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.
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.
Summary
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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Hey Chris, I am wondering about whether on can get tuberculosis from raw milk or milk in general, and also what about the prions that cause Creutzfeld-Jacob disease? Can we get those from raw milk or milk in general? I have been looking through this on the net and not found any definitive answers.
thanks
Cattle can carry a disease called brucellosis, that is similar to tb. It is no longer common in the US. It was one of the reasons people started pasteurizing milk.
Hey thanks Karl, because its a strain of tb from the bovine species line perhaps it is not as likely to affect us humans? Im more worried about the vCJD because those are spectacularly resistant to anything killing them and im not getting a definitive answer on the net about it. There were some articles saying that there was sheep prions found in sheep milk, but nothing in particular on cows.
Ive been wondering similarly about meat (even our grass fed paleo beef, lamb etc) but thats for another thread!
Thanks,
kitty
My personal opinion is that if you are eating animals that are being raised on their natural foods and are not treated with crazy drugs and pesticides you have little to worry about in terms of vCJD.
People can get brucellosis but it is easy to test for in animals so most farmers would not keep an animal that tests positive.
My questions – is raw milk and/or raw milk kefir low glycemic? Thanks!
I know the farm that got e. coli in their cows. They were a clean and perfect farm and did everything right. After watching them stay in a hospital for over a month to nurse their daughter back to health, we decided to take our own kids off of raw milk until they are older. My spouse and I continue to drink it but now only give low-temp past. milk to our kids.
My ancestors used dairy cows but food was also scarce in those days. There were times that milk was the only food source and during that time the benefits outweighed the risks. And there were times water was not available so milk was needed. They also did not have the super bacterias that we now have today that survive almost anywhere. At this time, we already do so many other low risk things such as free-range eggs, grass-fed beef, pork and lamb that there really is no reason to push raw milk on our kids. We have a clean water source from our well and they already get so many other benefits from other foods that are just as healthy.
I still think the raw milk risks are super low but I won’t risk my own children’s life over a few benefits that they really do not need in this food rich country. But I do respect other people’s choices to continue to do so and have friends that continue to give their babies raw milk.
All the scientific information provided here has made it very difficult for me to decide whether I want to try raw milk for the taste and nutritional qualities or just continue avoiding all cows milk as much as possible.
After considering everything in Chris’ articles and all the informative comments left by everyone, my mind always goes back to the argument against all dairy consumption due to the fact that no species other than humans consumes milk from another species. Milk is produced by mothers to nourish their young up until a certain time during their growth. My mind concludes then, that whilst cows milk is tasty and can be very nourishing, it is not necessary or essential for humans to consume it.
Having said that, if I found a reliable and ethical source of raw cows milk I would not hesitate to try it. The risk of becoming ill from it is extremely low in my opinion, and I’d love to see how much better raw milk tastes.
The Canadian study I linked to above noted that pasteurisation inactivated the lactoferrin in human milk [along with many other immunilogical agents]
Lactoferrin is an iron binding protein – it helps to prevents infection from getting at the body’s iron supplies, and is also a stimulant for bone growth, and protects against bone re-sorption into the body
[Lactoferrin- a novel bone growth factor]
lactoferrin has also been found to have protective effects against herpes, malaria, influenza, hepatitis and so on (google “bovine lactoferrin virus” and you’ll get the idea.)
This is just one example of the protective properties of raw milk that is destroyed by heat. In effect, it turns milk from a therapeutic agent, into just another food. Pasteurisation may kill contaminating pathogens, but it is also destroying some of natures finest natural medicines.
Instead of banning raw milk, we should be working on ways to make it safer and prevent contamination in the first place. That is how we do it with shellfish.
Wow, all great information Paul N. Thanks so much for providing it. You’ve expanded the information available here a lot supporting use of raw milk.
Thanks Paul for all the great information! I wholeheartedly agree that it is the practice that needs work. Why is it that rather than do it right and keep it clean we would allow what we consume to be produced in a filthy manner and then try to clean it up afterwards? Unfortunately the dairy industry is not exclusive in it’s filthy habits. The more I look into poultry production the less I want to eat it. If you don’t really want to know don’t start looking into it. You just might change what protein sources you choose to feed your families.
