Milk, Infants and Pasteurization, The Real Story
(Part 1 of 3 on Milk)
Milk advocates claim it builds strong bones, helps muscles grow and is a good source of vitamin D. Milk critics say it causes cancer, increases the risk of diabetes and can cause osteoporosis. It's time to cut through the hype and scare tactics. After going through 617 studies, this is what clinical testing revealed.
Milk and Infants
Let's start with babies. Milk from cows can lead to iron deficiency in children under 1 year of age. There are a combination of reasons.
- Cow's milk is low in iron, yet is used as a primary source of nutrition for many infants.
- 40% of normal infants will experience intestinal blood loss when they're fed cow's milk.
- Cow's milk is high in calcium and the protein casein, which inhibits the absorption of iron.
Each point is minor, but together they can cause iron deficiency in infants. Fortunately, researchers found that, "Loss of iron in the form of blood diminishes with age and ceases after 1 year of age." That means it's generally not a problem for children older than 1 year.
Milk also contains much more protein and minerals than an infant needs, so they pee more to get rid of the excess. The excess urine can lead to a negative water balance. If additional fluids aren't given to compensate it can lead to serious dehydration. This also ceases to be a problem as infants pass the age of 1 year.
The risk of iron deficiency and dehydration make cow's milk is a poor choice for infants or children under the age of 1 year. Mother's milk is best, but if you're unable to provide that, infant formulas can be a good choice.
Adverse effects of cow's milk in infants. By: Ziegler EE; Fomon Infant Nutrition Unit, Department of Pediatrics, University of Iowa, Iowa City, IA, USA.
When you're old enough to drink milk, the next debate that comes up is how processed the milk should be.
Raw vs. Pasteurized Milk
(IMPORTANT UPDATE POSTED 6/13/2025)
Raw milk and cheese pack a dangerous punch that's wildly disproportionate to their consumption. Though only 3.2% of Americans drink unpasteurized milk and 1.6% eat unpasteurized cheese, these products caused 96% of all dairy-related foodborne illnesses between 2009 and 2014, according to a 2017 study in Emerging Infectious Diseases.
The numbers are staggering: unpasteurized dairy products cause 840 times more illnesses and 45 times more hospitalizations per serving than pasteurized products. That means your risk of getting sick from a glass of raw milk is roughly equivalent to your risk of getting struck by lightning—except you're voluntarily drinking the lightning.
The culprits behind these illnesses read like a medical nightmare: Salmonella, Campylobacter, Shiga toxin-producing E. coli, and Listeria monocytogenes. These aren't minor stomach bugs—they can cause kidney failure, brain infections, and death, particularly in pregnant women, young children, and immunocompromised individuals.
Purists suggest that everyone should drink raw milk because it's so much healthier. Raw milk proponents claim it has protective components that kill pathogens, prevent pathogen absorption and strengthen the immune system.
To better understand pasteurization and what it does, the following information is from the Food and Drug Administration (FDA).
"Pasteurization is a process that kills harmful bacteria by heating milk to a specific temperature for a set period of time. First developed by Louis Pasteur in 1864, pasteurization kills harmful organisms responsible for such diseases as listeriosis, typhoid fever, tuberculosis, diphtheria, and brucellosis."
"Research shows no meaningful difference in the nutritional values of pasteurized and unpasteurized milk. Pasteurized milk contains low levels of the type of nonpathogenic bacteria that can cause food spoilage, so storing your pasteurized milk in the refrigerator is still important."
After reviewing the available data, we were unable to find any research directly observing the benefits that are supposed to come from drinking raw milk versus drinking pasteurized milk. We couldn't find any clinical evidence that raw milk could strengthen the immune system any better or prevent pathogen absorption to a greater degree than pasteurized.
We did find dozens of studies detailing the direct benefits of pasteurization in reducing illness. In several large-scale studies, involving hundreds or thousands of samples, raw milk was always cited as having more disease-causing problems from contamination than pasteurized milk.
Effective heat inactivation of Mycobacterium avium subsp. paratuberculosis in raw milk contaminated with naturally infected feces. By: Rademaker JL, Vissers MM, Te Giffel MC.; Department of Health and Safety, NIZO Food Research, Ede, The Netherlands. Jan.Rademaker@nizo.nl
Bacterial contaminations of informally marketed raw milk in ghana. By: Donkor E, Aning K, Quaye J.; Department of Microbiology, University of Ghana Medical School, Korle-Bu, Accra.
In raw milk's defense, advocates encourage consumers to "get to know" their local producer and make sure the milk is coming from a sanitary source. That's wonderful in theory. The reality is that very few people have the time to visit their local dairy and if they did, what should they be looking for? How can the average person tell if their local dairy is sanitary or not?
