Raw milk. In the past month, no two words have caused more controversy on Simple, Good and Tasty than these. In the wake of an E.coli outbreak that's been linked to raw milk from a small, Minnesota dairy farm, we have seen our readers line up in two distinct camps: those who can’t understand why anyone would risk drinking raw milk, and those who can’t understand why anyone would drink anything else.
I wanted to broaden the debate, to take it beyond the local story about the Hartmann Dairy farm, its customers, and the Minnesota Departments of Health and Agriculture. I wanted to know more about raw milk from the people who are considered the experts: so I e-mailed Bill Marler and David Gumpert.
Bill Marler was profiled here on SGT back in December. He’s the country’s most renowned attorney representing victims of food poisoning. We got to know Bill while covering the the story of Stephanie Smith, the young, Minnesota woman who became paralyzed after eating a Cargill hamburger laced with E.coli; Marler was her attorney. Marler is a bit of a paradox; he’s an avid supporter of local/organic/sustainably produced food, but warns locavores that the halo-effect of small farms does not protect them from food-borne illnesses.
David Gumpert is a journalist and writer who has become the standard bearer in the raw-milk movement. His book The Raw Milk Revolution: Behind America’s Emerging Battle Over Food Rights, and his blog, The Complete Patient, represent the most well-informed thinking among a growing group of raw-milk advocates. Gumpert has written articles about raw milk for Huffington Post, Grist, Business Week, Food Safety News, The Nation, and Boston Globe.
I asked both men if they would participate in an e-mail debate about raw milk. They agreed. So I started by e-mailing them the same five questions (see below). When I received their answers, I let them read what the other had written and then write a response. At that point, we exchanged e-mails again, and they got one more turn to counter each other. What follows is mostly their exact words; almost all of them. A minor amount of editing was done for clarity and space, but about 95 percent of their digital conversation is intact. Most of the hyperlinks were inserted by them; a few, again for clarification purposes, are mine.
SGT: Question 1
Why are so many people – do either of you have an estimated number? – willing to ignore the well-publicized risks associated with drinking raw milk?
I’ve seen estimates of between 0.2 and 4 percent of Americans consuming raw milk. No one knows because America’s public health and agriculture establishment – the FDA, CDC, USDA – don’t want us to know, since they strongly disapprove of people consuming raw milk. But the number seems to be increasing.
The fact that so many people are willing to ignore the well-publicized risks you mention is testimony to the loss of credibility of our public health institutions and agriculture establishment. I know when I first read warnings from the FDA about raw milk back in 2005, I didn’t even know people still drank unpasteurized milk. But I’d seen enough examples of FDA screw-ups in approving drugs that later caused illnesses and serious side effects, and in going after small food producers that weren’t creating problems, that my reaction to the raw milk warnings was cynical, as in: If the FDA says it’s bad, well, raw milk must be good.
Growing numbers of other people apparently have the same reaction. I’ve had several producers of raw milk in New York state, who have been temporarily shut down by claims of listeria in their milk – even though there haven’t been any listeria outbreaks – tell me that the shutdowns generate many inquiries from potential raw milk drinkers. That’s a strange way to market your product: state agriculture or public health officials issue warnings about it, and business bumps up. But that’s the sad state of government credibility related to food and health.
This growing interest is really testimony to the perceived health benefits of raw milk. A major study of nearly 15,000 children in Europe a few years ago indicated that children who drank raw milk had lower rates of allergies and asthma than children who didn’t. And I’ve met dozens of raw milk consumers who can’t stop talking about how raw milk has eliminated their problems with lactose intolerance, or reduced their children’s throat and ear infections. In addition, nearly everyone who drinks raw milk says it tastes much better than the pasteurized variety.
First, I’m not sure the risks associated with drinking raw milk are well publicized. Many people who have been sickened by bacteria in raw milk had no idea how dangerous it could be. And many people who become ill do not come forward for fear of harming their source or because of embarrassment for allowing their child to consume the product.
Bugs that exist today are nasty. When John Boy milked the Walton’s cow, I bet that E. coli O157:H7 was never a concern. Personally, I can’t imagine ignoring that kind of risk and giving it to my family, so I have to believe that there is such a strong pull away from our highly processed, widely distributed, and heavily marketed food chain that even when someone has heard about potential dangers of raw milk, the information is seen as untrustworthy.
