Raw Milk and Lactose Intolerance

People choose to drink raw milk for many different reasons. Some are seeking to support local farms and connect with the places from which their food originates.  Others want to make sure that animal welfare is a high priority in the production of their food. Some people choose raw milk for its delicious, rich flavor.  And still others seek out raw milk in order to address specific health conditions, such as asthma, allergies, and eczema.

Lactose intolerance and maldigestion of pasteurized milk are significant factors for many people who choose raw milk. Nonetheless, when researching the peer-reviewed literature, many would conclude that raw milk cannot help with lactose intolerance. Raw milk detractors often cite a study by Stanford University in their assertion that raw milk does not help with lactose intolerance. However, many people who have been diagnosed as “lactose intolerant” have reported that they can actually drink raw milk with no digestive problems. Let’s dig deep into all of this to better understand the disconnect.

The Stanford Study

The Stanford study, titled “Effect of Raw Milk on Lactose Intolerance: A Randomized Controlled Pilot Study,” assessed the effects of raw milk, pasteurized milk, and soy milk in 16 adults. The people participating in this study were confirmed to have “true lactose malabsorption” through the use of a Hydrogen Breath Test (HBT). Over a course of several weeks, the participants in the study consumed successively greater amounts of raw milk, pasteurized milk, and soy milk in an 8-day milk phase for each type of milk as shown in the figure below.  This study found that there was no improvement in lactose intolerance symptoms with the consumption of raw milk compared to pasteurized milk.

Milk dosage protocol and outcome measures for each 8-day milk phase: full amount of milk was consumed in 1 sitting on each day. Mummah, et al 2014.

Although the Stanford study has often been cited as proving that raw milk does not help with lactose intolerance, there are some significant problems with this study. The sample size of 16 participants is quite small, and this makes is very difficult to make any sweeping conclusions based on the results of the study.  The sample size becomes even more problematic when it is considered that 383 people initially signed up to participate in the study.

The 383 people who volunteered for this study considered themselves to be lactose intolerant. This means that they had experienced digestive symptoms such as diarrhea, abdominal cramping, audible bowel sounds, and/or flatulence as a result of consuming milk products. However, only 27 people were qualified to participate through the use of the Hydrogen Breath Test. Of these 27 people, 16 people chose to participate in the study. Out of the initial group of 383 volunteer participants, only 4% actually participated in the study. This means that 96% of the original volunteers were excluded from this study!

This calls into question the use of the Hydrogen Breath Test as an appropriate measure of lactose intolerance.  Although the HBT is used to characterize the clinical definition of lactose malabsorption, it is clearly not a sufficient test for identifying people who experience digestive symptoms as a result of consuming milk products. The study even mentioned that, “Many people with lactose malabsorption [as diagnosed through results of the HBT] do not report clinical lactose intolerance. Conversely, many individuals with perceived lactose intolerance do not experience malabsorption [as confirmed with HBT].” The Hydrogen Breath Test is clearly not a sufficient test for identifying people who experience digestive symptoms from the consumption of milk products.

Another significant problem with the Stanford study is that the length of the 8-day milk phases may have been too short.  Specifically, the study authors found that “the reduced H2 production observed for raw milk on day 8 vs day 1 suggests a degree of adaptation to raw milk… In contrast to raw milk, no adaptation was observed for pasteurized milk.” The participants had decreased levels of hydrogen in the HBT by the end of the 8-day raw milk phase, and this finding warrants further study to determine whether this trend would have continued over a longer period of time and resulted in a reduction of lactose intolerance symptoms.

Mummah, et al 2014

Overall, the Stanford study fell far short of actually answering the question of whether raw milk can be well-tolerated by people who describe themselves as “lactose-intolerant.” 96% of the volunteers who considered themselves to be lactose intolerant were excluded from this study. Furthermore, the study did not continue long enough to determine if the positive trend in hydrogen production from drinking raw milk would have continued and resulted in reduction of lactose intolerance symptoms.

First-Hand Accounts About Raw Milk and Lactose Intolerance

There have been numerous first-hand reports of improvements in lactose intolerance from the consumption of raw milk. For instance, lactose intolerance runs in my husband's family, coming through his father.  My husband and his siblings all developed digestive problems from consuming milk and other dairy products at around 18-20 years old. Prior to trying raw milk, my husband could only tolerate pasteurized milk products if he took lactase enzyme pills whenever he consumed dairy. However, my husband has been able to drink raw milk in moderate amounts (such as 1-2 glasses per day) with no problems, and raw milk consumption also corresponded with an increased ability to tolerate pasteurized dairy in cheese and ice cream.  My father-in-law was also able to consume raw milk without digestive problems and reported that it also increased his ability to consume pasteurized cheese and ice cream.  

Here are a few more first-hand accounts about raw milk consumption and lactose intolerance.

“I am lactose intolerant. I was diagnosed around the age of 12. I missed so much school due to upset stomach & went off of dairy fully for over 10 years. I can drink raw milk with no issues - I can have cups of it with no bad side effects. In fact - I can even have pasteurized dairy now with little to no problems. It has helped my gut health so much - I notice when I don’t consume it because my digestion gets weird.

“When I first started drinking it I was terrified but after the first cup my body craved it for the first month. It was all I wanted. I could have easily drank half a gallon a day if I didn’t limit myself. That’s tapered off now though.”       ~Bethanie N.

“I had IBS and had to take everything out of my diet and slowly add things back in to see what was bothering me. It was processed dairy. Found raw dairy and now that's all I consume most days. Raw milk, cheese, yogurt, butter. IBS gone, hemorrhoids gone, arthritis gone, inflammation gone, sinus problems gone. Feel like a new woman.” ~Patricia W.

“My kids were all lactose intolerant, but when I switched to raw A2, they all saw a huge difference in response. No more issues. One of my kiddos was at the point of needing her tonsils removed, but they shrunk down to normal size, and her sleep apnea went away.” ~mother of four children

Surveys About Raw Milk and Lactose Intolerance

There have been several raw milk surveys which collected data about lactose intolerance. In a 2007 survey of Michigan raw milk drinkers, 155 people participating in the survey had been diagnosed with lactose intolerance by a healthcare professional. Out of these 155 people, 118 reported that they did not have lactose intolerance symptoms from consuming raw milk.  Thus, 76% of the survey respondents who had been diagnosed with lactose intolerance were able to consume raw milk with no digestive issues.

