Pasteurization has evoked a serious ‘blind spot’ among many journalists, scientists, and industry and professional organizations who believe that there is no ‘downside’ to pasteurizing milk.
Pasteurization is falsely perceived as a silver bullet, killing pathogens and causing no adverse effects. However, neither raw nor pasteurized milks are ‘risk-free’. Communications by pro-pasteurization advocates commonly leave out evidence, limitations, and inconvenient truths, in order to perpetuate pro-pasteurization myths and maintain status quo to preserve the dominance of pro-pasteurization ‘blind spots’. Beware of entrenched beliefs masquerading as scientific facts that in reality are not supported by scientific evidence.
FACTS LEFT OUT BY PRO-PASTEURIZATION ADVOCATES
Below are some relevant facts that are often left out of public communications about milk, each with supporting evidence and references that you are encouraged to review and fact-check.
1. Neither pasteurized nor raw milk is ‘risk-free’.
a. See Table below for summary of the burden of illness from CDC outbreak data for 2005-2020 and the peer-reviewed manuscript on this dataset (Stephenson, Coleman, and Azzolina 2024).
b. More deaths are reported from leafy greens (23), pasteurized milk (4), and oysters (2) than the death of an adult with severe underlying illness associated with consumption with raw milk (Davis et al. 2016). Note that another death in an adult with severe underlying illness reported in this time period could not be attributed to raw milk consumption.
c. Higher burdens of illness are reported from leafy greens (16,434 illnesses), oysters (2,408), pasteurized milk (2,111), and many other foods than for raw milk (1,696).
2. Pasteurized milk is a highly processed food that is linked to adverse health effects.
a. Significantly higher outbreaks, hospitalizations, and deaths were associated with listeriosis in pasteurized dairy from 2007-2020 compared to raw dairy (Sebastianski et al. 2022).
b. Stillbirths, miscarriage, premature delivery were reported for pasteurized dairy, not raw dairy (Sebastianski et al. 2022).
c. Heating milk (boiling and pasteurization) denatures milk proteins, increasing allergenicity and contributing to inflammatory disease (Abbring et al. 2019; 2020).
d. Allergy to and intolerance of pasteurized milk is estimated to have a substantial public health burden in the US, with 30-37% intolerance of thermally treated milk from recent US surveys (C. M. Warren et al. 2022; C. Warren et al. 2024). Approximately 15 million US consumers (4.7% or nearly 1 in 20) are affected by thermally-treated/pasteurized milk.
e. Industrial processing of milk (heating, filtration, pressure, drying, freezing) causes denaturing, aggregation, and loss of function of cow milk antigens (α-lactalbumin, β-lactoglobulin, serum albumin, caseins, bovine serum albumins, and others), reductions in concentrations of bioactives (immunoglobulins, cytokines, peptides, lipophilic components, and microbiota), and impairs immunologic tolerance mechanisms (Jensen et al., 2022).
3. Approximately 15 million raw milk consumers benefit from access.
a. A recent government survey estimated 4.4% of US population consumes raw milk (Lando et al., 2022).
b. Multiple sources report consumption of raw milk is increasing, not decreasing (NielsenIQ figures cited by (Aleccia 2024; Lyubomirova 2024); Figure below included in Coleman manuscript under review in Risk Analysis).
c. CDC reported 1,696 raw milk illnesses for 2005-2020 (Stephenson et al., 2024) but not inflammatory disease (Dietert et al. 2022).
d. Raw milk was tolerated by children with allergy to pasteurized milk, and pasteurized milk induced adverse effects (Abbring et al. 2019).
e. Raw milk has a dense and diverse microbiota, similar to the breastmilk microbiota, both inducing benefits to gut microbiota, immune system function, and suppressing growth of pathogens (Coleman et al. 2021; Dietert et al. 2022; Coleman et al. 2023; Coleman, submitted).
f. Raw milk was associated with increased functional richness of the gut microbiota (notably genus Lactobacillus and Lactococcus and the short chain fatty acid valerate) and participants with higher than median anxiety scores showed significant score reduction for stress and anxiety (Butler et al., 2020).
4. Illness associated with raw milk is not increasing in the US or any US state based on recent CDC data.
a. No significant increase was reported for illnesses associated with raw milk outbreaks from 1998-2018 (upper panel of Figure 1 below) or numbers of outbreaks from 2005-2018 (lower panel of Figure 1 below (Koski et al. 2022).
b. No significant increase was reported for outbreaks or illnesses associated with raw milk, nor are rates by state increasing for NC or any other state (Stephenson et al., 2024, Figures 12 and 13)
5. Regarding children, consuming raw milk complete with intact natural microbes (microbiota) is beneficial to health.
a. Just as children benefit from raw breastmilk and its protective microbiota, children (and adults) also benefit from raw cow milk complete with its protective microbiota that enhance health of gut, immune, nervous, and respiratory systems (Coleman et al., 2021; Dietert et al., 2022).
b. No child has died in the US from consuming raw milk in recent decades based on CDC data for 2005-2020 (Stephenson et al., 2024).
c. Children with allergies to pasteurized milk tolerated raw milk consumption with no adverse effects while smaller volumes of pasteurized milk triggered adverse effects (Abbring, 2019).
d. Children consuming raw milk in multiple large studies developed no diarrheal illness, significantly fewer respiratory and ear infections, protection from inflammatory disease including atopy, asthma, and eczema, and improved immunologic and lung function later in life (Perkin and Stranchan, 2006; Depner et al., 2013; Loss et al. 2015; von Mutius 2016; Wyss et al., 2018; Brick et al., 2020; Dietert et al. 2022).