If you search for clinical studies comparing raw (cows) milk with pasteurised, most of them seem to be in the period 1900-1950, when pasteurisation was not mandatory. Not surprisingly, no research institutions, (and certainly not the dairy industry) are willing to fund such studies today, which is a shame, as with modern medical technology, we could find out a lot more about the differences.
However, there is a *large* body of work that has been done recently, on human milk, relating to methods of storing and using it in hospitals.
This paper from the Lancet, for example, found that;
“Supplementary formula feeds inhibited the protective effect of expressed raw and pasteurised human milk in 226 high-risk neonates in a randomised controlled trial. The infection rate in the group given pasteurised human milk and formula (33%) was significantly higher than the rates in the groups given raw human milk (10·5%), pasteurised human milk (14·3%), and raw human milk and formula (16%). This accords with the impressions that some of the association of infection with artificial feeding is partly attributable to the lack of the protective effect of human milk. Heating expressed human milk to 62·5°C for 30 min significantly reduces its protective effect.”
Or this one;
“This study compared concentrations of total protein, lysozyme, and immunoglobulins (IgA, IgG, IgM) in samples of colostrum (n = 101) obtained from mothers of infants < 32 weeks, 32 to 366 7 weeks, and ≥ 37 weeks gestational age, both before and after pasteurization….
…Pasteurization *significantly decreased* all of the factors analyzed."
[emphasis mine]
And another;
“Analysis indicated a high degree of contamination in raw human milk, and as for the pasteurized milk, despite elimination of the great majority of potentially pathogenic microorganisms, the percentage of *yeasts and molds* was higher than in raw milk, demonstrating that a lower degree of initial contamination would be necessary for pasteurization to be an efficient means of microbiological control.”
There is study after study on human milk showing that pasteurisation reduces/destroys all sorts of beneficial properties, and we can likely extrapolate these findings to animal milks too.
There is one legal source of raw milk products you can buy – aged cheeses. 60 day+ cheese can be made from raw milk and some of them do say “unpasteurised milk” on their ingredients – I look for this on any cheese I buy.
I see all this talk about concern about pathogenic bacterias found in raw milk. Raw CERTIFIED milk is much more safe to consume than any pasteurized milk is. The certification process is stringent and only a very diligent farm would pass this process. Read up on all of the people who have been poisoned by pasteurized milk. Dairy farms are inherently filthy and little effort is expended to make it any better with the assumption that the pasteurization is going to kill all bacteria present in the milk. What about the tank the milk is stored in? Can the milk which has been deemed “safe” become contaminated after it is pasteurized? Of course it can and does, do some research. I did and was appalled at what I learned about “safe” pasteurized milk. I will take my chances with our raw certified milk we get here from a local dairy farm. BTW my son has a rare autoimmune problem in which he was attacking his own GI tract and does very well on raw milk. His MD was quite skeptical about it at first but is accepting of our decision after she too did her research.
Mary wrote;
“Can the milk which has been deemed “safe” become contaminated after it is pasteurized?”
Not only can it become contaminated, but boiled (high temp pasteurised) milk is an *ideal* bacterial growth medium. It was widely used in labs up until about the 1950’s for this purpose.
here’s and abstract from a 1929 paper comparing medium and high heat pasteurisation;
“It is well known that fresh milk or milk heated at 58° or 60°C. for 20 minutes will inhibit the growth of a variety of organisms, while when milk is heated at a temperature of 80°C. or more the inhibitory principle is destroyed. That different streptococci behave differently when introduced into the same milk is brought out by the following observation: The growth of the nonhemolytic mastitis streptococ- cus is inhibited during the first 6 or 8 hours following inoculation and then growth begins and continues rapidly; but scarlet fever streptococci implanted in portions of the same milk gradually diminish in numbers until the milk finally becomes sterile. Both organisms grow readily in milk that has been boiled for 5 minutes.”
{emphasis mine}.