In a 2011 survey of 56 Michigan raw milk drinkers, “eleven individuals claimed that they experienced symptoms of lactose intolerance when drinking processed milks but had no ill side effects from drinking raw milk.”

In a 2014 survey of 153 Maryland raw milk drinkers, “Fifty-nine respondents claimed no discomfort after drinking raw milk but discomfort from drinking pasteurized milk.

Raw Milk and Lactase

Pasteurization inactivates enzymes and also denatures proteins, and consequently pasteurized milk induces digestive discomfort in many people. Lactase is the enzyme responsible for breaking down lactose into digestible form. Raw milk facilitates the production of lactase enzyme in the intestinal tract, and thus it makes sense that so many people have reported improvements in lactose intolerance from drinking raw milk.

Ancient populations who relied on dairy products adapted over time by developing lactase persistence genes. These genes allow people to digest lactose into adulthood, and they have been found in various indigenous populations in Africa, Europe, Asia, and the Middle East. Overall, around 35% of adults worldwide have lactase persistence genes.

Although it has been widely argued that only people who have lactase persistence genes can consume milk, there are currently many populations around the globe who subsist largely on dairy yet who do not have lactase persistence genes.  For instance, despite the fact that an estimated 95% of Mongolians do not have the lactase persistence gene, their diet relies very heavily on raw milk, cheese, and other milk products.

Furthermore, archaeological evidence shows that humans were consuming raw milk for thousands of years before the widespread appearance of the lactase-persistence gene. Raw milk allowed humans to thrive in conditions where survival would have been difficult. Scientists now believe that lactase-persistence genes were spread through natural selection. This means that the reproductive capacity and/or survivability of ancient raw milk drinkers was substantially increased compared to non-milk-drinking populations.

Large Body of Evidence for Raw Milk and Lactose Intolerance Benefits

First-hand accounts and surveys show that there are many people whose lactose intolerance symptoms are improved by drinking raw milk. Additionally, many worldwide raw milk-drinking populations do not have lactase persistence genes. Furthermore, the archaeological record shows that humans were consuming raw milk for thousands of years before the appearance of lactase persistence genes. This large body of evidence cannot be negated by one small study. The Stanford study should clearly not be seen as the final word on raw milk and lactose intolerance.

Antibiotic Resistant Genes in Raw Milk - What Does the Data Really Mean?

Government-Funded Study Finds ZERO Pathogens in Raw Milk Samples!

That’s what the headlines should have read.

Instead, the study was titled, “Reservoirs of antimicrobial resistance genes in retail raw milk” [1]. The study, funded by the National Institutes of Health (NIH) and the United States Department of Agriculture (USDA), was not able to find any pathogens in raw milk. So instead they focused on trying to create fear of antibiotic resistant genes which were found to proliferate when raw milk was allowed to sit at room temperature for hours.  

Antibiotic Resistant Genes are Ubiquitous

Antibiotic resistant genes are everywhere. They’ve been found in every environment, including pristine habitats that have been virtually untouched by humans such as Antarctica [2, 3].  They’re even found in the dust of buildings [4].

“Antibiotics are ancient, dating back hundreds of millions of years. Resistance is therefore equally ancient, and the number of genes in the resistome is a reflection of the continuous co-evolution of small molecules in natural environments and microbial genomes.”  

-Gerard Wright, Nature Reviews Microbiology 2007 [3]

Given that they are ubiquitous in the environment, it is no surprise that there are antibiotic resistant genes in many foods [5]. Breast milk, too, contains antibiotic resistant genes carried on bacteria found in the raw breast milk [6].

Breastmilk and Antibiotic Resistant Genes

Researchers in Helsinki found that, even though breast milk contains antibiotic resistant genes, babies who were breast fed actually have less antibiotic resistant genes in their guts than babies who weren’t breastfed or who terminated breastfeeding early [7].  Researchers attribute this benefit to the fact that breastmilk promotes the growth of beneficial bacteria such as bifidobacteria, which can then outcompete the bacteria carrying antibiotic resistant genes. Like breast milk, cow’s milk has also been shown to support the growth of bifidobacterial [8]. 

Potential Dangers of Antibiotic Resistant Genes

Antibiotic resistant genes can pose potential health threats in specific circumstances. When antibiotics are taken, the intestinal microbiome is disrupted as both beneficial and harmful bacteria are killed off. This weakens our immune systems overall [9]. If there are antibiotic resistant bacteria present in the gut, taking antibiotics actually allows these bacteria to proliferate in the absence of competing bacteria. There can then be infection or illness which is not able to be respond to antibiotics. Antibiotic resistance is now responsible for the deaths of tens of thousands of people every year in the USA alone [10].

For example, C. diff. colitis (clostridium difficile colitis) is infection of the colon that results from disruption of the healthy bacteria in the gut, usually as a result of taking antibiotics. C. diff. can cause diarrhea, abdominal pain, fever, bloody stools, kidney failure, and even death. One of the best treatment options for severe C. diff. infections is fecal transplant. Severely ill C. diff. patients have a 92% cure rate from fecal transplants, which provide a healthy flush of poop from a healthy human donor into the colon [11]. The fecal transplant recolonizes the gut with healthy bacteria.

Zero Pathogens in Raw Milk Samples

Coming back to the study funded by the NIH and USDA [1], researchers found that antibiotic resistant genes proliferated in raw milk that was allowed to sit at room temperature for hours.  Their research showed that raw milk which was kept refrigerated had low levels of antibiotic resistant genes.  What this actually demonstrates is that raw milk from around the country is being produced very cleanly, resulting in low bacteria counts.

Most of the potential beneficial bacteria to be found in milk is from either fecal or soil origin. Yes…dirt is very good for you and a little poop does not hurt either [12]. It has long been understood that living in a farm environment has substantial health benefits over living in urban environments [13]. However, in our modern world with immune-compromised consumers, the raw milk standards have had to change.

