22 Comments
founding

I'm so impressed that you continue to be willing to anger fringe groups and conspiracy theorists. Bravo! I had a brush with the raw milk stuff a while back. Pasteur was a smart guy. There's lots wrong with modern technological culture, but pasteurization isn't.

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One of the links you cited does not support your thesis. You wrote:

"From 2005-2016, a study found that among 232 dairy-related illness outbreaks, unpasteurized milk accounted for 66% of them. This resulted in 1,735 illnesses, 169 hospitalizations, and 2 deaths."

The linked article found by clicking the word "study" shows abundant evidence of benefits from raw milk, the opposite of what you wrote. Right below your highlighted section it has a data table that shows if you do get sick from dairy products, pasteurized daily products are far more likely to put you in the hospital or kill you.

Right above the section you highlighted was this: "Pasteurized dairy products were responsible for 32 dairy-related outbreaks (13% of all dairy), 2,225 illnesses (45%), 120 hospitalizations (26%), and 17 deaths (74%)" Much more pasteurized daily is consumed compared to raw dairy, but there is a long term trend of increased sales of raw dairy.

The problem with this kind of infection data is it does not distinguish between the different types of raw milk that cause infection and lumps them all together. There is conventional milk that was supposed to be pasteurized but wasn't. Conventional daily is much more likely to be full of dangerous bacteria before it's pasteurized. The 2nd type is raw milk from a farmer who is not certified and maybe does not test his milk. The 3rd type is certified raw milk like in California, where the milk is frequently tested and regulated by the state. Certified raw milk is the safest type, but it is far more expensive than pasteurized milk.

Getting sick from any kind of dairy is extremely rare. Article: "Of outbreaks with identified food vehicles, 232 (4.4%) involved dairy foods (Supplementary Table 1), resulting in 9.2% of all illnesses."

Raw milk consumption has gone up, but outbreaks of infection have gone down, according to this article. Raw milk is safer than it was in the past.

Very strange that raw milk consumption went up after the CDC announced bird flu was in milk but also said pasteurized milk was safe, implying that unpasturuized milk was unsafe. It's like the public is doing the opposite of what the CDC advises.

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Thank you for clarifying this dairy issue. It's like any other food - you have to know the source and how it was raised/ manufactured etc. I have used raw dairy for 20 years that comes directly from the farmer. I know the cows that produced the milk grazed on clean grass and were not fed antibiotics. I know they rotated fields and used their muscles. For the same reasons I buy my meat from these regenerative farms that raised the animals without drugs and don't let them stand in their own waste. And eggs from chickens that rotate fields after the cows. Big agriculture - and politicians that rely on money from them say we can't feed the world like this. I would argue we can and have to. Our soil is dead and needs chemicals to support any growth. We can not sustain that. By the way, everyone drank raw milk and did fine until the folks in New York decided to feed the cows the leftover from their distillery plants. The wealthy drove to the country to get pure milk - the poor got sick from drinking milk from unhealthy cows.

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My dad (I'm 73) grew up in a rural area and often described how as children they would get a squirt of milk into a cup from people milking cows (which was still done by hand then) as a treat. He also described periodic bouts of undulant fever (Brucellosis) during which, as he put in, "I was so damn sick I was delirious. My fingers felt as if they were the size of cucumbers!"

That doesn't sound like fun.

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founding

Thank you both, yet once again, for separating science from voodoo. Your bottom line is perfection, particularly this: “There is a reason we have been pasteurizing milk for more than 100 years.”

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May 16·edited May 16

I grew up on a dairy farm, drinking copious amounts of our own fresh, unprocessed milk, and this has imparted a lingering interest in the topic. It's refreshing to read reliable, scientific information about it.

In addition to being inexpensive, we found on-farm milk to have superior flavor and especially better mouth feel than store bought, processed milk. I can think of several reasons why this might be the case:

- Freshness. Milk was never held on the farm as long as 60 hours and usually less, and I don't recall ever seeing cream rise on the stuff in the fridge.

- Not homogenized.

- Only mechanically handled once.

- Consistently held at the correct temperature.

- Not pasteurized.

For someone who is determined to consume unprocessed milk but does not themselves have daily access to a farm, it would be easy to wind up consuming milk that's less fresh, more handled, or stored at the wrong temperature. I suspect that these factors would both reduce the drinking quality and increase the risk of food-borne illness.

On the farm where I grew up, we owned the cows and cleaned the barn. We did the milking, and we sold the milk to a processor for human consumption. And we did all of these things with the knowledge that we would drink that same milk, ourselves, raw. I find this to be morally satisfying. That moral satisfaction isn't available buying milk from someone else's farm, so I content myself with stuff from the store.

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All good points here! Thank you. Another effective way to drive this home would be to consider walking up to a cow, getting down on your knees, and drinking unpasteurized milk straight from the udder.

No one would do that.

I think.

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author

You would be surprised…

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Thank you this is a good one for sharing

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Coincidentally interesting article in STAT on this subject. I don't have a subscription but they allow 3 free reads per month. The URL is impossibly long to copy/paste

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What's next, I wonder? A crusade against artificial antiseptics? "Recover from wounds the natural way—pack them with maggots!" Or maybe we should revive bleeding. I mean, it worked for our ancestors, back when America was Great.

