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Raw Milk Reality: Is Raw Milk Worth the Risk?


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In Is Raw Milk Dangerous, we examined the risk associated with drinking unpasteurized milk compared to the risk associated with consuming other foods, and with other activities such as driving a car. In Raw Milk Benefits, we covered some of the possible benefits of unpasteurized milk. In this article, I’m going to present a framework for determining whether raw milk is worth the risk for you and your family.

As I said in the first article, I’m not here to convince you to drink raw milk. I don’t work for a raw milk producer. I don’t make money promoting raw milk. I have nothing to gain if you decide to drink raw milk, nor do I have anything to lose if you choose not to.

This is a decision you have to make on your own, by weighing the risks vs. benefits and considering more personal variables such as your health status, risk tolerance, values and worldview. Every day we make choices that involve this kind of evaluation, whether we’re conscious of it or not. Each time we get into a car, for example, we are deciding that the convenience and efficiency driving offers is worth the risk of injury or death. We may not consider the decision in these terms – because we’re so accustomed to driving – but that doesn’t mean the risk isn’t real and we aren’t making a choice.

With that in mind, let’s discuss a few of the factors you might consider in your decision.

Are dairy products even necessary?

In a word: no. Humans have only consumed dairy products for a short period of our evolutionary history, and we thrived without them. No one suffers from “dairy deficiency”.

That said, I do believe dairy products can be beneficial when they’re well-tolerated. Several epidemiological studies have linked dairy consumption (especially full-fat dairy) with positive health outcomes. (1) While this does not prove causality, we also know that dairy contains healthful nutrients like fat-soluble vitamins, calcium, and conjugated linoleic acid (natural trans-fat), some of which can be difficult to obtain elsewhere in the diet.

Fermented dairy products like yogurt and kefir can be particularly beneficial, especially for those with gut issues.

And we don’t eat only for health. We also eat for pleasure. Dairy is one of the most popular food categories around the world, equally beloved by people of all ages, ethnicities and walks of life. We have sayings like “butter makes everything better” and “crème de la crème” for a reason!

Do you tolerate pasteurized milk?

If you tolerate pasteurized dairy, and you’re concerned about the risk associated with raw milk, you might try to find a small, local dairy with grass-fed cows that uses vat or low temperature pasteurization. In contrast to the ultra-high temperature (UHT) pasteurization process used by large commercial dairies, vat pasteurization heats the milk to a lower temperature (145 degrees) for a longer period of time (30 minutes) and then cools it as quickly as possible. Proponents of vat pasteurization say that it tastes better than milk pasteurized with high temps, and it seems reasonable to assume that the nutrient loss would be less (although I haven’t seen any data on this).

An additional benefit of these small dairies is that many don’t homogenize their milk. As Cynthia pointed out in a recent comment, homogenization squeezes large casein micelle complexes through small pores to break them up. The micelles are held together by calcium phosphate. When the micelles are broken up in homogenization, the fats are exposed to calcium, which forms calcium soaps (“saponification”). Calcium soaps not only irritate the gut and make it leaky, but also decrease the absorption of protein, vitamins and minerals. (2, 3)

A similar option is purchasing raw milk, and then pasteurizing it at home. You can do this with a home pasteurization machine, or with your stovetop using the low-temperature method I described above. Click here for instructions.

However, even those that “tolerate” pasteurized dairy often find that they feel much better drinking unpasteurized milk. And of course if you’re one of the many  people that doesn’t do well with pasteurized milk products, raw milk is your only option if you wish to consume dairy.

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Are you elderly, pregnant, immunocompromised or do you have young children?

In Is Raw Milk Dangerous I presented data indicating that the risk of developing a serious illness (requiring hospitalization) from drinking unpasteurized milk is very low: less than one in a million. I also pointed out that other foods like fish, shellfish, poultry, eggs, and beef are far more likely to cause illness than dairy products, even when adjusted for consumption.

That said, there is a risk of serious illness associated with drinking unpasteurized milk. And it’s important to note that this risk is more heavily weighted toward young children (under 3-4 years old), pregnant women, the elderly and those with less developed or compromised immune systems.

These illnesses can be severe. For example, in a recent outbreak in Oregon, a toddler and two young teens were hospitalized after drinking raw milk contaminated with E. coli 0157:H7, one of the most virulent foodborne pathogens. Two of them had hemolytic-uremic syndrome (HUS), a form of kidney failure. In another outbreak involving E. coli 0157:H7 this year in Missouri, two were hospitalized, including a two-year old with HUS.