For raw milk to be legal for sale and safe for the general public (including immune-compromised people), it must be very hygienic. It can no longer have dirt or poop in it. So, all that is left is clean, delicious, safe raw milk from deep inside the cow’s or goat’s udder. The government-funded study tested retail raw milk samples and they found ZERO pathogens! This should be celebrated as true progress towards farm cleanliness and testing.

“[Raw] milk samples in the present study were screened for Listeria spp., Salmonella enterica, and E. coli O157:H7. None were detected.”

-Liu et al. Microbiome 2020 [1]

Fermenting Raw Milk

For thousands of years, people have known how to ferment or “clabber” raw milk by simply leaving it at room temperature instead of refrigerating it.  In the absence of refrigeration, traditional cultures often consumed raw milk in fermented form [14]. Such milk would have contained ample beneficial lactic acid bacteria from the small amounts of dirt or manure that would have been present on the udders and teats of the milk animals, and would therefore quickly ferment at room temperature. 

In modern times, people have largely lost their taste for spontaneously fermented, sour raw milk. Raw milk farmers and consumers aim to maintain the sweet flavor of fresh milk as long as possible. The farmers do this by thoroughly cleaning the udders and milking equipment to ensure the milk will have low bacteria counts [15], as well as by rapidly chilling the milk and keeping it cold.  Consumers, too, work to make sure their raw milk is kept cold, even during transport.  Keeping raw milk cold allows it to retain its sweet taste and gives it a longer shelf life.

One useful point of information from the government-funded study was the finding that “spontaneous fermentation does not grow beneficial lactic acid bacteria”. This means that the very clean, low-bacteria count raw milk which is currently available in the USA may not ferment very well in the traditional way. The flavor of spontaneously fermented raw milk is not generally palatable to the modern raw milk consumer. Thus, most raw milk consumers actually work to make sure that their raw milk does not ferment and stays fresh and sweet.

Generally, raw milk consumers who intentionally ferment their milk will do so by adding beneficial bacteria such as yogurt starter or kefir grains. Kefir, in particular, is associated with a wide number of health benefits including lower blood pressure, decreased insulin resistance, tumor suppression and prevention, and improved composition of the gut microbiota [16-19].

The Bottom Line

The NIH and USDA-funded study found no pathogens in raw milk. This is further confirmation of the findings published in the January 2020 Journal of Epidemiology and Infection which concluded that “raw milk can be produced with a high level of hygiene and safety” [20].

The government-funded study focused on antibiotic resistant genes which can proliferate in raw milk that is left at room temperature for hours. However, it is no surprise that raw milk, like breastmilk and many other foods, contains antibiotic resistant genes. The presence of antibiotic resistant genes is not an issue unless the balance of good bacteria in the gut gets disrupted. Both breastmilk and raw milk are known to promote the growth of beneficial bacteria such as bifidobacteria. The study completely ignored the growing body of evidence that has shown that children who drink raw milk have decreased rates of asthma, allergies, eczema, ear infections, fever, and respiratory infections [21-23].

The best way to beat antibiotic resistant bacteria is to protect and nourish the biodiverse bacteria in the gut. You can do this by avoiding antibiotics and processed foods, which damage the gut and immune system [24, 25]. Instead, eat plenty of whole foods such as raw milk, milk kefir, grassfed beef, eggs, and fresh or fermented vegetables and fruits to feed the beneficial bacteria in the gut and allow it to thrive [26].

References

[1] Liu, J., Zhu, Y., Jay-Russell, M. et al. (2020) Reservoirs of antimicrobial resistance genes in retail raw milk. Microbiome 8, 99 (2020). https://doi.org/10.1186/s40168-020-00861-6

[2] Durso LM, Miller DN, Wienhold BJ (2012) Distribution and Quantification of Antibiotic Resistant Genes and Bacteria across Agricultural and Non-Agricultural Metagenomes. PLOS ONE 7(11): e48325. https://doi.org/10.1371/journal.pone.0048325

[3] Wright, G. (2007) The antibiotic resistome: the nexus of chemical and genetic diversity. Nat Rev Microbiol 5, 175–186 (2007). https://doi.org/10.1038/nrmicro1614

[4] Ben Maamar S, Glawe AJ, Brown TK, Hellgeth N, Hu J, et al. (2020) Mobilizable antibiotic resistance genes are present in dust microbial communities. PLOS Pathogens 16(1): e1008211. https://doi.org/10.1371/journal.ppat.1008211

[5] Fogler K, Guron GKP, Wind LL, Keenum IM, Hession WC, Krometis L-A, Strawn LK, Pruden A and Ponder MA (2019) Microbiota and Antibiotic Resistome of Lettuce Leaves and Radishes Grown in Soils Receiving Manure-Based Amendments Derived From Antibiotic-Treated Cows. Front. Sustain. Food Syst. 3:22. doi: 10.3389/fsufs.2019.00022

[6] Pärnänen, K., Karkman, A., Hultman, J. et al. (2018) Maternal gut and breast milk microbiota affect infant gut antibiotic resistome and mobile genetic elements. Nat Commun 9, 3891. https://doi.org/10.1038/s41467-018-06393-w

[ 7] Ravindran S. (2019) Breastfeeding May Help Protect Babies from Antibiotic-Resistant Bacteria. SPLASH! milk science update: January 2019 Issue. https://milkgenomics.org/article/breastfeeding-may-help-protect-babies-from-antibiotic-resistant-bacteria/

[8] Rova S, Rada V, Marsik P, Vlkova E, Bunesova V, Sklenar J, Splichal I. (2011) Growth of bifidobacteria and clostridia on human and cow milk saccharides. Anaerobe 17(5). https://doi.org/10.1016/j.anaerobe.2011.07.009.