Also anesthesia. Bite a bullet and meditate!|

Maybe I shouldn't be giving RFKJ and the GOP ideas....

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founding

I am personally aware of a case of hemolytic uremic syndrome in a young child caused by ingestion of raw milk.

Serious infections related to raw milk are undoubtedly under reported.

If folks really knew the facts as Dr Jetelina lays out, they would never let raw milk pass their lips.

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Folks who drink raw milk are basically the same folks that use supplements and fringe therapies. Pointing out that only certain viruses survive in the gut , point on..."Stomach flu" is not caused by Influenza viruses.

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"There are 2 hypothetical routes to immunity but, on a biological level are likely impossible to come from [drinking] raw milk:

+ "Antibodies" that is "short lived" "passive immunity".

+ "Virus" that is the cat cohort data demonstrates risk to humans.

YLE & guest thank you once again. 🎯

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Trust in government institutions and public health recommendations continues to decline, yet Public Health perpetuates its own credibility crisis by making sweeping assertions about topics like raw milk without adequate research. These claims often ignore industry influence in dairy research and resort to false equivalencies, ad hominem attacks, and fear-mongering. This post exemplifies the issue, overlooking contemporary evidence and modern production practices. The narrative surrounding raw milk needs careful evaluation, considering factors like false equivalency in safety data and historical context, rather than relying on outdated antimicrobial fervor.

Industry influence further complicates the discussion, with research on raw milk safety and benefits scarce in the U.S. due to its competitive advantage over pasteurized milk. Additionally, public environmental health departments, entrenched in enforcing milk regulations, face disincentives for course correction.

Despite these challenges, dismissing raw milk controversies, neglects its potential benefits and the larger context of a growing movement toward less industrialized food systems.

Embracing a balanced approach, rooted in evidence and open dialogue, is crucial for making informed public health recommendations amidst evolving challenges.

For my full response: https://docs.google.com/document/d/1OmyHd9uVA0gweu_-fxUirchz2s0IkXjmC3pimIMs_ZQ/edit?usp=sharing

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Possibly slightly off-topic, a question - - - does breast milk for a newborn, or even for a 6-month-old carry the Mom's antibodies forward to the baby?

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author

It’s a bit complex in humans (the biology is different with other animals). Human milk mainly contains antibodies of the secretory IgA type. These can coat the gastrointestinal tract and provide good protection against microbes that infect the GI tract (such as polio, for example). However, these antibodies cannot be absorbed into the circulation. Because of this, their protective effect against pathogens is largely restricted to those that infect the GI tract. There are some exceptions. For example, it is thought that during the very first few days of life, antibodies in milk can be absorbed into the circulation, although this seems to be a bit controversial. We do also have a few case reports where mothers had antibodies against the baby’s red blood cells and it seems that they came from breastmilk and when breastmilk is stopped, the antibodies fade away. In humans, maternal antibodies are passed along during pregnancy directly through the placenta and they enter the circulation meaning that they end up more or less everywhere. This is why certain vaccines in pregnancy are so critical- it lets you boost the antibodies so that they get transferred across the placenta, whereas they might not work if you were to pass them solely by breastmilk (for example, infants are not protected from whooping cough by breastfeeding but they are by maternal vaccination).

All of this aside, milk does have a lot of other substances in it that can potentially protect the child and has many critical nutrients. It also likely does have a major role in shaping the infant’s microbiome and seems to have a protective effect against the development of allergies. But as far as protection from infectious diseases, only a role for GI infections is well supported. It should also be noted that human milk is not a complete form of nutrition for infants- vitamin D supplementation for exclusively breastfed infants in important and vitamin K levels in breastmilk are also low (in part why we administer vitamin K shortly after birth).

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May 16Liked by Edward Nirenberg

Big Thank You.

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May 16·edited May 16

I am not a scientist, but I am a father and did grow up on a dairy farm. I welcome any correction from the scientists here.

In birthing class, we were taught that human breast milk during the first few days of lactation would contain significant amounts of antibodies, which would be imparted to the baby if he/she consumed it.

Dairy farmers hold back the milk from a cow's first few milkings. It has a thick texture and yellow color that would likely be unwelcome in the market. Farmers would go out of their way to feed this to the calves, to improve the calves' rate of survival. We kept several containers of the stuff in the freezer in case we had a situation where a calf survived but the cow did not, to make sure that that calf could get colostrum.

In both humans and cows, that early milk with the antibodies is referred to as colostrum. My partner was not pleased to find that knowledge from the dairy industry crossed over into the process of having children.

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Can virus be transmitted through raw milk? I was wondering if there is evidence that the cats caught H1N1 from the raw milk, or if this is given as evidence that raw milk doesn't prevent bird flu in mammals.

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founding

Thanks for the link to the cheese question. Good stories: both yours and the other one.

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Another well-communicated piece, Ed - thanks. I managed to talk the faddies in my family and acquaintance out of drinking raw milk a long time ago. I've talked a number out of drinking cow lymph all together. A really effective line was "if you wouldn't drink it while you were pregnant why would you drink it when you're not."

But I feel no compulsion to be consistent in my own life, nor does being called a hypocrite bother me much. Which is to say I absolutely will eat unpasteurized cheeses under the right circumstances, those being 1) with wine, and 2) near the cheese's point of origin. They really do taste better.

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