There's another little problem. The sale of raw milk has been outlawed in nearly half the states and cannot be sold in interstate commerce.
Because of the potential problems including possible contamination and the legal restrictions on sale, we cannot at this time suggest raw milk as an alternative to pasteurized milk. There are simply too many risks for consumers to adequately protect themselves.
Part 1 2 3
UPDATE 1/30/2018
Raw milk is much more dangerous than we estimated when this article was first written. As of 2015, approximately 3% of all milk consumed is raw milk. However, 80% of all pathogen outbreaks linked to milk are attributed to RAW milk. Think about that, 3% of the market but responsible for 80% of the disease outbreaks.
The stats are sobering. Drinking raw milk is 150 times more likely to result in illness than pasteurized milk.
The Centers for Disease Control (CDC) put together a great informational piece about Raw Milk.
Read it here: Raw Milk Questions and Answers
Download a PDF of the article here: Raw Milk Questions and Answers
UPDATE 4/17/2025
We did a deep dive into studies on raw versus pasteurized milk during the month of March, 2025. Here is a summary of our efforts.
There are no clinical studies showing that raw milk is healthier than pasteurized milk. The available clinical evidence comparing health outcomes of raw versus pasteurized milk is extremely limited, and major health organizations—including the CDC, FDA, and American Academy of Pediatrics—do not recognize any proven health advantage of raw milk over pasteurized milk.
Most of the research on milk and health focuses on the nutritional content and safety of pasteurized milk, as well as the well-documented risks of consuming raw milk, which include serious foodborne illnesses caused by bacteria such as Salmonella, E. coli, and Listeria. While some proponents of raw milk claim it is more nutritious or better for digestion, these claims are not supported by rigorous clinical trials.
Summary of the evidence:
No randomized controlled trials or large-scale clinical studies have demonstrated superior health outcomes from drinking raw milk compared to pasteurized milk. We found numerous CLAIMS made about this, but were unable to find any clinical studies to back up those claims.
The nutritional differences between raw and pasteurized milk are minimal; pasteurization does not significantly reduce the levels of most vitamins, minerals, or proteins in milk.
The health risks associated with raw milk are well-documented and include a higher risk of bacterial infections, which can be especially dangerous for children, pregnant people, the elderly, and those with weakened immune systems.
If you are seeking evidence-based recommendations, the consensus in the scientific and medical communities is that pasteurized milk is significantly safer and just as nutritious for the general population.
Reference Links:
Foodborne illness outbreaks linked to unpasteurised milk and relationship to changes in state laws – United States, 1998–2018
Lia Koski, Hannah Kisselburgh, Lisa Landsman, Rachel Hulkower, Mara Howard-Williams, Zainab Salah, Sunkyung Kim, Beau B Bruce, Michael C Bazaco, Michael B Batz, Cary Chen Parker, Cynthia L Leonard, Atin R Datta, Elizabeth N Williams, G Sean Stapleton, Matthew Penn, Hilary K Whitham, Megin Nichols
Epidemiology & Infection, Published 2022 Oct 25;150:e183. doi: 10.1017/S095026882200164Click Here for the Study: https://doi.org/10.1017/s0950268822001649
Nonpasteurized Dairy Products, Disease Outbreaks, and State Laws—United States, 1993–2006
Adam J. Langer, Tracy Ayers, Julian Grass, Michael Lynch, Frederick J. Angulo, and Barbara E. Mahon
Emerging Infectious Diseases, Published Volume 18, Number 3—March 2012Click Here for the Study: https://wwwnc.cdc.gov/eid/article/18/3/11-1370_article
Increased Outbreaks Associated with Nonpasteurized Milk, United States, 2007–2012
Elisabeth A. Mungai, Casey Barton Behravesh, and L. Hannah Gould
Emerging Infectious Diseases, Published Volume 21, Number 1—January 2015Click Here for the Study: https://wwwnc.cdc.gov/eid/article/21/1/14-0447_article
Unpasteurized Milk: A Continued Public Health Threat
Jeffrey T. LeJeune , Päivi J. Rajala-Schultz
Clinical Infectious Diseases, Published Volume 48, Issue 1, 1 January 2009, Pages 93–100,Click Here for the Study: https://academic.oup.com/cid/article-abstract/48/1/93/291424?redirectedFrom=fulltext
Food Safety Hazards Associated with Consumption of Raw Milk
Stephen P. Oliver, Kathryn J. Boor, Steven C. Murphy, and Shelton E. Murinda
Foodborne Pathogens and Disease, Published 8 September 2009Click Here for the Study: https://www.liebertpub.com/doi/10.1089/fpd.2009.0302
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4/25/2010
Updated 1/30/2018
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Updated 6/13/2025