6. Claims that raw milk is ‘inherently dangerous’ and that ‘risks exceed benefits’ are unfounded and not supported by the body of scientific evidence.
a. Recent trends in unpasteurized fluid milk outbreaks, legalization, and consumption in the United States (Whitehead and Lake, 2018).
b. Examining Evidence of Benefits and Risks for Pasteurizing Donor Breastmilk (Coleman et al., 2021).
c. Nourishing the Human Holobiont to Reduce the Risk of Non-Communicable Diseases: A Cow’s Milk Evidence Map Example (Dietert et al., 2022).
d. Trends in Burdens of Disease by Transmission Source (USA, 2005–2020) and Hazard Identification for Foods: Focus on Milkborne Disease (Stephenson et al., 2024).
This is an excerpt from Peg Coleman’s article, “'Dread Reckoning' And 'Blind Spots' for Oral Transmission of H5N1”. Peg Coleman is a medical microbiologist, microbial risk analyst, and a Fellow of the Society for Risk Analysis. Peg Coleman is on the Advisory Board for Raw Milk Institute. You can view Peg’s full article here: https://www.colemanscientific.org/blog/2025/5/21/dread-reckoning-and-blind-spots-for-oral-transmission-of-h5n1
References
1. Abbring, Suzanne, Daniel Kusche, Thomas C. Roos, Mara A. P. Diks, Gert Hols, Johan Garssen, Ton Baars, and Betty C. A. M. van Esch. 2019. “Milk Processing Increases the Allergenicity of Cow’s Milk-Preclinical Evidence Supported by a Human Proof-of-Concept Provocation Pilot.” Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology 49 (7): 1013–25. https://doi.org/10.1111/cea.13399
2. Abbring, Suzanne, Ling Xiong, Mara A. P. Diks, Ton Baars, Johan Garssen, Kasper Hettinga, and Betty C. A. M. van Esch. 2020. “Loss of Allergy-Protective Capacity of Raw Cow’s Milk after Heat Treatment Coincides with Loss of Immunologically Active Whey Proteins.” Food & Function 11 (6): 4982–93. https://doi.org/10.1039/d0fo01175d
3. Aleccia, JoNel. 2024. “Raw Milk Sales Are up despite Bird Flu Outbreak in Dairy Cows.” Fast Company. May 14, 2024. https://www.fastcompany.com/91124899/raw-milk-sales-rise-bird-flu-outbreak-dairy-cows
4. Brick T, Hettinga K, Kirchner B, Pfaffl MW, Ege MJ. 2020. The beneficial effect of farm milk consumption on asthma, allergies, and infections: from meta-analysis of evidence to clinical trial. The Journal of Allergy and Clinical Immunology: In Practice 8:878–889 DOI 10.1016/j.jaip.2019.11.017
5. Butler MI, Bastiaanssen TF, Long-Smith C, Berding K, Morkl S, Cusack AM, Strain C, Porteous-Allen P, Claesson MJ, Stanton C, Cryan JF. 2020. Recipe for a healthy gut: intake of unpasteurised milk is associated with increased lactobacillus abundance in the human gut microbiome. Nutrients 12(5):1468 DOI 10.3390/nu12051468
6. Coleman, M. E., T. P. Oscar, T. L. Negley, and M. M. Stephenson. 2023. “Suppression of Pathogens in Properly Refrigerated Raw Milk.” PLOS ONE 18 (12): e0289249. https://doi.org/10.1371/journal.pone.0289249
7. Coleman, Margaret E., D. Warner North, Rodney R. Dietert, and Michele M. Stephenson. 2021. “Examining Evidence of Benefits and Risks for Pasteurizing Donor Breastmilk.” Applied Microbiology 1 (3): 408–25. https://doi.org/10.3390/applmicrobiol1030027
8. Davis, Kenneth R., Angela C. Dunn, Cindy Burnett, Laine McCullough, Melissa Dimond, Jenni Wagner, Lori Smith, Amy Carter, Sarah Willardson, and Allyn K. Nakashima. 2016. “Campylobacter Jejuni Infections Associated with Raw Milk Consumption—Utah, 2014.” Morbidity and Mortality Weekly Report 65 (12): 301–5.