Here is a quote from a Canadian study about hospital banking of human breast milk, in regard to pasteurisation;
“There are effects on immunological factors (40). Along with inactivation of all viruses and most bacteria through pasteurization, all beneficial immune cells are also inactivated. Secretory immunoglobulin (Ig) A, which binds microbes within the digestive tract, is found at 67% to 100% of its original activity. Targeted IgG antibodies are reduced at 66% to 70%. IgM antibodies are completely removed. Lactoferrin, which binds iron required by many bacteria, thus reducing their growth, is reduced to 20% (41) of its original level. Lysozyme enzyme, which attacks bacterial cell walls, drops to 75% activity. A reduction in certain cytokines by pasteurization permits an expanded function of epidermal growth factor, which may lead to increased growth of intestinal epithelial cells exposed to pasteurized human donor breast milk (42).”
I expect results on cows milk would be fairly similar.
So, as a general rule, pasteurisation kills most pathogens that may be in the milk, but, especially with higher heat methods, also destroys the natural defences, making it *very* susceptible to re-infection.
Though I don’t have any evidence on this, its probably likely that industrially produced milk from grain fed cows is less “self protective” than that from grass fed cows, and thus in greater need of pasteurisation.
And this from someone that grew up on grass fed, raw milk, milked by my own hands. My siblings and I never got sick (winter colds, etc) and had the healthiest teeth of anyone in our extended family or school – just one cavity between all three.
We switched to raw milk about four years ago for the nutritional benefits and were so pleased with the luscious taste that it is now very hard to drink “store milk” at all. Although I am not lactose intolerant I was pleasantly surprised when my dentist commented on my panoramic xrays that he had never seen a patient with such clear sinuses. It dawned on me that I had not had any sinus issues since switching to raw milk. My neighbor switched to raw milk and discovered her seasonal allergies went away. When she had to stop raw milk for awhile due to financial issues she found they came back with a vengeance and she is now back to the raw milk and feeling much better again.
I’m 83 and have been drinking raw milk–half from grass-fed cows, half from alfalfa fed–for 14 years. Wish I could say it’s made a big health difference in my life, but the fact is that I’m no more healthy than I was when I was 69 because I’ve never had any of those health problems that seem to afflict many who benefit from drinking raw milk. The fact is, I just like the stuff. Anybody who says there isn’t a taste difference doesn’t have good taste buds. The unanswerable question, of course, is what would have been my health state if I hadn’t started drinking raw milk. bobd
I would like a clarification on numbers. In your raw milk serious I’ve seen two different risk findings. One artlcle stated a risk of becoming seriously ill from drinking raw milk to be 1 in 6 million and the other article said one in 1 million. Have I misunderstood something in one case or the other? Thanks so much for all that you do!
I am still hesitant about giving my child raw milk and I can’t find any low temperature pasteurization sellers in Utah. So I decided to low temp pasteurize raw milk myself. I was just wondering how different low vs high is to decide if it even worth it. How much nutrient content is lost. Are the enzymes destroyed.
My sister, age 87, and I have been drinking raw milk since 1950, when our parents moved to California and learned about raw milk from Weston A. Price literature. My sister is still on a bowling league with me. Neither of us have spent time in a hospital or take any prescriptions or medications. We both feel particularly good after drinking kefir I make from raw milk. My children grew up on raw milk, and my grandchildren drink raw milk. This covers a lot of years for its safety.
That’s amazing! Being strong and healthy at 87 is no small feat and certainly isn’t the norm. I think your comment is actually one of the best and supports the truth. There’s too much silliness and uninformed scare tactics surrounding raw milk. It always amazes me that those with the most rage against raw milk don’t even bother with it and don’t want anyone else to either. You go girls!!!!
What are good alternatives for young infants and kids to drink then? Just water??
Any suggestions would be great!!!
My infants (past) and young children (present) drink my raw breast milk, amongst other things like water, juice, coconut milk and bone broth.
Dennis,
I humbly suggest that water is the only natural beverage, and is therefore the only one any of us should drink for optimal health. Nourishment can be obtained from foods. Water is for hydration. I feel teaching children to consume beverages other than water is like giving them sugar. It is starting them on un-health at the beginning of their lives. Just my point of view as I approach 70 and hope I haven’t killed my chances of reaching 100 or 120 because of horrible food habits that no one taught me to avoid when I was young.