On the other hand, it could be argued that growing children, pregnant women and people with under-functioning immune systems have the most to gain from the benefits of raw milk. This is illustrated by a comment from a reader on the last post in this series. He recently had an intestinal transplant (both small and large) and is taking powerful immunosuppressant medication, which would certainly place him in the “immunocompromised” category. Yet he feels that unpasteurized milk has been a significant factor in his unusually speedy recovery. He is the only recipient of the transplant that he’s aware of that hasn’t returned to the hospital with sepsis and systemic infection. Shortly after the surgery, he attempted to drink pasteurized milk and got severe cramps and diarrhea and lost 10 pounds. Yet in spite of his doctor’s warning that he’d never be able to tolerate dairy (because all intestinal and multivisceral tranplant recipients become lactose intolerant), he has thrived on raw milk.

A story like this doesn’t prove that unpasteurized milk had anything to do with his recovery. But I’ve read about and heard from many people who’ve had similar – albeit less dramatic – experiences, and I also feel that raw milk kefir was a crucial factor in my own healing process. And as we discussed in Raw Milk Benefits, there is substantial epidemiological evidence that children that consume raw milk may be protected against asthma and allergic diseases.

What is your risk tolerance? And what is important to you?

The extremely small risk of developing a serious illness is enough to turn some people off to raw milk. That is a perfectly valid choice.

Others feel so much better when they drink unpasteurized milk that they’re willing to take the risk. Or perhaps they love dairy, but can’t tolerate pasteurized milk. Or maybe they’re a “foodie” and they simply prefer the taste of raw milk to pasteurized milk.

Each day we make choices, and take risks. We’re more aware of some than others. We are hundreds of times more likely to die in a car crash than develop a serious illness from drinking unpasteurized milk, yet that doesn’t stop us from driving (by ourselves or with our children). Some may argue that driving is a necessity, while drinking raw milk is optional. I would argue that both activities are optional, and whether we choose to do one or the other is simply a reflection of our priorities and preferences.


Two good alternatives to raw milk that I mentioned above are finding a small, local dairy with grass-fed cows that uses vat pasteurization and preferably doesn’t homogenize their milk, and purchasing raw milk and pasteurizing it at home.

These may be ideal solutions for those that are concerned about risk, but have no problem digesting pasteurized milk.

If you don’t tolerate pasteurized milk, or choose to drink raw milk for any other reason, there are steps you can take to minimize the risk. That will be the subject of the final article in the series.

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Join the conversation

  1. It speaks to the power of propaganda that there is so much hand-wringing over the risk of drinking raw milk – despite the fact that there have been no deaths related to drinking raw milk in the past 37 years, according to CDC statistics.

    Cantaloupe, on the other hand, caused at least 13 deaths last year.. Why are there no armed raids against cantaloupe vendors?

    We’ll know our country has regained its sanity when big Pharma execs are held to account for knowingly and willfully putting people at risk with their toxic drugs which kill thousands every year.

  2. Would making kefir out of raw milk (goat’s milk is what I have access to) do anything to prevent the growth of disease causing organisms?

    • I’ve been making raw goat kefir at room temp for two years with no problems. One of my oldskool books on goat husbandry (McKenzy) suggests you’d need to be over the top unsanitary before you’d have a problem.

  3. I posted this on the last post on raw milk but perhaps it is more valid here:

    My uncle Johnny passed away last year at the age of 82. At his funeral a family member gave an account of how he was born.

    He was born at just under 6 months gestation (on October 31, 1928 of all days) and Va, my great grandma, was told by the doctors that he wouldn’t survive and that they could keep him at the hospital in an incubator until he passes. Va told the doctor that if he was going to die then he was going to die at home. They fashioned a bed for him out of a shoe box and kept him by the stove for warmth. He was too young to breast feed so he was given goats milk (presumably raw) and obviously survived against all odds.

    Milk, regardless of what animal it comes from, is a life giving substance. There is much more to this food than we know.

    • The exact same story for our Auntie Dolly! She was less than 2 lbs and was kept in a ladies size 5 shoe box by the fire, to peacefully pass away.. She defied the odds and is going strong (all 4 ft 10 of her ) aged 88 :))

      • Amazing how we dealt with life way back then isn’t it! One thing I forgot to mention is that my Uncle passed away due to cancer so it wasn’t even old age that got to him.

