For the fourth straight year, a bill that legalizes on-farm sales of unpasteurized milk or milk products directly to individuals has been introduced in the Iowa House. The bill, HSB131, would also allow the dairy farmer to deliver the unpasteurized milk to the consumer, as well as sell it at farmers markets. Current Iowa law does not allow raw milk to be sold in any way (farm, retail, cow shares or as pet food). Many of the states that allow on-farm sales require milk to be Grade “A,” and the dairy farm must be licensed and inspected. The containers must be labeled as “raw” milk, the package must contain a warning about the hazards of drinking raw milk, and the milk must be routinely tested for pathogenic bacteria. HSB131 would exempt Iowa dairy farms that sell raw milk from being licensed, regulated or inspected; containers of raw milk would not have to be labeled, nor would a warning label be required. Not only would the milk not have to be graded, but testing the milk for pathogens would also not be a requirement. States that allow farm sales and have regulations in place like those mentioned above still have outbreaks involving raw milk. From 1998-2010, there were 56 raw milk outbreaks associated with states that allow on-farm sales. These outbreaks resulted in 520 illnesses with 89 people requiring hospitalization. Many parents who give their children raw milk are convinced by the scientifically unsupported data that raw milk is the “miracle cure” for all types of health issues and that it is healthier and safer than pasteurized milk. Many of these children are lucky and do not become ill or may have only a day or two of diarrhea. Other children have not been as lucky. They had bloody diarrhea and developed hemolytic uremic syndrome which led to acute kidney failure. They were on dialysis for weeks and some even required mechanical ventilation to survive. The long term prognosis is that all of these kids with acute kidney failure are at a much higher risk of needing a kidney transplant in their future. I encourage you to check out the following link to find short video testimonies describing some of these cases. Medical costs in these cases vary based on the severity of the illness but have been as high as $1 million. This does not include the future costs these victims face if a kidney transplant is needed or the lifetime supply of immunosuppressant drugs that are required for transplant patients. The owners of these raw dairy farms need to be made aware of what an outbreak could cost them. If people/children get sick from drinking the farm’s milk, somebody will sue them. While there is no way of knowing the settlements in past raw milk cases due to confidentiality clauses, we can look at settlements of other foodborne outbreaks because many of the organisms responsible for raw milk outbreaks are also found in other types of food (E. coli, Campylobacter, Listeria, etc.). Individual cases have been settled for: $15.6 million (E. coli), $3.2 million (Campylobacter) and $3.5 million (Listeria). Many raw milk supporters and some legislators do not consider raw milk to be a food safety issue, but instead one of personal freedom. These supporters and a few legislators have stated that they “do not care about the facts or the science involved with raw milk. It is their right to drink whatever they want and it’s not the government’s job to protect a person from themselves.” However, this is where informed consent comes into play. Informed consent can only take place if a person is given all the facts including both risks and benefits. Since the organizations that promote raw milk market its unproven benefits and do not mention its risks, informed consent cannot possibly take place. Public Health is fighting to protect people from this scientifically unsupported data and not “protect people from themselves.” Public Health is also fighting to protect children from this misleading marketing campaign. Children are typically the ones who become seriously ill from drinking raw milk given to them by a parent who believed the unsubstantiated claims about its benefits. In these cases, the child did not have the freedom to choose and the parents did not have the information to make an informed decision. An example of where food safety took a back seat to personal freedom was during the 2012 Iowa House Judiciary subcommittee hearing on raw milk. After hearing from opponents and proponents of raw milk, two of the three subcommittee members proudly announced they were voting for the bill in the name of freedom. This vote completely ignored the raw milk outbreak that was occurring in Pennsylvania at the time of the hearing. By the time this outbreak was over, 80 people had been reported ill in four states with 9 people requiring hospitalization. Thankfully, the committee chair did not have the votes to pass the bill so it was never brought up in the full committee. This year, as the subcommittee prepares to hold a hearing on this bill, a story comes out about a 2-year old girl from Oregon. Last April, she was 1 of 15 children who became ill from drinking raw milk (containing E. coli) that was obtained from a farm that provides herd shares near Portland. This young girl and three other children developed HUS (hemolytic uremic syndrome) and acute kidney failure. She suffered a stroke and died, but was resuscitated. Almost a year later and she is not able to stand or walk on her own, she can’t speak, and she is fed through a feeding tube. Part of her colon has been removed, she has pancreatic problems and now her kidneys have shut down. As of last week, she is back on dialysis and has been placed on the list for a kidney transplant. Will this story be enough to help legislators who currently support raw milk to understand they are putting Iowa’s children at risk if they vote for this bill? In the past three years, we have been fortunate that the bills introduced only made it out of a house committee one time. The bill was not debated on the House floor that year because it was considered too controversial; however, this has not stopped the supporters from continuing to propose it year after year as they continue to ignore the science and the past 100 years of history that support pasteurization as the only way to ensure that milk is safe from pathogenic bacteria.