I hardly touched water until I was 20 years old. I always drank milk when I was thirsty, just because it was in the refrigerator and it had a better taste than water. I’m sure I hurt my health by doing this, as I was always mildly lacto-intolerant. How many children will be in this same condition and their parents won’t know the disservice they are doing to encourage milk drinking?
I support people’s right to buy and consume raw milk because they shouldn’t have that liberty taken away, but I don’t really think it’s necessary for life, or even an ideal way to get liquids or any of the nutrients needed to flourish.
Just my point of view. Elsewhere I have responded with some information on why kefir may be a preferred method for taking in raw milk. That is provided for those who are sold on using raw milk products and want some help in deciding if raw milk is safe, and if kefir might even be safer. That contribution was mostly information. This one is just viewpoint. Just trying to be helpful in both cases. There are a lot of ways to look at every issue. Let’s do it. It’s beneficial, just as introducing certain strains of bacteria into our gut is beneficial. But if no body every looked at the beneficial side of bacteria, we could never possibly be as healthy as we can be once we consider that alternative.
I really enjoy raw milk, especially kefir and whipped cream. May I laugh at the tiny risk, please?
I guess as a sixty year old mountain and ski guide that has been to more than a few funerals for collegues, I have a different perspective. One misses out on a lot of life when focused on avoiding risk. “In the long run we are all dead.”, Keynes.
I also want to add that the risk SEEMS insignificant until it happens to you. Then suddenly it isn’t so insignificant, lol. That said, I am all for freedom of choice and support the raw milk producers and everyone’s right to choose for themselves.
I think my reply to your 2nd post should have gone on this one! After getting sick from raw milk, we have compromised by drinking milk from a small, local dairy with grass-fed cows that uses vat pasteurization. They do homogenize, unfortunately. I wish I could find a similar source that doesn’t. But for now, I’m comfortable with this choice.
Again, thanks for this series. Well done.
One of the things I rarely see in this discussion about the safety of food is what is the actual cause of HUS. As far as I understand the toxins in E. coli 0157:H7 are released upon death of the bacteria. So common situation is someone goes into the doctor for stomach problems and gets an antibiotic that kills the ecoli releasing large amounts of toxin into the blood and overwhelming the kidneys. So to me it is the doctors who are responsible because of mistreatment because they fail to do a culture and see what the cause is. This is why you see more serious problems in the beginning of an outbreak before the doctors start following proper protocal. There should be a holistic scientific approach to treating ecoli infection and we would not have to blame our food. Of course the real problem probably lies in the lack of good bacteria in the gut.
Karl. This line of reasoning makes me very angry with fanatic pro-raw milk people. please do not spread this misinformation around any longer. If children who are genuinely sickened with HUS causing ecoli, they would most likely die of kidney failure. Then raw milk fanatics could no longer claim no death from raw milk. It is exactly because of life saving emergency medicine that these HUS children are alive.
http://www.ncbi.nlm.nih.gov/m/pubmed/12190370/
http://www.foodsafetynews.com/2010/08/antibiotics-hus-and-gastroenteritis/
I meant to say that if children who are genuinely sickened with ecoli 0157:H7 and go on to develop HUS were treated with HOLISTIC medicine, they would die rapidly. They are usually saved by dialysis and other lifesaving emergency procedures.
Kristen, people making comments here about E.coli 0157:H7 and HUS don’t have a clue what they are talking about. The death rate has been lowered for this horrible disease because modern medicine has had about 20 years to figure out how to support the human body as the Shiga toxin does it damage. Extreme support is the use of a ventilator. The child is placed in a medially induced state of sleep. This is done by the use of Versed and Morphine. (My child was like this for 9 days. A little girl in the recent raw milk outbreak in Oregon went for 25 days). It is similar to a coma, but the child can hear you and respond by nodding. This is done so that the child’s body doesn’t have to work so hard. In severe cases of HUS, it takes a lot of energy to breath and when the fluid builds up in the body, it puts a huge strain on the body, especially the heart. Medical support also involves kidney dialysis, blood and plasma transfusions and IV feeding. A child may not die, but strokes, heart attacks, kidney failure, seizures, removal of colons and gallbladders are not fun stuff. The post HUS child may be alive, but will never resemble the child you had before.