As stories emerge about dangerous chemicals in our foods (BPA, for example), it might seem the smart move to go as close as possible to the source of the food, so that you get it right from the udder, and don’t give big business a chance to mess with it, or mess it up. They’re hearing from the farmer/seller that outbreaks happen when someone isn’t careful, and that this farmer/seller is so careful that it will never happen to their product. But my experience is that it does, even to very, very conscientious producers.
Second, a lot of the information that people find online has to do with raw milk helping conditions that medicine has no cure for – asthma, eczema, and rheumatoid arthritis. People who are suffering from these diseases – or whose children are suffering from them – are desperate for help. When they read that raw milk might make a difference, it might seem worth a try – unless the dangers are clearly spelled out. That’s why I contributed to the public-private partnership that created the website Real Milk Facts so that people could evaluate the risks and possible benefits, and make an informed choice.
Here’s what I think about Bill’s claims that “the bugs that exist today are nasty.” Yes, they are (though nowhere near as nasty as those like typhoid and tuberculosis that got into milk and other foods in the late 1800s and early 1900s). But the important point to keep in mind is that these bugs can infect people via all kinds of foods. We’ve seen many outbreaks affecting ground beef, leafy green veggies, and fast food, not to mention peanut butter and pistachios. So people are coming to understand that there are risks of pathogens associated with nearly all foods. When it comes to raw milk, increasing numbers of people are deciding that it’s worth taking the risk to gain the health benefits perceived to be in raw milk. In our free and open society, we allow people to make all kinds of decisions about engaging in activities that are risky, from rock climbing to riding motorcycles to eating heavily salted and sugary foods to taking prescription drugs with often-serious side effects. Why should we treat raw milk so differently?
SGT: Question #2
What is the biggest misconception about raw milk? What is the biggest misconception about pasteurized milk?
For raw milk, the biggest misconception is that it is inherently unsafe, that there’s no way it can be produced safely. This stems from the large-scale illnesses that developed from raw milk in the late nineteenth and early twentieth centuries, when milk was often watered down, produced from sick animals, and without knowledge of the importance of sanitation and refrigeration.
For pasteurized milk, the biggest misconception is that you can’t get sick from it. You can, and we’ve had outbreaks affecting tens of thousands, even hundreds of thousands of people within the last 25 years; I describe a number of these outbreaks in my book The Raw Milk Revolution: Behind America’s Emerging Battle Over Food Rights. Such outbreaks don’t happen very often – they are invariably the result of after-processing contamination – but when they do, they are big problems, since pasteurized milk is distributed so widely.
For raw milk, the biggest misconception is just how risky consumption is, particularly for the populations especially at risk: infants, children, pregnant women, and the immune-compromised. When raw milk advocates tout the relatively small number of illnesses or deaths associated with raw dairy products, they ignore one of the most basic tenets of statistics: the denominator, e.g. how few people are exposed. In spite of the fact that less then one/half of one percent of all fluid milk consumed in the country is consumed unpasteurized, raw dairy products account for more than twice the number of outbreaks.
I would hope that people would weigh what could happen if they or their child got seriously ill with E. coli, Campylobacter or Salmonella, which are just some of the bugs that can be present in unpasteurized milk. For pasteurized milk, few people understand the just how regulated the product is. Take a look at the bible of milk safety regulation, the Pasteurized Milk Ordinance.
Raw milk opponents often raise the scary image of children becoming ill from raw milk. Children become ill, as well, from other foods that contain the pathogens Bill mentions. I’ve met many parents, including medical professionals, who regularly feed their children raw milk and are convinced their children’s health benefits. Now, granted, the stories about improved health are seen as “anecdotal” by the scientific community, but I’ve met enough of these people (and devote a chapter to their experiences in my book that I have come to respect and take seriously such experiences.
SGT: Question #3
The sale of raw milk for human consumption is illegal in 22 states; 19 states – including Minnesota – only allow raw milk to be sold at the farm directly to the consumer. What do State agricultural and health departments fear most about raw milk?
There are two fundamental schools of thought about raw milk at the state agriculture and health department levels. The one that tends to prevail in the states where raw milk is illegal is that raw milk is by its nature unsafe – end of argument. The second school of thought, prevalent in the states that allow raw milk, is that raw milk can be produced safely, with attention to proper sanitation and animal health. However, sometimes in states that allow raw milk, there is a difference of opinion between the agriculture and health departments. As one example, in Massachusetts, which allows on-farm sales of raw milk, the Department of Public Health has been pushing the Department of Agricultural Resources to clamp down on delivery services that bring raw milk from farms to consumers in cities. In May, the public health commissioner, in a letter, told the agriculture commissioner “in an ideal world we would prefer that all milk sold in Massachusetts be pasteurized...”
