being called into question.

The most common arguments made in favor of raw milk consumption are the added health benefits not found in pasteurized milk.  So does raw milk contain some health benefits that pasteurized milk does not?  Maybe, but that’s not the concern of this article.  My concern is the risk.  Those potential benefits, which may include certain vitamins, minerals, and probiotics, are readily available from a multitude of other sources that do not have the absurdly high health risks that have been linked time after time to raw milk consumption.  Those risks include infection with Campylobacter, or worse, shiga toxin-producing E. coli–a really nasty bug.  For example, it only takes a few microscopic E. coli bacteria to produce bloody diarrhea, renal failure, and ultimately death.

Consider this true story (one of many just like it):  A young boy, then age nine, developed an E. coli O157:H7 infection in September, 2006 following his consumption of raw milk.  He was hospitalized beginning on September 8, suffering from severe gastrointestinal symptoms, including bloody diarrhea.  Shortly thereafter, he developed hemolytic uremic syndrome (HUS).  In an effort to properly treat his rapidly deteriorating condition, he was moved to multiple medical facilities, twice by life-flight.   His HUS was remarkably severe, marked by prolonged renal failure, pancreatitis, and severe cardiac involvement.  He required 18 days of renal replacement therapy.  On two occasions his cardiac problems became so severe that he was placed on a ventilator.  At several junctures, the possibility that he might not survive was very real.  Ultimately, he was hospitalized through November 2, 2006, and incurred over $550,000 in medical bills.  Renal experts have opined that he is likely to develop severe renal complications in the future, including end stage renal disease (ESRD), and require a kidney transplant.

Given the incredible harm that can result from raw milk consumption, is it good sense for a person to knowingly consume it for the few possible health benefits that can be derived from much safer sources?  As a person who is generally risk averse, I would argue that it is not good sense to make such a choice.  But what about the instance where a consumer does not realize they are choosing raw milk?

It is the locations where raw milk is available at the retail level that my concern for possible consumer confusion is at its greatest.  There are places in the United States where, for example, nostalgic, classic-styled milk bottles containing unpasteurized milk are easily found at the local grocery store, especially those stores catering to the consumer who favors organic and natural food choices.  These bottles usually have the name of the dairy from which the milk was derived, along with the fat content (non-fat, 2%, whole).  But one notation on the bottle that a consumer may not notice is the word “raw.”  The potential repercussions from inadvertently purchasing raw milk and feeding it to a person who is at-risk (including children, the elderly, pregnant women, and anyone with a compromised immune system) are enormous.  

Admittedly, the likelihood of this scenario is not equal across the United States.  The availability of raw milk for sale at the retail level is governed by a combination of federal and state laws, and at present there are many states that outright ban the sale of raw milk for human consumption.

On August 10, 1987, the FDA published 21 CFR Part 1240.61, a final regulation that mandated the pasteurization of all milk and milk products in final package form for direct human consumption. This regulation banned the shipping of raw milk in interstate commerce, and became effective September 9, 1987.  In the Federal Register notification for the final rule to 21 CFR Part 1240.61, the FDA made a number of findings, including the following: “Raw milk, no matter how carefully produced, may be unsafe.”  

Today, it is a violation of federal law to sell raw milk packaged for consumer use across state lines (interstate commerce), but each state can regulate the sale of raw milk within the state (intrastate).  Some states therefore allow raw milk to be sold.  Looking at the issue on a national level, the distinctions between applicable laws in individual states are bewildering.  In 2006, 25 states had laws outright banning the sale of raw milk intended for human consumption.  In the remaining states, dairy operations may sell raw milk to local retail food stores or to consumers directly from the farm, or at agricultural fairs or other community events, depending on the state law.  Restrictions are further varying, from specific labeling requirements, to requirements that milk only be bought with personal bottles, to the purchase of raw milk through cow shares exclusively, to permitting a sale only with a written prescription from a doctor, to sales of raw goat milk only, and to sales of a limited daily quantity only if made without advertising.  

Some states, like Washington, have strict labeling requirements which may reduce the likelihood that a consumer will unknowingly select a raw milk product from the store shelf.  By Washington state law, all retail raw milk products sold in Washington must prominently display the following label on the container’s principal display panel: “WARNING: This product has not been pasteurized and may contain harmful bacteria. Pregnant women, children, the elderly and persons with lowered resistance to disease have the highest risk of harm from use of this product.”  

Unfortunately, not all states have such a warning label requirement on raw milk products.  Some only require the words “raw” be printed somewhere on the product, while others require a statement that “raw milk is not pasteurized, pasteurization destroys organisms that may be harmful to human health.”  Personally, I think the Washington label is decent, although I prefer it define “risk of harm” to include the specific type of harm that can result from consuming the product–including renal failure and death from shiga toxin-producing E. coli strains frequently found in the feces of cows.

Because the potential for inadvertently selecting raw milk exists at the retail level, I implore you to please pay extra attention while selecting your milk at the local grocery store if you live in a state where raw milk is legal to sell.  Look carefully at the product for words like “raw” and “unpasteurized.”  And if you are a person who is deliberately choosing to consume raw milk or raw milk products in spite of the abundant scientific evidence and federal, state, and local health agency-investigated outbreaks that have linked devastating human illness to the consumption of raw milk, then please do not give it to those most at risk–children, the elderly, pregnant women, and any person with a compromised immune system.  The
potential for devastating he
alth consequences is not worth the possible health benefits that are available from many other, much less dangerous sources.