Go back a read all the comments in this series. People are making the decision to feed their children raw milk because they think it is a healthier option. There is no other food source that makes the claims of curing all that ails you by consuming it. This product is also marketed to parents of children in high risk categories: autism, ADD, allergies and asthma.
I encourage everyone consuming raw milk to do a little research on all the different pathogens that can find their way into raw milk. Do you know all the pathogens and animal diseases that can be passed on through raw milk? Can you name all the illnesses these pathogens can cause?
Other high risk foods typically are vulnerable to one type of pathogen. For example, deli meats become contaminated with listeria, beef with E.coli 0157:H7, and chicken, turkey and eggs with salmonella. Raw milk is vulnerable to multiple pathogens because multiple pathogens are in cow poop.
Chris had an interesting presentation of the statistics. It is fraught with many flaws. I can tell you first experience that you can NEVER take back the decision to give your child raw milk that was contaminated with a pathogen.
I would encourage everyone to go to http://www.realrawmilkfacts.com/outbreak-tables and look at the outbreak chart for the past couple of years. Raw milk dairies across the nation are poisoning people. What other food source is having 5 or more outbreaks a year?
Mary,
As someone who has stood by my daughter who had almost died from complications during a routine dental procedure I can understand a little bit of the pain you must have gone through. I can also never take back the decision to see the dentist…
You are just spreading fear because pathogens are everywhere. The only good defense seems to be healthy gut flora so that is what I am going to work on for me and my family.
By the way veterinary medicine already knows this and works hard to promote healthy gut flora in animals to prevent disease.
People have gotten infected by swallowing lake water while swimming, touching the environment in petting zoos and other animal exhibits, and by eating food prepared by people who did not wash their hands well after using the toilet. Almost everyone has some risk of infection.
http://www.cdc.gov/nczved/divisions/dfbmd/diseases/ecoli_o157h7/
You say it as if the risk of getting this life-threatening illness only applies to foods like raw milk… whereas the cases of children dieing are not from raw milk, they are usually from sources like contaminated beef from feed lots, and yes these children are got life-saving emergency procedures. Such a virulent strain of bacteria is not found amongst HEALTHY cows otherwise people would be dropping dead left and right from drinking raw milk.
Kristen,
The two links you provide actually make Karl’s case quite nicely for him. Not so much for purely e.coli, but for antibiotics vs pathogens in general in cases of HUS. He said “So to me it is the doctors who are responsible because of mistreatment because they fail to do a culture and see what the cause is.” What I think he is saying that is confirmed by your links is that just throwing any antibiotic at any pathogenic organism can worsen the infection, or if not that, can worsen the patient’s condition, bringing on HUS. No antibiotic should be used until the pathogen is identified.
The 2nd article confirmed this, saying:
“So the evidence mounts that the class of antibiotic that includes Cipro (a fluoroquinolone) may drive the risk of HUS through increased Stx production. However, it is important to note that antibiotics are clearly indicated for some gram negative bacterial infections of the gut including infections such as Campylobacter jejuni and Shigella, which clinically resemble E. coli O157:H7 enteritis. Further, antibiotic use in the elderly, immune compromised, and those with co-morbidities may be indicated even if the face of a Shiga toxin-producing infection. Thus, wholesale avoidance of antimicrobials for infectious diarrhea is not prudent, but identification of the infectious agent before antibiotic administration is very helpful.”
And also:
“More recent studies indicate that the risk of HUS is increased by the use of some antibiotics. The differing mechanisms of action in different antibiotics impact the production of Shiga toxin (Stx) differentially. [3]”
Karl’s opening question is “What is the cause of HUS?” You claim it is “E. coli 0157:H7” but all I could find in the 2nd link are these two statements:
“The first study that looked at whether antibiotic use increased the risk of HUS in children was published in 2000. [1] The study found that antibiotic use was a strong and independent risk for the development of HUS regardless of the severity of the inciting infection.”
And
“More recent studies indicate that the risk of HUS is increased by the use of some antibiotics.”
I’m left wondering why you cited these two references. Are you reading them differently than I am? I mean are you reading only the parts that bring a different point of view, and ignoring these sections I quote? And if so, why are these quotes not relevant and significant?
