Given the choice, most of us prefer fresh food. Processing food often means adding ingredients to make it shelf-stable that aren’t exactly healthy. So, you can understand why the idea of raw milk, or milk that’s “fresh from the cow” would have a certain appeal.

Isn’t raw milk just more natural, organic, and healthy?

That’s what many people think.

Pasteurized vs Raw Milk

If you buy your milk from the grocery store, then it’s gone through pasteurization. This simple heating process kills harmful bacteria, like tuberculosis and listeria, as well as viruses. But some people also think the process kills good bacteria and leads to problems like lactose intolerance.

Are they right?

To UVA Health Children’s pediatrician Joshua Jakum, MD, the issue is clear-cut. “Raw milk does not resolve lactose intolerance, treat asthma, or improve allergies. Raw milk does not offer any nutritional superiority.”

What Risks Are There with Raw Milk?

Raw milk can carry a range of diseases. In recent years, most outbreaks related to raw milk have been due to:

• Listeria
• Salmonella
• E. coli
• Campylobacter

Other illnesses killed by pasteurization include tuberculosis and bird flu.

H5N1 has been found in raw milk samples around the country. Learn more about bird flu and how to stay safe.

Who Is Most at Risk with Raw Milk?

“Young children (under the age of 5), adults over 65, pregnant women, and those immunocompromised are at the greatest risk of serious illness from the bacteria in raw milk and milk products,” Jakum says.

Of particular concern are the significant increases in toxoplasmosis or listeriosis infections during pregnancy. These infections can cause stillbirth, preterm delivery, and neonatal infections.

“A specific bacterium, E. coli O157, is associated with a dangerous diarrheal disease and kidney failure in young children,” he says.

Do People Frequently Get Sick from Raw Milk?

Most people don’t drink raw milk at all. But even with a small number of people drinking raw milk, outbreaks of illness happen.

“Between 1998 and 2009, there were 93 illness outbreaks, 1,837 illnesses, 195 hospitalizations, and 2 deaths,” Jakum adds. As a pediatrician, he’s especially passionate about sharing the risks because “79% of outbreaks involved at least 1 person younger than 20.”

And the numbers are rapidly increasing. Between September 2023 and March 2024, a 4-state Salmonella outbreak infected 171 people. 22 of those needed hospitalization. The median patient age was 7.

Certainly, some risk of illness caused by food is unavoidable. With milk, we can easily avoid this risk by drinking pasteurized milk. It’s easy to get and not expensive.

Which makes raw milk a pointless risk.

Is Raw Milk Healthier?

No.

Pasteurization doesn’t get rid of vitamins or fat content. It only kills the things that could make you sick. And really, if you get E. coli, not much else about your diet matters.

So, the Nutritional Content Is Identical?

Interestingly, vitamin content does shift during pasteurization. The process increases vitamin A but decreases vitamins C and B2.

Most doctors and dietitians consider this a great trade. Without dairy, many wouldn't get enough vitamin A in their diet. The B2 content of pasteurized milk is still very good.

Most farms that pasteurize also fortify their milk with Vitamin D. Vitamin D, coupled with the calcium and fat needed to digest it, offers a ton of benefits:

• Better bone health
• Immune booster
• Decreased diabetes risk
• Improved strength
• Better mood 

Vitamin D is also the only added ingredient in pasteurized milk.

But What About the Probiotics in Raw Milk?

One claim you may come across is that raw milk offers probiotics. Probiotics are bacteria that can support a healthy gut biome, improve digestion, and build immunity.

It turns out that clean raw milk doesn’t have probiotics. In fact, when tested, the only samples of milk with any probiotics were those contaminated with feces. The bacteria came from the poop. Not the milk.

Is Raw Milk Easier to Digest for People with Lactose Intolerance?

People with lactose intolerance don’t have enough lactase to break down the lactose (a type of sugar) found in milk. This results in bloating, abdominal pain, and other digestive symptoms. All milk has lactose. Raw milk, pasteurized milk, and even goat milk will all cause symptoms in those with lactose intolerance.

So why then do some people find it easier to drink unpasteurized milk?

Not all abdominal discomfort following milk consumption is lactose intolerance. While true lactose intolerance will react to any milk, other sensitivities can be accommodated.