  4. Chris, Do you have an opinion on whether the Lyme disease spirochete can be transmitted through raw milk? I recently came back positive for Lyme and am being treated (think I got it 20 yrs ago, since that’s when my pain – chronic daily headaches – started). I have been in favor of raw milk for many years, but after reading up on Lyme, I’m concerned that there is a possibility of Lyme being in raw milk. Lyme can be transmitted through human breast milk, and cattle can get Lyme and pass it to other cattle through urine, etc. So, some experts suggest it is possible.

    • Thank you for this presentation, Dr. Kresser. I have the same question. I also have had Lyme (multiple vector borne infections) for years and an extremely compromised immune system, and am struggling to find a combo of non-pharma treatments to get (some semblance of) my life back. My D.Ac wanted me to start drinking raw milk, but understood my concerns about spirochete content and transmission. Growing understanding of the nutrient-dense, medicinal qualities of breast milk – maybe even with spirochetes – I’m reconsidering the relative risks and benefits of raw milk in healing.

      • I don’t know the answer to the spirochete question. I’m not sure anyone really does at this point.

        • http://www.news-medical.net/health/Lyme-Disease.aspx
          I’m a veterinary technician and I have been to many continuing education seminars on Lyme and other tick borne diseases. It is my understanding that Lyme can only be transmitted by a tick and has to be attached for over 24 hours to transmit the disease. The Lyme spirochete goes through a transition in the tick as it’s feeding from the host, which takes some time, then the tick transmits the infective Lyme spirochete when it releases from the host after feeding.The tick regurgitates as it releases and that is when the Lyme enters the host. The veterinary field has developed effective vaccines against dogs developing Lyme disease by inhibiting the spirochete from being infective from the blood of the vaccinated dog that the tick feeds on. Brilliant. The human pharmaceuticals were not so ingenious when developing a vaccine for humans. Thank you, free market, for allowing the veterinary industry to come up with one. The vaccine affects the outer surface proteins (Osp A and C) of the spirochete so it can’t be infective. Unfortunately, the tick disease that veterinarians are diagnosing in their canine patients isn’t manditorily reportable. If so, the human physicians in a given area might be more astute in tick borne diseases being on their differential when presented with patients with tick borne disease symptoms. Oh, the stories I could tell you of people I know personally that went undiagnosed with Lyme when I could diagnose it. An obvious tell tale rash and symtoms were diagnosed as ringworm and the flu when clearly a coworker’s husband had Lyme and has to go to another Dr that figured it out. Canines are like the canary in the coal mine-they get all the same tick borne disases that we do, therefore, people in the same region are equally at risk. My hairdresser’s daughter almost died from RMSF and went undiagnosed for too long. Three Dr’s thought she just had a flu virus. I live in south central PA, by the way.

          • In response to the post about Lyme disease, I would say GO FOR IT!! GET RAW MILK (from a good farm, of course…do your research). At a recent vet visit I found out my dog had at one time been exposed to both Lyme and Anaplasmosis, both bacterial diseases. If you think about it, in the American diet there is little exposure to GOOD bacteria….like that found in raw milk. Back to my dog, the funny thing is we never even knew she had those diseases except for a minor loss of appetite. She was eating an all natural diet with raw pastured meat and RAW MILK. When we first found this out (way after the fact) the vet was surprised that she had fought both off and her blood work was now completely normal!! Raw milk has also healed my IBS when no drug or anything else was able to help me. It simply replaced all the bad bacteria in my stomach/intestines with good bacteria. It is rare now that I get sick and when I do, it is short lived. What you eat severely affects your immune system. Go raw, go natural. Get your food from the farm, not the store!! Best of luck to everyone!! And thanks for writing such a great article!!

    • I own a small raw milk dairy in Excelsior Springs, MO. I just had a woman buy milk from us today who has Lyme disease and says she has experienced a dramatic improvement in her symptoms since she starting drinking raw milk. Take it for what it’s worth! 🙂

  5. Yes, I think it is worth the minimal risk. I have been reading up on raw milk for some time, and just discovered a “cow share” program that is not subject to my jurisdiction’s anti-raw milk regulations. I just had my first delivery of raw milk this week. My main motivation is that I am pregnant, and I want to do everything I can to optimize my nutritional intake at this point. The risk of illness is too insignificant to deter me.