Please don’t consider me aligned with the “fanatic pro-milk people”. I don’t drink milk and think it is only for infants. I am just interested in freedom of choice and in ridding discussions of deceptive distortions so that people can maintain freedom to chose, untricked by faulty logic, commercial cons, vague statistics, and plays on sympathy. You finish, in your followup statement, by saying the (childrens’) lives were saved by the emergency medical treatments of dialysis etc. But you didn’t mention antibiotics here as a life-saving mechanism. So you seem to be admitting that the antibiotics are actually worsening the situation, either leading to HUS, or making it worse.
Since which way people end up leaning after reading all 3 of these articles seems to be now hinged on the risks to quite young children, and the absolute risk to their very lives, I think it is important to hang tenaciously to this little subject of the possibility that in many cases it is the medical treatment, once within the hospital, that is life threatening to the children, rather than the pathogen in the raw milk. I think we need to thank Karl for introducing this point of view, and you, Kristen, for providing the important links to show how relevant this may be to the discussion and the choices some people need to make.
Kristen,
I don’t think that asking questions about causation is a problem at all, it is the basis of science. Yes there have been great improvements in treatment of HUS but still little is know about what causes it. The study you linked says that more research is needed. I found some research suggesting that manganese could help prevent uptake of shigella toxin, interestingly it is also a compound that is destroyed in pasteurization of milk.
http://www.livescience.com/18550-toxic-turnaround-manganese-nsf-ria.html
My point is that we should turn our efforts toward research that can help prevent and treat the symptoms of e-coli 0157:H7 infection that can further prevent the complications that develop in less than 5% of infections. Look at the links below and you will see that HUS is a rare side effect that is mostly treatable.
Moreover, for the acute diarrheal illness, antibiotics have not proven useful. In fact, some studies have shown that antibiotics may increase the chances of developing HUS (up to 17-fold). This effect is thought to occur because the antibiotic damages the bacteria, causing them to release even more toxin. Most investigators suggest antibiotic use only if a patient is septic, that is, there is evidence that the bacterium has spread to parts of the body other than the intestine. In addition, use of atropine and diphenoxylate (Lomotil), drugs that are commonly used to control diarrhea, may also increase symptoms and trigger complications.
http://www.medicinenet.com/e_coli__0157h7/article.htm
How is it treated?
For mild illness, antibiotics have not been shown to shorten the duration of symptoms and may make the illness more severe in some people. Severe complications, such as Hemolytic Uremic Syndrome, require hospitalization.
http://www.cdphe.state.co.us/dc/epidemiology/stec_fs.html
“According to existing recommendations, antibiotic treatment of STEC infection is discouraged because this therapy might increase the risk of HUS development.”
http://www.sciencedaily.com/releases/2012/03/120313185907.htm
I found a local family who owns a goat. We use their goat milk. They use vat pasteurization themselves. I feel much better about drinking it than store bought goat milk and I feel that it’s safe.
About how long does raw milk last in the fridge if it’s fresh that day? Can you freeze it or is it better to drink within the time limit and make yogurt or kefir with the rest?
I will have to drive about an hour away and between that and a very tight budget, it will not be a regular purchase for me.
Thanks in advance.
It is most important that raw milk is stored in very clean glass jars. It is possible if it’s kept very cold on the way home and in the fridge that it will last for two weeks. I used to have to drive 45 minutes to get my milk and I never had any issues. An important thing to note is that when RAW milk starts to sour, it is NOT bad!! When the milk starts to taste off and I not longer like to drink it, I give it to my dog or use it in baking or sometimes make chocolate milk. It actually makes awesome pancakes too! Once you are used to how long it lasts, you will be good at estimating exactly how much you need without it going bad. You can try freezing, although I’ve never tried it. I figure if you can freeze breast milk, what’s the difference? Just bring it down to the fridge to thaw instead of warming it up and do some research as to what type of container to use. Best of luck!! Trust me, you will soon see that raw milk is worth every one of those trips and you will find a way to make it work!!
In Germany you can build raw milk (German: “Rohmilch)” at the farmer. If raw milk is sold in a shop, it is called “Vorzugsmilch”. The Vorzugsmilch, the cows and the persons working with it are checked for microbes every month. Vorzugsmilch is mainly sold in organic stores and is about 50% more expensive as pasteurized organic milk. (This model could maybe also be a political compromise for the US, better than illegalizing raw milk).