[9] McAfee M, Smith S. (2020) Immunity, the Immune System, and Raw Milk. Raw Milk Institute website. https://www.rawmilkinstitute.org/updates/immunity-the-immune-system-and-raw-milk

[10] Centers for Disease Control and Prevention. (2019) More People in the United States Dying from Antibiotic-Resistant Infections than Previously Estimated. CDC website. https://www.cdc.gov/media/releases/2019/p1113-antibiotic-resistant.html

[11] Brandt L. J. (2012). Fecal transplantation for the treatment of Clostridium difficile infection. Gastroenterology & hepatology, 8(3). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365524/

[12] Akst, J. (2020) The influence of soil no immune health. The Scientist website. https://www.the-scientist.com/news-opinion/the-influence-of-soil-on-human-health-66885

[13] Wells, AD, Poole JA, and Romberger DJ. (2014) Influence of farming exposure on the development of asthma and asthma-like symptoms. International immunopharmacology, 23(1), 356–363. https://doi.org/10.1016/j.intimp.2014.07.014

[14] Levi, J. (2014) The Smoke Cured Fermented Milk of the Samburu. Presentation at Wise Traditions London 2014. https://westonaprice.london/videos/samburu/

[15] Smith, S. (2020) Udder Preparation for Raw Milk. Raw Milk Institute website. https://www.rawmilkinstitute.org/updates/udder-preparation-for-raw-milk

[16] Bourrie BC, Willing BP, and Cotter PD. (2016) The Microbiota and Health Promoting Characteristics of the Fermented Beverage Kefir. Frontiers in microbiology, 7, 647. https://doi.org/10.3389/fmicb.2016.00647

[17] Bellikci-Koyu E, Sarer-Yurekli BP, Akyon Y, Aydin-Kose F, Karagozlu C, Ozgen AG, Brinkmann A, Nitsche A, Ergunay K, Yilmaz E, and Buyuktuncer Z. (2019) Effects of Regular Kefir Consumption on Gut Microbiota in Patients with Metabolic Syndrome: A Parallel-Group, Randomized, Controlled Study. Nutrients, 11(9), 2089. https://doi.org/10.3390/nu11092089

[18] Guzel-Seydim ZB, Kok-Tas T, Greene AK, Seydim AC. (2011) Review: functional properties of kefir. Crit Rev Food Sci Nutr. 51(3):261-268. doi:10.1080/10408390903579029

[19] de Oliveira Leite AM, Miguel MA, Peixoto RS, Rosado AS, Silva JT, and Paschoalin VM. (2013) Microbiological, technological and therapeutic properties of kefir: a natural probiotic beverage. Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology], 44(2), 341–349. https://doi.org/10.1590/S1517-83822013000200001

[20] Berge AC, Baars T. (2020) Raw milk producers with high levels of hygiene and safety. Epidemiology and Infection. 148:e14. doi:10.1017/S0950268820000060

[21] Loss G, Apprich S, Waser M, Kneifel W, Genuneit J, Büchele G, Weber J, Sozanska B, Danielewicz H, Horak E, Joost van Neerven RJ, Heederik D, Lorenzen PC, von Mutius E, Braun-Fahrländer C; GABRIELA study group. (2011) The protective effect of farm milk consumption on childhood asthma and atopy: The GABRIELA study. Journal of Allergy and Clinical Immunology. 128 (4): 766-73. https://www.jacionline.org/article/S0091-6749(11)01234-6/fulltext

[22] Perkin MR and Strachan DP. (2006) Which aspects of the farming lifestyle explain the inverse association with childhood allergy? Journal of Allergy and Clinical Immunology. 2006; 117 (6):1374-81. https://www.jacionline.org/article/S0091-6749(06)00651-8/fulltext

[23] Loss G, Depner M, Ulfman LH, Joost van Neerven RJ, Hose AJ, Genuneit J, Karvonen M, Hyvärinen A, Kaulek V, Roduit C, Weber J, Lauener R, Pfefferle PI, Pekkanen J, Vaarala O, Dalphin JC, Riedler J, Braun-Fahrländer C, von Mutius E, Ege MJ; PASTURE study group. (2015) Consumption of unprocessed cow's milk protects infants from common respiratory infections. Journal of Allergy and Clinical Immunology.  135 (1): 56-62. https://www.jacionline.org/article/S0091-6749%2814%2901274-3/fulltext

[24] Watanabe K, Gilchrist CA, Uddin J, Burgess SL, Abhyankar MM, Moonah SN, Noor Z, Donowitz JR, Schneider BN, Arju T, Ahmed E, Kabir M, Alam M, Haque R, Pramoonjago P, Mehrad B, Petri WA. (2017) Microbiome-mediated neutrophil recruitment via CXCR2 and protection from amebic colitis. PLOS Pathogens; 13 (8): e1006513 DOI: 10.1371/journal.ppat.1006513

[25] Paula Neto HA, Ausina P, Gomez LS, Leandro JGB, Zancan P, Sola-Penna M. (2017) Effects of Food Additives on Immune Cells As Contributors to Body Weight Gain and Immune-Mediated Metabolic Dysregulation. Front Immunol.8:1478. doi:10.3389/fimmu.2017.01478

[26] McAfee M. (2020) Build Immune System Strength With Whole Foods: Drink Raw Milk! Raw Milk Institute website. https://www.rawmilkinstitute.org/updates/whole-foods-build-immune-system-strength

Two Types of Raw Milk

My family has been drinking raw milk for nearly 15 years. I drank raw milk through both of my pregnancies, and have raised both of my kids on raw milk since they were weaned from breastmilk as toddlers. I have purposely chosen raw milk for my family because of its exceptional health benefits and animal welfare.

Studies performed in Europe have shown that children who drink raw milk have decreased rates of asthma, allergies, eczema, ear infections, fever, and respiratory infections. Nonetheless, when I tell people that my family drinks raw milk, I often hear responses such as:

“Raw milk is dangerous!”

“Doesn’t raw milk make people sick?”

“I heard that raw milk was bad for you.”

The reason for raw milk’s negative reputation is that there are two types of raw milk!  Raw milk that is intended for pasteurization is quite different than raw milk produced for direct human consumption.

Raw Milk Intended for Pasteurization

When my family drives past a nearby dairy that produces milk for pasteurization, we are struck by the horrendous smell and filthy living conditions.  The animal yard is completely covered with manure. The cows have no choice but to lie and stand in manure all day. It is truly disgusting to think that this operation is producing food for families!