  6. The fact that dairy products are NOT necessary is enough for me. Thank you Chris for writing this article.

  7. One point I don’t recall seeing you make in this series, Chris, which is:

    NEVER drink raw milk that comes from a conventional dairy. Raw milk must be handled carefully to produce a safe product. A conventional dairy that expects its milk to be pasteurized does not need to exercise this care, and therefore its products should only be consumed after pasteurization.

    • take with a grain maybe wrong as i don’t have the data at my fingertips but my understanding that in the CAFO milk due to being grain fed plus antibiotics etc the cows actually produce unsafe milk due to the proliferation of “bad” bacteria in their multiple stomachs. How this translates to the mammary glands; I don’t know so therefore could be hype – just seem to recall I had read from a credible source.

  8. Chris, for the risk adverse, it might help if you maintain the context of your first post by mentioning that the very small risk of very serious illness is not limited to unpasteurized milk but also includes many foods we regularly eat without even considering their risk.

    Sometimes it is surprising that this issue even needs serious conversation. An equivalent discussion about the risks of eating raw strawberries vs. cooked strawberries could be had. I don’t have the data at hand, but I’m confident the small risks of eating raw strawberries from a major grocery chain are significantly higher than eating them cooked. Folks would laugh if I even started such a conversation, let alone gasp “Oh my gosh! You let your kids eat fresh strawberries?!!!”

  9. Great article. I’d read the information before about the role pasteurization plays in soponification (Deep Nutrition -Catherine Shanahan MD) however, timing is everything. As I sipped my coffee to which I’d just added some cream I’d skimmed off of the raw milk, I watched my boyfriend steam his commercial milk for his latte. Although he likes raw, his complaint was that he couldn’t get a good foam on the raw. Ahhh, now I get it! Could it be that the raw milk lacks calcium soaps?! He’s just now getting over the “loss” of grains, gluten, and his beloved Starbucks pumpkin scones…. It’s all a process.

    • Oh, and I’ve also become the local kefir grain “dealing” dentist in town – giving tons away to patients!

  10. One important factor that a lot of people don’t understand is how much a pregnant woman’s immune system goes on hiatus, particularly in the third trimester. I did not understand why Listeria was so hyped as a pregnancy risk until I read that pregnant women are 20x more likely to be infected following exposure than someone with a non-pregnant immune system!

    The big raw milk dairies near me have all had listeria and salmonella outbreaks too. 🙁

  11. Hi Chris,

    Great article. It is common practice, at least in the west, to give babies pasteurized milk once they’re weaned and generally after 12 months of age. What about introducing raw milk in this time frame? Besides the risks and benefits you’ve already mentioned, are there others to consider in this scenario?

    • I tend to think that dairy should be one of the later foods to be introduced, whether raw or pasteurized. We started introducing it slowly and in small amounts with our daughter Sylvie at about 9 months.

      • Interested in your approach to weaning a one year old onto raw milk. Any certain timeline?

    • My son has been drinking raw dairy since 12 months. He weaned from the breast at nine months and I felt raw milk was the best substitute for him. He’s thrived on it and he’s big on milk. We are fortunate to live in a state where the raw milk isn’t illegal and you can shop around. It’s been over a year now and we’ve not had an issue, but of course, like CK said, it’s another calculated life risk!

      Honestly though, there are tons of recalls for baby formula on a regular basis… Some for quite insidious pathogens.

  12. I love raw milk for its flavor and for making cheese and kefir. I was excited to hear about low temperature pasteurization as a possible compromise option. I searched for a local dairy providing vat pasteurization. The closest was the Golden Glen Creamery near Seattle. Googling them, I discovered their butter and cheese had been recalled due to contamination with Listeria last fall. I still think vat pasteurization is a good option, but people with immune issues should be aware that it does not provide 100% protection.

  13. Yes, we would if it were easier to find. We enjoy raw hard cheeses and would love to add other raw dairy products, since we don’t do well with processed dairy other than butter.

  14. The http://www.happyherbalist.com/ also has Kefir cultures among many other kinds of dairy & non-dairy cultures.
    I was making Kefir from raw milk for a while, but was somehow not tolerating it well, so I had to drop it. Even with raw milk, I personally have to keep it to a minimum. I still put a little raw cream in my coffee! Mmmmmmm!
    As it turns out, Casein showed up as a level one allergen for me in the food allergy blood panel, as I had suspected. Thus while the raw &/or fermented aspect would help with lactose intolerance, not so much with casein. Oh well.
    Despite my own low tolerance, I am convinced that raw dairy is a health elixir for those without either casein or lactose issues, and totally worth the risk. But I also eat raw oysters, ride a bike & drive, so obviously I have a higher tolerance for risk.
    I wouldn’t trust any information from the FDA any further than I could throw the entire institution with my pinkie finger. To be quite frank I think the FDA is a scientific laughingstock, not to mention possibly the most corrupt branch of government we have at both the federal and state levels. They are basically the “enforcement arm” of corporate agriculture & the pharmaceutical industry. But I’m probably preaching to the choir here, huh?


