Raw Milk: Sorting the Evidence From the Noise

Key takeaways

• What pasteurization does: heats milk to kill harmful germs without significantly changing its nutritional value
• Interstate sale for drinking: banned by federal law; state laws on in-state sale vary
• Most useful single change: Look for the word "pasteurized" on milk, cheese and other dairy labels.
• Commonest mistake: Raw milk, cheese or yogurt during pregnancy or for babies and young children.
• See a doctor if any of the signs under "When to speak to a doctor" below apply to you.

What it is

Milk from cows, goats, sheep or other animals that has not been pasteurized, a heat treatment that kills harmful germs. It sits within Food Safety. The table below gives the figures guidance actually works from.

The numbers, in one place

What helps

You do not have to do all of it, and you do not have to start today.

• Look for the word "pasteurized" on milk, cheese and other dairy labels
• Choose pasteurized milk and cheese for children and during pregnancy
• Refrigerate milk at 40°F (4°C) or below and use it by the date on the label
• Ask about pasteurization when buying dairy at farmers markets or farm stands

What to avoid

Things that seem reasonable and are not.

• Raw milk, cheese or yogurt during pregnancy or for babies and young children
• Assuming milk from a clean, local or organic farm is free of germs
• Feeding raw milk to pets, which can also become ill

In depth

Milk straight from an animal can pick up germs in several ways: from the animal's udder or blood if it is infected, from manure on the skin and equipment, and from the environment during milking and storage. Even farms with careful hygiene cannot fully prevent this, because healthy-looking animals can carry harmful bacteria. Pasteurization, which heats milk to a set temperature for a set time, was introduced in the US in the early 1900s and is credited with a large drop in diseases once commonly spread through milk.

Some people choose raw milk because they believe it is more natural, tastes better, or offers extra nutrients, enzymes or probiotics. According to the FDA and CDC, pasteurization does not significantly reduce milk's nutritional value, and claims that raw milk treats or prevents conditions such as allergies or lactose intolerance are not supported by evidence. Meanwhile, the risks are well documented: raw milk causes a disproportionate share of dairy-linked outbreaks relative to how little of it is consumed.

Since 2024, highly pathogenic H5N1 bird flu has been found in dairy cattle in the US and in raw milk from infected herds. Pasteurization inactivates the virus, and federal agencies have advised against consuming raw milk and raw-milk products because of this added risk. Laws on raw milk differ widely between states, from outright bans on retail sale to farm-only or retail sale, but federal law bans selling raw milk for drinking across state lines.

Signs and symptoms

• Diarrhea, sometimes bloody, with stomach cramps and vomiting
• Fever, chills and body aches
• Fever, muscle aches and fatigue in pregnancy, which may signal Listeria
• Recurring fevers, sweats and joint pain over weeks, which may signal brucellosis
• Red, irritated eyes or flu-like symptoms after contact with raw milk from infected herds
• Weakness or tingling in the legs that spreads upward, a rare complication after Campylobacter

Causes and risk factors

• Bacteria from an infected udder or from the animal's bloodstream
• Manure contamination during milking
• Unclean equipment, tanks and bottling
• Warm storage that lets bacteria multiply
• Infected herds carrying H5N1 bird flu
• Soft cheeses and other products made from unpasteurized milk

How it is checked

Tell your doctor that you drank raw milk or ate products made from it, because this changes what they look for. Stool tests can identify Campylobacter, Salmonella and E. coli. Listeria and Brucella are usually found through blood tests. Your doctor may also check kidney function if you have bloody diarrhea, because some E. coli infections can damage the kidneys.

If you have flu-like symptoms or eye irritation after contact with raw milk that might come from infected cattle, your doctor may test for influenza and contact the health department, which can arrange specific testing for H5N1. These cases are monitored closely by public health authorities.

Treatment and support options

Switch to pasteurized products

Pasteurized milk, cheese, yogurt and ice cream offer the same essential nutrients, including protein, calcium and, in fortified milk, vitamin D. Many aged hard cheeses, soft cheeses and specialty products are available pasteurized. If you enjoy the taste of local dairy, look for farms that pasteurize on site; some use lower-temperature methods that still meet safety standards.

Read labels and ask questions

Look for the word "pasteurized" on the label. At farmers markets, farm stands and specialty shops, labels may be less clear, so ask directly whether milk, cheese or yogurt was made from pasteurized milk. Cheese sold as raw-milk cheese in the US is required to be aged, but aging does not remove all risk, particularly from Listeria.

Treatment if you become ill

Many raw-milk infections are managed with fluids and rest. Some, such as listeriosis and brucellosis, need antibiotics, and brucellosis often requires a long course. Antibiotics are generally avoided for E. coli infections that produce Shiga toxin. Your doctor will decide based on the germ identified and your health.