Raw milk that is “intended for pasteurization” is typically sourced from Concentrated Animal Feeding Operations (CAFOs). This type of milk is actually defined under the Federal Grade A Pasteurized Milk Ordinance (PMO).  Such milk is being produced in conditions where animal health is often compromised and mastitis (udder infection) is common.  Antibiotics are often utilized in these herds, and hormones are used to stimulate higher levels of milk production. The animals are housed in an abundance of manure, and there is a corresponding high rate of pathogens.

This milk is intended to be pasteurized to kill pathogenic bacteria, and as such, it is often produced with little care towards preventing contamination with pathogens. Furthermore, this type of milk is generally commingled with milk from multiple dairies, which increases the risk of pathogenic exposure. Studies have shown that up to 33% of this type of milk tests positive for pathogens. This type of raw milk is clearly unsafe to consume. I would never feed this type of raw milk to my family.

Raw Milk Intended for Direct Human Consumption

When my family visits the dairy that produces the raw milk that we drink, we see a very different setting from the CAFO dairy. The cows at the raw milk dairy are happily grazing on lush pastures. The cows look clean and healthy. The milk is bottled on-farm, and we can see that the milk bottling room is clean and neat. There is a stark contrast between the CAFO dairy and this raw milk dairy.

Raw milk that is carefully and intentionally produced for direct human consumption is wholly different from raw milk being produced for pasteurization. Raw milk farmers carefully manage the cleanliness and hygiene of the farm from grass-to-glass, with much care to ensure that the animals are healthy and the milk is clean.

From the health of the herd, to cleanliness of the milking parlor, to the specific cleaning processes for the milk line, to ensuring rapid milk chilling, to regularly testing their milk, and everything in between, raw milk farmers are dedicated to taking their farm management to the next level in order to ensure that their raw milk is safe to consume.

Although there are no federal standards for raw milk, the Raw Milk Institute has established Common Standards for raw milk that is intended for direct human consumption.  This type of raw milk is tested often and held to rigorous standards to ensure that it is being produced in a way that discourages pathogen growth.

Where Do Pathogens in Milk Originate?

The four main pathogens in milk that can cause human illness are E coli 0157:H7, listeria mono, salmonella, and campylobacter. The two most common sources of pathogens in milk are manure and mastitis. It is estimated that one-third of CAFO dairy cows have mastitis, and the cows in CAFOs stand and lie in manure all day. Clearly, this type of dairy environment is primed for pathogen growth.

On the other hand, the raw milk dairy environment is carefully managed to prevent pathogens in the milk. These farmers manage the health of their herd to prevent mastitis, and ensure that the milk from any animals that are showing signs of mastitis is not used for direct human consumption.  Raw milk farmers meticulously clean the udders before milking to ensure that no manure or other contaminants are present. They also rigorously and frequently clean their milking machines, milk lines, and milk tanks.

Take a look at the milk filters shown below.  Even with just a quick look, it is apparent that the milk being produced with the intent to be pasteurized is clearly not clean, whereas the milk filter from the intentionally-produced raw milk looks impeccable. (To be fair, there are some dairy farmers who produce milk for pasteurization that is much more hygienic than most others. However, that milk is still commingled with milk from other dairies, many of which are likely to not use hygienic practices.)

Comparison of Bacterial Test Standards for Two Types of Raw Milk

Okay, I’m gonna get technical here.  If reading about standards and looking at charts is not your thing, you can skip ahead to the last section. :)

Two important types of bacterial testing for milk are Standard Plate Count (SPC) and coliform count. The SPC is a measure of the total number of aerobic bacteria in the milk. High SPC numbers can indicate dirty milking equipment, poor milk chilling, and/or poor udder preparation.

Coliform count measures the amount of coliform bacteria present in the milk. Coliform counts measure the overall hygiene and cleanliness of the milk. High coliform counts generally indicate the presence of manure or other environmental contaminants on the udders or milking equipment. High coliform counts are likely to correspond to the presence of pathogens in the milk.

According to the PMO, pre-pasteurized milk is allowed to have up to 100,000 colony-forming units (cfu) of bacteria per mL in SPC testing. The PMO does not have a standard for how many coliforms are allowed in pre-pasteurized milk, but the state of California allows coliforms up to 750 cfu/mL of milk.

In comparison, the Raw Milk Institute Common Standards call for <5,000 cfu/mL for SPC testing, and <10 cfu/mL in coliform testing. As you can see in the chart below, intentionally-produced raw milk is measurably quite different from pre-pasteurized raw milk, and even meets stricter standards than pasteurized milk.

The Raw Milk Institute has been collecting monthly Standard Plate Count and Coliform Count data from its LISTED raw milk dairies since 2012.  This dataset of thousands of test results shows that raw milk farmers who have been properly trained can routinely meet the stringent standards set forth in the Common Standards.

Research on Raw Milk Safety

Recently, researchers from Canada and Europe have studied the safety of raw milk intended for direct human consumption. They have found that carefully produced raw milk is a low-risk food which is fundamentally different from pre-pasteurized milk. 

The table below contrasts pathogen test data from pre-pasteurized milk vs. raw milk intended for direct human consumption.  As illustrated in the table, pathogen testing of pre-pasteurized milk samples has detected pathogens in up to 33% of samples.  In contrast, there were zero pathogens detected in thousands of milk samples from raw milk intended for direct human consumption. It is clear from this test data that pre-pasteurized milk is categorically different from raw milk intended for direct human consumption.

Data courtesy of the British Columbia Herdshare Association

Not All Raw Milk Is Dangerous!

It is clear that raw milk produced with the intention to be pasteurized is likely to contain dangerous pathogens. This type of raw milk is unsafe, and I would never feed it to my family. Unfortunately, this type of raw milk’s negative reputation has led many to believe that all raw milk is unsafe to consume.