    • There is some talk about A1 and/or A2 milk protein – A2 being much more tolerated. If I understand correctly goat (and some – very few cows) have A2 beta casein. My sis is working on breeding Dexter cows that produced A2 milk exclusively to add to her goat milk dairy.

  15. What about goat milk? Are goats grass-fed? I know their milk is not homogenized like cow milk, so that’s an advantage. I heard that if you don’t tolerate cow milk you may tolerate goat milk.

    • I grew up “allergic” to cow’s milk and was given goat’s without issue. My grandfather raised goats and milked them daily for me. Just to clarify, goats are always pastured because they are very active and need to run around. They are not “grass-fed,” however, because they don’t eat grass. They eat everything but the grass. They are “browsers” eating weeds, shrubs, your flowers, your apple trees. Also, if the nanny goats are kept anywhere near a billy goat, the milk will taste ridiculously horrible.

      • Goats will also eat your laundry off the line, bars of soap, twine, sticks… 🙂
        Sorry I couldn’t resist. My family raised goats when I was young.

        • I have to say this comment made me chuckle. Goats will nibble on everything tasting to see if it is edible, and if they like the flavor they will eat it up. But they are actually one of the most picky farm animals that I have ever owned they will nibble the flakes off of the stem and leave of the stems, to the point of starving you can not force a goat to eat like moldy hay. All in all I like the goat above the cow. I have had both the cow was larger and harder to manage, the goat eats a smaller amount and is easier to milk, they do produce less milk but per size and feed they produce very well. As far as the milk raw milk cows or goat will take a second to get used to, because it is raw, not cooked. Like fresh apples vs cooked apples. I personally have not gotten sick from either raw apples or raw milk.

  16. Chris,

    Tell me what you think about raw goat milk as compared to cow milk. I’ve been told that people that struggle to digest cow milk generally do much better with goat milk.


    • Yes, some people do better with goat milk. The composition of goat and cow milk differs significantly.

      • Chris, could you talk about GOAT milk in particular? I’ve found a source for RAW goat milk and yogurt and I’m keen to try, but of course, nervous of the risks.

      • But it is not real cultures I have origin russian cultures they are much more stronger with much more strains. I am from europe so it is easy to get it here well no one sell it it is gift, someone gave it to you and then when you have enough you give it to someone else

      • I noticed on the culturesforhealth.com site that they also offer kefir cultures for making coconut water kefir and also kombucha cultures. Since those are both made from sugary starters are they safe for someone following a VLC diet? Thanks.

  17. I absolutely believe raw milk is worth the risk! So much so that I’ve been drinking it my entire pregnancy! Although it is in the back of my mind that I could get sick, its in the back of my mind while driving that I could be risking my life yet it doesn’t stop me from driving. I think one precaution that can be taken is to wait a day or two when getting a new batch before giving it to young children and pregnant Moms to see if anyone gets sick. This is easy for our situation because everyone in our co-op is drinking milk from the same batch. There hasn’t been an outbreak here in Nebraska during the time we’ve been getting it -2.5 yrs. I really trust our dairy farm even without all the fancy equipment that the big dairies have.. nor do they do any testing. If no one ever gets sick… why test?

  18. Burton, the website realmilk.com lists raw milk dairies in the United States by state. The co-op where I was getting my raw milk was just a couple weeks ago served with a cease and desist order by the USDA. I will now have to go directly to the farmer, but I’m willing to do that. I get goat milk, which freezes well, and I usually kefir it anyway. My point is, in many states there is somewhat of a war on to take raw milk dairies out of business, so please be discreet if raw milk is not “legal” in your state. On the other hand, please support the wonderful farmers who are willing to produce this milk for us!

  19. Chris,

    I’m most interested in learning where to find raw milk, especially grass-fed raw milk. If you find any sources of information on this please let me know. Thanks!


    • I live in the Hudson Valley in NY and get raw milk from Shunpike Dairy in Lithgow near Millbrook. Yummy. They have a website.