Raw milk is having a moment. Here are the risks patients should understand

Pasteurization of milk became mandatory Canada-wide in 1991, but resistance persists—largely driven by boutique farms, raw-food enthusiasts, libertarians and social media influencers.Testimonies for raw milk are trending on social media sites, the Associated Press reported in May. It pointed out that between late March—when the Highly Pathogenic Avian Influenza (HPAI) was confirmed in U.S. cattle for the first time—and mid-May, weekly sales of raw cow’s milk ticked up 21%-to-65% compared with the same period a year ago, as reported by market research firm NielsenIQ. (Exact numbers are hard to come by as sales of raw milk are illegal in many states and Canada.)Read: Meet the medical contrarians picked to lead health agencies under Trump and KennedyCurrently, celebrities like Gwyneth Paltrow, politicians such as Robert F. Kennedy Jr., and other medical contrarians, are regularly espousing the benefits of raw milk. Meanwhile, public health authorities like the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) and their Canadian counterparts are doubling down on their recommendations to avoid raw milk. One need only read some headlines to grasp the scale and flavour of the debate: “How milk became the new culture war dividing America” (the Telegraph), “How Raw Milk Went from Hippie to MAGA” (New York Magazine), “Raw Milk Is Booming. A Salmonella Outbreak Highlights Its Risks” (the New York Times), “Why Is Social Media Telling Us It’s OK to Drink Raw Milk?” (Food & Wine) “Raw Milk: The Influencer Wellness Fad with a Side of Bird Flu,” (Business of Fashion).Here in Canada, groups like Canadian Artisan Dairy Alliance (CADA), Ontario Alliance for Raw Milk and Raw Milk Alberta (the latter having doubled its membership over the last year to more than 9,000 on Facebook alone), are vocal advocates for the consumption and legalization of raw milk sales.While the sale of raw milk is restricted or illegal in certain U.S. states and in Scotland, Canada stands out as the only G7 nation that entirely bans its private sale and distribution. Canadian public health authorities strongly discourage its consumption, citing serious food safety concerns, particularly the potential presence of dangerous pathogens such as salmonella, E. coli, and listeria. Nonetheless, some Canadians legally buy raw milk sold in border states that allow it or buy it illegally from Canadian farms. Dr. Allison McGeer, an infectious disease specialist at Sinai Health in Toronto, is vocal on the dangers of raw milk consumption, emphasizing that pasteurization is essential for preventing serious illnesses like salmonella, E. coli, avian flu, brucella, campylobacter and listeria.“There have always been people in favour of raw milk, claiming it tastes better or is nutritionally superior,” she said in an interview with the Medical Post. “And now with social media and people like Robert Kennedy, it doesn’t help.” Read: Cats can get sick with bird flu. Here’s how to protect themA 2023 commentary by the Public Health Agency of Canada reported 263 confirmed cases of intestinal and zoonotic illnesses linked to raw milk consumption in Canada between 2005 and 2013, along with seven outbreaks recorded between 1998 and 2021. “This number is likely an underestimate, as the vast majority of enteric illnesses often do not present to healthcare or are tested to a confirmatory extent; literature has identified that there may be nearly 25 times the number of unreported cases of illness as compared to confirmed cases. . . . unpasteurized dairy products cause 840 times more illnesses and 45 times more hospitalizations than pasteurized products, making raw milk a dangerous food,” it noted. The report also found 3.6% of Canadians surveyed had drunk raw milk in the previous seven days. Meanwhile, a January 2025 Canadian study published in Food Microbiology confirms that pasteurization inactivates HPAI (H5N1) in milk and that pasteurized milk does not pose a food safety risk related to the virus.Bigger concern: E. coliBut H5N1 is not our biggest concern, says Dr. McGeer, who is also a professor in the departments of laboratory medicine and pathobiology and public health sciences at the University of Toronto. “So far, we don't have cattle infections in Canada that we've detected, and cattle don’t move much across the (U.S.) border, and so avian flu is not the primary reason for not drinking raw milk at the moment.”Top of her list of her concerns is E. coli O157:H7, sometimes called Shiga toxin-producing Escherichia coli (STEC) and related strains, which can occur in raw milk and is particularly dangerous for children. Read: Bird flu virus was found in raw milk. What to know about the risksSTEC is often the most virulent and can cause hemolytic uremic syndrome, which affects the kidneys and the ability of blood to clot. It is what sickened hundreds and sent 38 children and one adult to hospital due to an outbreak at a Calgary daycare in late 2023.Animals, including dairy cows, and people can be carriers of E. coli without showing signs of illness, notes Dr. McGeer. “E. coli is colonized in cattle. It doesn’t make them sick, but it gets into raw milk, and pasteurization is needed to eradicate it.”“The problem with unpasteurized milk is firstly that it's frequently not me that's at risk, it's children. Adults who have an E. coli infection can infect others for up to a week. However, in some cases, children can infect others for up to three weeks.”Read: How E. coli got in daycare meat loaf, sickening hundreds, may never be known: reportHealth benefitsWhile proponents of raw milk claim it offers numerous health and nutritional advantages, including improved digestion, lower inflammation, higher levels of beneficial nutrients and enzymes and potential protection against conditions like asthma, allergies and eczema, Dr. McGeer says the risks far outweigh any potential benefits, which have yet to be proven anyway.“It's still a really significant risk, which is why we recommend against it. That E. coli daycare outbreak in Calgary didn't happen because people were terminally incompetent or not caring about children. It happened because you can get into trouble with these organisms if you're not more careful than you think you need to be.”Dr. McGeer suggests practitioners remind patients who consume raw milk or want to that people have become seriously ill and died by its consumption. Even if the risk is remote, pasteurization is a key safeguard, like stoplights or wearing a seatbelt.“It’s important to remember and remind patients that our public health workforce is under-resourced and under-paid. The only reason they do what they do and provide recommendations is because they care about public health. So, you should listen.”

Raw milk is having a moment. Here are the risks patients should understand

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