It is important to note that there is no such thing as a perfectly safe food. An analysis of foodborne illnesses from 2009-2015 showed that the top food categories commonly linked to illnesses were chicken, pork, and seeded vegetables. Pasteurized milk is not perfectly safe, either, and is implicated in foodborne illnesses and outbreaks every year.  The CDC outbreak and illness data which is used to assert that raw milk is unsafe does not distinguish raw milk intended for pasteurization from raw milk that is carefully produced and intended for direct human consumption.

It is clear from the above-presented test data that intentionally-produced raw milk is a low-risk food. In my family, we purposely choose raw milk for its superior nutrition and significant health benefits over pasteurized milk.  Raw milk contains greater bioavailable nutrients than pasteurized milk, as well as a wide array of beneficial enzymes and probiotics which are known to have benefits on the immune system and gastrointestinal tract.   

Advice for Farmers Considering the Switch to Raw Milk

In today’s unpredictable world, many dairy farmers are interested in selling raw milk. Due to the domino-effect of changes in the supply chain due to COVID19, many dairy farms are having to dump their milk. The dairy processing industry which was previously supplying milk to schools and restaurants cannot rapidly adapt to bottling and delivering milk for retail sales. Selling raw milk may seem like a good alternative to many of these dairy farms, but in actuality this would be a complex change requiring a large amount of forethought and precaution.

Demand for raw milk is increasing in recent years as consumers learn about raw milk’s significant health benefits. Raw milk consumption has been correlated to decreased rates of asthma, allergies, eczema, ear infections, fever, and respiratory infections. Raw milk consumption has also been correlated with improved lung health, and many consumers who are lactose intolerant can actually consume raw milk with no problems.  Plus, raw milk tastes great! Raw milk’s deliciousness is one of the main drivers for why consumers choose raw milk over pasteurized milk. 

It’s Not a Trivial Change

Switching from producing milk intended for pasteurization to raw milk intended for direct human consumption requires a huge shift in mindset and practices. Studies have shown that up to 24% of pre-pasteurized milk contains pathogens, whereas raw milk from well-trained farmers is very unlikely to contain pathogens.

Chart from “Two Types of Raw Milk” by the British Columbia Fresh Milk Project

Farmers who produce low-risk raw milk carefully manage the cleanliness and hygiene of the farm as a whole from grass-to-glass. From the health of the herd, to cleanliness of the milking parlor, to the specific cleaning processes for the milk line, to ensuring rapid milk chilling, to regularly testing their milk, and everything in between, raw milk farmers have to be dedicated to taking their farm management to the next level in order to ensure that their raw milk is safe to consume.

For dairy farmers who are considering the switch to raw milk production, here are some specific guidelines for producing safe raw milk.

Cleanliness

Cleanliness is of paramount importance in producing raw milk. Your whole milking system, from udders to bottling, must be cleaned exceptionally well, or else there is a much higher likelihood that the milk will end up tainted with pathogens.

Udder preparation and cleaning is of particular importance, since dirty udders are the most probable source for pathogens in milk. Udders need to be clean and dry at milking.  For raw milk production, udder prep typically includes:

• brushing and/or cleaning the udders to make sure they are hygienic

• using a clean rag and towel for each cow/doe

• applying iodine-based teat dip, which is left on for at least 30 seconds

• wiping off the teat dip with a clean, dry towel

• stripping each teat with clean hands or gloves, and inspecting the milk to look for any signs of clotting, blood, etc.

(More details on udder prep are given here.)

Special care needs to be taken to ensure that the milking system, chiller, and tank are cleaned frequently and thoroughly.  Typically, the milking system needs to be cleaned after each milking with cool/tepid water first, followed by very hot alkaline cleaner, and then finished with hot acidic cleaner. Milk tanks need to be cleaned frequently, including complete disassembly and cleaning of the tank valve.

Milk bottling should ideally occur in a clean, uncluttered room with smooth washable walls and floor. Care should be taken to ensure that the milk bottling room is kept clean and is not contaminated with manure or other filth.

Herd Health

Herd health is very important in raw milk production, as unhealthy animals are more likely to develop infection and mastitis which increases the likelihood of having pathogens in the milk. Your raw milk herd must be verified to be free of tuberculosis, brucellosis, and Johne’s disease. Biosecurity must be carefully managed to ensure that the herd does not come into contact with other animals (wild or domesticated) that may be carrying disease.

Rapid Chilling and Maintaining the Cold Chain

Under ideal growth conditions, bacteria counts double every 20 minutes.  Increased bacterial counts are associated with faster milk souring as well as greater presence of pathogens.  Decreased temperatures slow bacterial growth dramatically, and thus it is quite important to make sure that raw milk is rapidly chilled to slow bacterial growth. Ideally, raw milk should be chilled to 38F within an hour of milking. Keep raw milk cold throughout the bottling process and all the way through customer receipt of the milk.

Preventing Cross Contamination

Be aware that other farm animals such as chickens, rodents, birds, and pigs can pose a pathogen threat. For instance, chickens may carry salmonella and campylobacter, and cows/does that lie down in chicken manure may end up with pathogen contamination on their udders. Your milking herd should be kept separate from pigs and chickens. Chickens and birds should be kept out of the milking barn.

Milk stacking occurs when milk from subsequent milkings is placed in the same tank. Milk stacking is to be avoided as much as possible because it increases the likelihood of having bacterial problems. One bad batch can contaminate the rest. Additionally, milk stacking raises the temperature of the previously-cooled milk, making it more likely to support bacterial growth.

If your farm will produce both pasteurized and raw milk, you’ll need to take special care to ensure that the pasteurized milk is kept completely separated from raw milk. Pasteurized milk provides an ideal growth environment for pathogenic Listeria mono be can because there is no beneficial bacteria present to outcompete the Listeria.

Regular Testing

Don’t make the mistake of assuming that, just because your family can drink your raw milk with no problems, there are no pathogens present. Farm families have robust immune systems due to repeated exposure to the farm environment, so they are less likely to become ill from raw milk.  However, if you are selling raw milk to the public, you may end up with customers who have weak or impaired immune systems.  These customers will have a much lower threshold for illness from pathogens than farm families.