Lactose intolerance alternatives

If you were drawn to raw milk because regular milk upsets your stomach, lactose-free milk, yogurt with live cultures and aged hard cheeses are often easier to digest. Fortified soy milk is another option. A doctor or registered dietitian can help you check whether lactose intolerance is the cause.

Prevention

• Choose pasteurized dairy for everyone in the household, especially children
• Check labels on imported and specialty soft cheeses
• Avoid handling raw milk if you are pregnant or have a weakened immune system
• Wash hands after contact with livestock or farm environments
• Keep pets away from raw milk and raw-milk pet products

Day to day

If you live on or near a dairy farm, or someone in your family works with cattle, the safest approach is to pasteurize milk before drinking it, even when the herd seems healthy. Home pasteurizers are sold, and Cooperative Extension offices can explain safe methods. Workers on farms with H5N1-infected herds are advised to use protective equipment such as eye protection and gloves when handling raw milk.

Family members sometimes disagree about raw milk. If you choose to keep it in the house, store it separately at 40°F (4°C) or below and make sure children, pregnant people and anyone with a weakened immune system do not drink it. Being honest with your doctor about raw milk use allows them to recognize unusual infections quickly.

For specific groups

Children

Children are more likely to become seriously ill from raw milk. E. coli infection can lead to hemolytic uremic syndrome, a form of kidney failure, and raw milk is not recommended for babies or young children.

Pregnancy

Raw milk and soft cheese made from it, such as some queso fresco, are a recognized source of Listeria, which can cause miscarriage, stillbirth or newborn infection. Choose pasteurized dairy throughout pregnancy.

Older adults and people with weakened immunity

Infections from raw milk are more likely to become severe or spread to the bloodstream in this group. Pasteurized dairy is strongly advised.

Questions to ask your doctor

• Should I be tested for any infections after drinking raw milk?
• Which symptoms should prompt me to come back quickly?
• Is raw milk safe for my child, or during my pregnancy?
• Could lactose intolerance explain my problems with regular milk?
• Do I need any precautions because I work with livestock?

More questions, answered

Does pasteurization destroy the nutrients in milk?

Not significantly. According to the FDA, pasteurized milk keeps its key nutrients, including protein and calcium. Small changes in some heat-sensitive vitamins are minor, and milk is not a major source of those vitamins anyway.

Is raw milk from grass-fed or organic cows safer?

No. Organic, grass-fed and small-farm herds can still carry harmful bacteria, and contamination can occur during milking regardless of how carefully animals are raised. Only pasteurization reliably kills these germs.

Can I get bird flu from pasteurized milk?

Federal agencies have found that pasteurization inactivates H5N1 bird flu virus, and the commercial pasteurized milk supply is considered safe. The concern is raw milk and products made from it.

Are raw-milk cheeses safe because they are aged?

Aging reduces some risks but does not eliminate them, especially for Listeria. Soft and fresh cheeses made from raw milk carry the highest risk. Hard, aged cheeses are lower risk, but people in high-risk groups are advised to choose pasteurized versions.

Does raw milk help with allergies or asthma?

There is no good evidence that drinking raw milk treats or prevents allergies or asthma, and it carries real risks. Talk to your doctor or an allergist about proven treatments.

Can I make raw milk safe at home?

Heating milk to pasteurization temperatures at home can kill harmful germs, and some families use home pasteurizers. Your local Cooperative Extension office can explain tested methods. Simply chilling or filtering raw milk does not make it safe.

Related topics

• The Evidence on West Nile Virus and Mosquitoes, Without the Hype (Infectious Diseases)
• Gut Health and Immunity: What the Evidence Actually Says (Immunity)
• The Evidence on Vegetarian and Vegan Diets, Without the Hype (Healthy Recipes)
• Food Allergy: What the Evidence Actually Says (Allergies)

Where to go next

• Making Sense of Raw Milk
• The Raw Milk Checklist: What to Do and What to Skip
• Raw Milk — the reference entry
• Food Safety: The Complete Guide
• Eggs and Salmonella: What Published Guidance Supports
• Listeria in Pregnancy: What Published Guidance Supports

When to speak to a doctor

See your doctor if you develop vomiting, diarrhea, fever, muscle aches or red, irritated eyes after drinking raw milk, and tell them what you drank. Call 911 for bloody diarrhea with little or no urine, a stiff neck with fever, confusion or a seizure.

Where this comes from

• FDA — The Dangers of Raw Milk: Unpasteurized Milk Can Pose a Serious Health Risk
• CDC — Raw Milk

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.