One of the nice things about not pasteurizing milk, or radiating food or putting in chemical conservatives is that this forces the producers to handle their products with care.
Pathenogenic bacteria thrive at room temperature which is what is often recommended for kefir. While there is no studies to back up my claims, it just makes sense that if the pathogens are in your raw milk, then they are going to thrive in your kefir.
If the raw milk had pathogenic bacteria, it would not turn into kefir! the cultures in kefir are very powerful and very likely could overrun any pathogenic bacteria and turn into nice smelling kefir. If your ferment smells off this is a very good indicator that the milk did not culture but the pathogenic bacteria took over.
Chris:
Can you please clarify this with your expertise,
considering you make raw milk kefir?
It doesn’t make sense to me that the beneficial bacteria/yeasts from the kefir can kill
off pathenogenic bacteria?
It seems to me that if e.coli 0157:H7 can survive in an acidic environment like stomache acid, that it can survive in acidified raw milk (kefir).
Like I said if you leave raw milk out to culture, one or the other is going to ferment- the pathogenic or the beneficial… I have never heard from any of my research on ferments that both could culture and still turn into a ferment like yogurt or kefir. So if you really have a case of e. coli you would know it after you let it sit out, it would be ‘off’. Maybe I should not have said that the kefir culture could possibly win out over any pathogenic bacteria, I can’t provide you with any research on that, its just from my knowledge on the same type of situation that happens in the gut.. we all have some strains of e.coli but the good guys keep it at bay. I really dislike this war on germs, they are everywhere, including on other raw produce. I do think that some strains have become way more virulent because of antibiotic resistance, but I don’t think people should fear raw milk because of it. I actually got food poisoning from eating a cheap pizza, there are lots of things that can potentially cause illness.
Yes, I don’t see why E. coli couldn’t survive in kefir or other fermented dairy products. There is some evidence that pathogens may be less likely to proliferate in raw milk (and perhaps kefir), but that’s very different from saying that raw milk or kefir can “kill” pathogens.
I never said ‘kill’, I said overrun, and like you said there is evidence of this because of the healthy bacteria count. I wish I had time to do the research for your audience, we are not doing a good service to people by making them fear even healthy fermentation. I wish CAFO’s had never come about or that people didn’t overuse antibiotics because then this would very likely not even be an issue. But I don’t think cooking everything or irradiating everything is the answer to these virulent strains of bacteria.
Janelle,
I just wanted to say that I put my main response to Kristen’s comment where it would address her comment. However, what I provided was hopefully, basically the “research” you said you wished you could provide to keep innocent people from having to fear something so safe and wonderful as a healthy kefir culture they have begun in their home.
As you allude to here, it’s basically the bacteria “count” that matters. A species that has an advantage is not going to allow a competitive species to take over. It may allow a symbiotic species to co-exist, or a non-confrontational species to persist, but it won’t allow a competitor to get a foothold.
You may have not used the word “kill” but don’t be afraid of it. That is exactly what is done in war, and war is what to expect when, for example, e.coli meets the forces of a kefir, which include several species of bacteria as well as yeasts which work together to protect their environment.
I hope this helps. After studying kefir, it seems to be the safest way to consume raw milk, if anyone even had a worry about its safety. It seems it must provide safety several orders of magnitude greater than just plain raw milk.
Thank-you I was hoping someone else besides me would speak up about culturing milk!
You are welcome, Janelle. And like you, it is a little strange to be among people who are obsessed with a “war on germs” as you put it. If people are going to be into living naturally, and eating raw foods, they need to understand that germs are everywhere and that trying to kill them with anti-bacterial soap and pasteurization is not a healthy way to go. It’s way better to just “outnumber” them. You body has all the defenses it needs if it is healthy and has a sufficient culture of microbes working for it in the gut and on the skin and mucous membranes. I totally trust my microorganisms to fend off pathogens. I don’t worry about a little dirt on my food. There is strength in numbers. Modern health science has determined that I carry about 10 times as many cells of microorganisms with me as I have cells that hold my DNA. That’s a lot of protection. To make me sick, it’s going to take a dose of food very heavily tainted with a pathogen that can outnumber my protective forces. If people are really worrying about pathogens, the first thing they need to do is build up their probiotics, both in their gut and in their garden.