Testing is an important part of safe raw milk production. Testing provides a verification step that the practices and procedures are working well to produce low-risk raw milk. According to the Raw Milk Institute (RAWMI) Common Standards, raw milk should be tested regularly for coliforms and standard plate count. These tests provide a good indication of the hygiene, cleanliness, and handling of the milk. The Common Standards call for <10 coliforms/mL and <5,000 for SPC.

Take Care of Your Market

Selling to people versus selling to a processor: It’s an entirely different and very rewarding world. If you get it right, you’ll become a trusted brand and be beloved. 

As farmers who want to switch into the raw dairy market, besides following high standards for cleanliness and farm management, one of the biggest changes for you will be selling directly to people, kids, and families. You will no longer sell to a processor. The families you provide raw milk to trust you, and you’d better do an outstanding job! 

Building a market for raw milk does not just happen. Selling to a processor doesn’t require answering questions from end consumers or developing close consumer relationships. You’ll have to work hard to develop each relationship with your consumers, and be prepared to answer lots of questions. You must be interested in answering these questions and carefully researching to assure that the most current and accurate information is provided. All of this needs to be done with a warm smile :) and some compassion. 

As we say at RAWMI, “You don’t sell raw milk. You teach it”. If you teach enough, you can sell enough. It’s all about making that consumer connection with very high quality and safety. 

That means you become both a teacher and a producer.  If consumers don’t know what is so great about raw milk... they won’t buy it.  Why would they? They must learn first, then the sale is a done deal. Knowledge is gained and trust is earned before a sale is completed. 

Welcome to world of raw milk and directly nourishing people. 

We’re Here to Help

If you want more information on switching to raw milk production, please don't hesitate to ask. The Raw Milk Institute (RAWMI) trains and mentors farmers in the production of low-risk raw milk. RAWMI is a non-profit organization, so our training and mentoring is FREE for farmers. We also have brochures that can help with educating consumers about the benefits of raw milk. We'd be happy to help you in making sure you get off to a good start with raw milk. You can email us at contact@rawmilkinstitute.org.

Factory Farms vs. Sustainable Local Farms During COVID19

Milk is Being Dumped While Stores are Selling Out

Mother Nature has her ways of giving us advice. Sometimes that advice is subtle and sometimes it is brutal.  This time she was pretty direct, and she did not mix her signals.  Consolidated, centralized food systems have not been able to adapt to the rapid changes brought on by the COVID19 pandemic.

The Standard American Diet and its production, processing, logistics and delivery systems have failed.  American farmers that serve this highly consolidated food system are dumping 3 million gallons of milk per day; meanwhile American supermarkets are stripped clean of dairy products. The dairy processing industry which was previously supplying milk to schools and restaurants cannot rapidly adapt to bottling and delivering milk for retail sales.

For many years, the demand for fluid pasteurized milk has been dropping at a rate of ~1% per year. During this long decline, bottling plants have been closed and cheese plants have been opened. When America was asked to stay at home in response to COVID19, much of the food service industry was stopped, restaurants were idled, and schools were closed.

At home, kids wanted cereal and needed three meals every day. They wanted milk! The demand for milk raged upwards. Yet the supermarkets could not meet that demand. Panic-buying made matters even worse, with store shelves remaining sporadically empty for weeks, and even now milk is being rationed in many places.

Meanwhile, dairymen are dumping truckloads of milk. The market price of milk is dropping like a rock from $18 per hundredweight (CWT) to $14 CWT or even lower. The break-even price for dairymen is around $18-$20 CWT. Thus, dairies are continuing to fail at an unprecedented rate while stores are not able to meet the demand for milk.  It is an unmitigated disaster.

“Get Big or Get Out”

This is the 50 year old story of “Get Big or Get Out”. This philosophy of feeding the world and starving the American farmer was started in the early 1970’s by Earl Butz, who was Secretary of Agriculture under Nixon. Butz’s idea was that the most efficient farmers would overtake the smaller farmers, prices would drop, and supply would increase.

This structure concentrates power into the hands of a few aiming at cheap food for all, with an abundance which America would then export into the world markets. We would feed the world.  This design has become part of the America farm culture and has led to a massive decline in the number of dairies.  

Massive Decline in Number of Small Dairies

In 1940, America had over 4 million dairy farms. By the late 1990’s, that number had dropped to just over 100,000 dairies in the USA. Currently, there are only about 30,000 dairies left, and we are losing an additional 5% of dairies every year.   

According to USDA data, there has been a sharp decline in the number of dairies with 30-200 cows; meanwhile, the number of large dairy farms is increasing. From 1992-2012, “the number of dairy farms with at least 1,000 cows more than tripled.” One future-thinking dairy leader has projected that America will have only 100 dairies in 20 years. America would still have its 9+ million cows, but those cows would be contained in massive concentrated animal feeding operations (CAFOs) with 90,000 cows each.

Consumer polls clearly indicate that consumers don’t want their milk coming from 90,000 cow massive CAFO operations. The environmental impact from large CAFO operations is devastating. The manure lagoons are the size of lakes and the smell is horrendous. There are no pastures. The feedlots go on and on forever!  This system has many flaws, and more of those flaws showed themselves to the world in the last 6 weeks during the COVID19 pandemic.

Consolidated Food Systems Lack Resilience and Adaptability

COVID19 has demonstrated that a consolidated food system fails the American public in times of crisis. Consolidated massive operations and their logistics can not adapt and they are not resilient. These operations cannot adjust to changing market conditions and they fail when the consumer demands change. The consolidated milk industry failed to meet the needs of Americans because it was not able to respond and adapt in the face of rapid change. Similar issues have arisen in consolidated vegetable industries and meat industries during this crisis.

The food chain stress test has been performed. The results are in and America’s big food systems have failed miserably.  This has become a serious threat to American national food security!

Food security is seriously jeopardized with milk going to just a handful of milk processors. That’s the future of “Get Big or Get Out” and it is smelly, ugly, and does not work to serve America. Additionally, with so much of this system relying on imports and exports, when countries close their borders, this system cannot function.

Consumer Connected Farmers Are Thriving

The local farmer-to-consumer system has also been tested during this time of crisis, and the results have been quite different. Farmers who sell directly to consumers are thriving. The comparison of this market to the CAFO-driven market is dramatic.  