9. Depner M, Ege MJ, Genuneit J, Pekkanen J, Roponen M, Hirvonen M-R, Dalphin J-C, Kaulek V, Krauss-Etschmann S, Riedler J. 2013. Atopic sensitization in the first year of life. Journal of Allergy and Clinical Immunology 131:781–788 DOI 10.1016/j.jaci.2012.11.048
10. Dietert, Rodney R., Margaret E. Coleman, D. Warner North, and Michele M. Stephenson. 2022. “Nourishing the Human Holobiont to Reduce the Risk of Non-Communicable Diseases: A Cow’s Milk Evidence Map Example.” Applied Microbiology 2 (1): 25–52. https://doi.org/10.3390/applmicrobiol2010003
11. Jensen SA, Fiocchi A, Baars T, Jordakieva G, Nowak-Wegrzyn A, Pali-Schöll I, Passanisi S, Pranger CL, Roth-Walter F, Takkinen K, Assa'ad AH, Venter C, Jensen-Jarolim E; WAO DRACMA guideline group. 2022. Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update - III - Cow's milk allergens and mechanisms triggering immune activation. World Allergy Organ J. 15(9):100668. doi: 10.1016/j.waojou.2022.100668. PMID: 36185551; PMCID: PMC9483786.
12. Koski, Lia, Hannah Kisselburgh, Lisa Landsman, Rachel Hulkower, Mara Howard-Williams, Zainab Salah, Sunkyung Kim, Beau B. Bruce, Michael C. Bazaco, and Michael B. Batz. 2022. “Foodborne Illness Outbreaks Linked to Unpasteurised Milk and Relationship to Changes in State Laws–United States, 1998–2018.” Epidemiology & Infection 150:e183.
13. Lando, A.M., Bazaco, M.C., Parker, C.C. and Ferguson, M., 2022. Characteristics of US Consumers reporting past year intake of raw (Unpasteurized) milk: results from the 2016 food safety survey and 2019 food safety and nutrition survey. Journal of food protection, 85(7), pp.1036-1043.
14. Loss, Georg, Martin Depner, Laurien H. Ulfman, R.J. Joost van Neerven, Alexander J. Hose, Jon Genuneit, Anne M. Karvonen, et al. 2015. “Consumption of Unprocessed Cow’s Milk Protects Infants from Common Respiratory Infections.” Journal of Allergy and Clinical Immunology 135 (1): 56-62.e2. https://doi.org/10.1016/j.jaci.2014.08.044
15. Lyubomirova, Teodora. 2024. “Bird Flu Latest: FDA Raises Raw Milk Risks Awareness, Studies Pasteurization Effectiveness.” Dairyreporter.Com. June 26, 2024. https://www.dairyreporter.com/Article/2024/06/26/FDA-tells-consumers-to-know-the-risks-of-raw-milk
16. Mutius, Erika von. 2016. “The Microbial Environment and Its Influence on Asthma Prevention in Early Life.” The Journal of Allergy and Clinical Immunology 137 (3): 680–89. https://doi.org/10.1016/j.jaci.2015.12.1301
17. Perkin, M.R. and Strachan, D.P., 2006. Which aspects of the farming lifestyle explain the inverse association with childhood allergy?. Journal of Allergy and clinical Immunology, 117(6), pp.1374-1381.
18. Whitehead, J. and Lake, B., 2018. Recent trends in unpasteurized fluid milk outbreaks, legalization, and consumption in the United States. PLoS Currents, 10, pp.ecurrents-outbreaks.
19. Wyss AB, House JS, Hoppin JA, Richards M, Hankinson JL, Long S, Henneberger PK, Freeman LEB, Sandler DP, O’Connell EL. 2018. Raw milk consumption and other early-life farm exposures and adult pulmonary function in the Agricultural Lung Health Study. Thorax 73:279–282 DOI 10.1136/thoraxjnl-2017-210031.
20. Sebastianski, Meghan, Natalie A. Bridger, Robin M. Featherstone, and Joan L. Robinson. 2022. “Disease Outbreaks Linked to Pasteurized and Unpasteurized Dairy Products in Canada and the United States: A Systematic Review.” Canadian Journal of Public Health 113 (4): 569–78. https://doi.org/10.17269/s41997-022-00614-y
21. Stephenson, Michele M., Margaret E. Coleman, and Nicholas A. Azzolina. 2024. “Trends in Burdens of Disease by Transmission Source (USA, 2005–2020) and Hazard Identification for Foods: Focus on Milkborne Disease.” Journal of Epidemiology and Global Health, March. https://doi.org/10.1007/s44197-024-00216-6
22. Warren, Christopher, Ruchi Gupta, Arpamas Seetasith, Robert Schuldt, Rongrong Wang, Ahmar Iqbal, Sachin Gupta, and Thomas B. Casale. 2024. “The Clinical Burden of Food Allergies: Insights from the Food Allergy Research & Education (FARE) Patient Registry.” World Allergy Organization Journal 17 (3): 100889. https://doi.org/10.1016/j.waojou.2024.100889
23. Warren, Christopher M., Avni Agrawal, Divya Gandhi, and Ruchi S. Gupta. 2022. “The US Population-Level Burden of Cow’s Milk Allergy.” The World Allergy Organization Journal 15 (4): 100644. https://doi.org/10.1016/j.waojou.2022.100644