As I’ve said before, if people have a fear of drinking raw milk, their mind is probably set looking in the wrong direction, and none of us should try to change that. They also won’t trust other raw foods, especially cultured ones like sauerkraut, raw cheese, unpasteurized wine, etc. because these have been sitting “unprotected” for long periods of time, able to be tainted by all kinds of pathogens.
It just happens though that raw milk, not protected by a healthy culture, or refrigeration, is a fairly good medium for growth of an unhealthy culture. I think those on the side who favor drinking raw milk should acknowledge that. Milk doesn’t carry with it a protective coat against pathogens like whole fruits and vegetables do. It was made to be taken directly from udder or breast into the stomach of the young. When we extract it artificially, and put it into a container, and play time games with it, and don’t give it a dose of a protective culture, we are obviously creating a level of risk that is greater than just leaving a peach in the fruit bowl for 3 days. That raw milk is used by someone other than the person or family who owns the cow (in most cases these days) is a situation that may add a little more “unknown” to the equation of how safe a particular sample of raw milk actually is.
If I had children at home still, and believed they needed the nourishment of cows’ milk (I no longer do), and yet didn’t like even the risk portrayed by Chris’s first article, I would try to improve my children’s odds against becoming sick by probably (my seat of the pants estimate) 1000 fold by: 1) inspecting the dairy that I use; 2) testing the newest batch introduced to my home (on myself) before giving it to the kids; 3) never letting the kids indulge in milk as a treat or means of hydration, but only giving a reasonable amount with a healthy meal; 4) never feeding the kids sugar; 5) never letting them eat any sweet foods such as fruit at the same time as fatty meals – this provides an ideal fermentation atmosphere, even in the stomach, such that when the tainted food finally leaves the stomach, it’s bacterial content has already possibly doubled! 6) making sure that milk containers are kept in refrigeration as much as possible; 7) empty all milk from the glasses as soon as the meal is finished so children can’t drink warm milk later.
Yes, 5 of 7 guidelines I listed are aimed at the assumption that a small, innocuous number of microbes in a serving of raw milk can possibly become debilitating if the milk isn’t handled properly by the purchaser. Why ask kids to wash their hands before a meal and yet let them otherwise act in a way that multiplies the germs that are always already in the food?
I ran across a study or experiment if you will – gosh I should have started keeping track – where they inoculated raw and pasteurized milk with e-coli. Both room temp and refrigerated for some set time. The room temp raw was safe to drink and the pasteurized was dangerous in a short time…. way cool. Hopefully could google it or it could have been in a interview with that big raw dairy in Calif
At any rate I think as far as the “risk” goes like the 1 in 6 million or whatever it is , If the dairy tests the current batch of raw milk to be free of pathogenic bacteria then it becomes a mute point eh ? Drink up
Kristen, and others commenting on this subject, even though you say “…it just makes sense that if the pathogens are in your raw milk, then they are going to thrive in your kefir.”, we that favor the consumption of raw milk all seem to be looking for something that proves that pathogenic microbes cannot live in the presence of a healthy culture – a culture such as that which makes kefir, or which lives in a healthy gut, like we try to introduce via “probiotics”. If we found that an established group of microbes could maintain and control their environment against hostile invaders, then possibly we could again believe that a healthy microbial system, such as raw milk, or intestinal flora, could keep control, and fight off invaders, and keep the invaders from “thriving” as you mention.
So if readers here can, for a moment, ignore the fact that this link is provided by an agent of the big-Pharma industry, and overcome the fact that you are going to have to listen to a lecture instead of read a text document, and get past the fact that it is a lengthy lecture, I think you’ll see that it is very possible for a culture, such as a kefir culture, to protect it’s preferred environment and to fight off smaller cultures of adversarial bacteria such as e.coli. It turns out that bacterial systems are quite intelligent collectively, and can operate in synchronized ways to wipe out opposing cutures. Please listen to this TED talk if you are interested in a scientific answer to this question:
http://www.ted.com/talks/lang/en/bonnie_bassler_on_how_bacteria_communicate.html