Farmer–to-consumer sales are highly adaptive and resilient, because the farmers are connected to their consumers. They know and hear one another!  Farmers can adjust quickly to changes in consumer demand. During the COVID19 pandemic, many dairy farmers who sell directly to consumers saw a huge increase in the demand for milk. They were able to meet this demand by diverting milk which would have been used to make butter and cheese into bottled milk instead. Both the farmers and consumers benefited from this ability of the farmers to adapt to the changing demand.

Farmers who sell directly to consumers produce fresh foods which are unprocessed or less-processed. These fresh foods support and build immune systems through nourishing healthy gut biomes. Up to 80% of the immune system makes its home in our gut and is powered by a biodiversity of bacteria and the whole foods that feed them. These foods come from sundrenched rich soils and local ethical farmers that connect directly to consumers. This food system is thriving and growing.

In contrast, highly processed foods with long shelf life, which are filled with preservatives and antibiotics, are destructive to the gut biome. Consumers have begun to understand this.

Within the dairy community, farms such as cow share programs, micro dairies that produce raw milk, and dairies with their own processing plants have been able to quickly adapt and respond to the changing demand from consumers and stores. These food systems are responsive, adaptive, nutritionally rich, and economically alive.

You Vote With Your Food Dollars

America must make a decision about its fate. Food systems are very much a part of our America. Will America thrive, be resilient and adapt to threats? Will America continue to become even more economically, environmentally, and immunologically compromised and depressed? Or will America embrace smaller local farms who produce nourishing whole foods? Will America embrace disease-prevention and whole food nutrition? Will it build or suppress its innate and adaptive immune systems?

Each dollar spent on food directs America’s future. Where we direct our food dollars is a very personal question. Will we have healthy children or not?  Will we take personal responsibility for our own health with whole food nutrition or will we continue to vote for “Get Big or Get Out”?   

The food system stress test results are in. Let’s move beyond “Get Big or Get Out.”  Let’s invest in illness prevention with farm-direct local, unprocessed, whole foods that build our immunity. It’s a personal gut microbiome choice. Let’s adapt and become resilient. The alternative is a dead end.

How to Find a Good Raw Milk Farmer

Is your raw milk farmer really producing low-risk, safe raw milk?

Numerous scientific studies have shown that raw milk is correlated with decreased rates of asthma, allergies, eczema, ear infections, fever, and respiratory infections. However, improperly-produced raw milk can be dangerous! For instance, studies have shown that there are disease-causing pathogens in up to 24% of samples taken from bulk tanks of milk intended for pasteurization.

So how do you find a good source for low-risk raw milk? Keep reading for a handy checklist to assess your local raw milk dairy.

LISTED Farmers

The Raw Milk Institute (RAWMI) has developed a rigorous program for raw milk farmers who are dedicated to producing clean, safe raw milk. RAWMI LISTED farmers develop a plan for managing the health and hygiene of their farm, receive one-on-one mentoring and guidance for low-risk optimization, and test their milk regularly to ensure compliance with the RAWMI Common Standards for low-risk raw milk. RAWMI LISTED farmers meet regularly as a community to share lessons learned and stay up-to-date on the best practices for low-risk raw milk production.

RAWMI currently has LISTED farms in Arizona, Arkansas, British Columbia Canada, California, Iowa, Michigan, Minnesota, Montana, New York, North Carolina, Ohio, Ontario Canada, Oregon, Pennsylvania, Virginia, and Wisconsin. If you are lucky enough to live near a RAWMI LISTED dairy, you’ve got a great source for low-risk raw milk nearby.

Other Sources for Raw Milk

If you don’t live near a RAWMI LISTED dairy, the following sites might be helpful in finding a source for raw milk:

This site has a comprehensive state-by-state list of raw milk dairies in the USA.

This site has a handy interactive map of raw milk dairies across the USA.

For raw milk in the United Kingdom, this website has an interactive map of raw milk dairies.

Includes a county-by-county listing of raw milk dairies in Ireland.

Checklist for Assessing Raw Milk Dairies

Since most of these dairies have not been LISTED by RAWMI, it is recommended that you do some research to make sure that the raw milk you buy is low-risk. Here is a short list of some things to look for in a raw milk dairy:

• Make sure the cows/goats look like they're in good health, with regards to body confirmation, udders, coat, etc.

• Check whether the cows/goats get sunshine and have access to outdoors and some grass.

• Inspect to make sure that everything involved in the milking process looks very clean, including the milking parlor, all milking equipment, bottle cleaning area, bottling area, milk jars/bottles, etc.

• Find out about their process for cleaning bottles, such as whether they use hot water, washing machine, etc.

• Ask to see what the udder cleaning process looks like, making sure the udders are cleaned very well, pre-dipped, dried, and stripped before milking begins. 

• Learn about their milk chilling process. It is best if the milk is chilled quickly to just above freezing (38-40 degrees F) in ~45-60 minutes, such as with an ice bath or other more high-tech chilling equipment.

• Find out what their water source is and whether their water is tested regularly.

• Find out what the shelf-life of their milk is, from fresh to souring. Cold, clean raw milk should have good flavor and taste for at least 12-14 days or even longer.  Short shelf life with rising bubbles in the milk would indicate high presence of coliform bacteria, which indicates that the milk is not hygienic.

• Ask about what regular testing they do, and find out specifically what their coliform counts have been. RAWMI Common Standards aim for <10 coliforms/mL of raw milk.

• Take a look into the farmer's kitchen: does it look clean and orderly? Look at their truck, too. Personal practices often say so much about behaviors when no one is watching. 

• To really make sure their overall processes and procedures are optimal for low-risk raw milk, direct them to contact RAWMI and consider becoming RAWMI LISTED. 

If your local raw milk dairy is not LISTED by RAWMI, consider asking them to contact the Raw Milk Institute. We provide mentoring and training, help farmers develop their own unique on-farm Risk Assessment and Management Plan, and provide ongoing support. It is FREE for farmers and helps ensure that their milk is low-risk and safe for you and your family!