State agricultural and health departments are charged with preventing food-borne disease and the people in those departments take their responsibility seriously and very personally. For many their work is a calling, a job they are proud of. These professionals really do want to prevent the next child with kidney failure or the young woman with paralysis, like Stephanie Smith.
On a larger scale these agencies also worry that unregulated or under-regulated raw milk consumption will increase exponentially (exploding with the fervor in which Americans always embrace the next fad). This could lead to outbreaks, illnesses and deaths from raw milk, the likes of which we haven’t seen since the first half of the last century, when it is estimated that 25 percent of all food borne illness was associated with the consumption of raw dairy products.
From the regulators’ point of view this is not a freedom of choice issue, anyone can milk a cow or goat and drink the milk; it is about people making money ($10 to $16 per gallon in California) by selling a dangerous product. Regulators’ mindsets typically follow that dangerous or potentially dangerous products (like alcohol or cigarettes) should be regulated, and the dangers well publicized.
Bill is repeating what should be labeled as regulator hysteria that growing raw milk consumption “could lead to outbreaks, illnesses and deaths from raw milk, the likes of which we haven’t seen since the first half of the last century.” We are today talking about some dozens of people becoming mostly mildly ill versus many thousands who became seriously ill or died in the early 1900s; there hasn’t been a death from raw milk in at least 25 years. (The two deaths attributed to raw milk by the CDC actually resulted from so-called “bathtub cheese,” which most raw milk advocates avoid, since it’s often made from milk intended for pasteurization.)
The established dairy industry, with an estimated $140 billion in annual revenues, also likes to paint such a picture, since the dairy industry is increasingly coming to fear raw milk as a competitive threat. (Remember, each one percent of market share grabbed by raw milk is equal to $1.4 billion.)
In addition, to suggest that dairies producing raw milk are “about people making money … by selling a dangerous product” is unfortunate. The farmers I’ve met who sell raw milk are extremely dedicated and personally committed to producing a high-quality product they know improves the health of many of their customers. Yes, raw milk usually costs more than conventional milk, but that is because dairy farmers take special care in the feeding of their cows and the milking methods they use. And higher prices for their product enable raw-milk-producing dairies to become economically sustainable – something that is nearly impossible for small dairies that produce milk for conventional processors. We’ve lost 88 percent of our dairies over the last 40 years; let’s not be so quick to condemn the small ones trying to survive to the junk heap.
SGT: Question #4
If people are so intent on drinking raw milk, are there ways it can be made safer?
When you think about it, hundreds of thousands of people drink raw milk every day, without problems. The U.S. Centers for Disease Control, in a report made available in 2008 to the Farm-to-Consumer Legal Defense Fund (in response to a Freedom-of-Information Act request), showed an average of 54 reported illnesses from raw milk during the 33-year period between 1973 and 2005. That’s not a major public health problem by any stretch of the imagination.
There has been a spike in illnesses attributed to raw milk in the last year, but it’s still nowhere near a serious problem. But the spike points up the need for constant vigilance by producers of raw milk and other raw dairy products. There needs to be a focus on modern sanitation: availability of running water, careful cleanup of equipment, sanitary barn conditions. Keeping a closed herd – that is, not picking up cows at farm auctions that may have been exposed via feedlots to pathogens like E.coli 0157:H7 and campylobacter – seems important. Also, feeding the cows on pasture and hay, and avoiding a lot of grains, may well help reduce the incidence of pathogens.
There have been at least nine outbreaks since January 2010. Although I do believe that there are farmers that try and produce a safe product, there are other producers who seem to both shun all government regulation and have very little interest in the science of bacterial and viral pathogens that inhabit cattle feces – even those of grass-fed cows. If raw milk if going to be produced and people do not simply want to buy their own animal, and in lieu of banning raw milk products, some states have adopted regulations that attempt to protect public health and allow for consumer choice. Here is what I would suggest:
1. Raw milk should be sold only on farms that are certified by the state and inspected and tested regularly. Make ambiguous black market milk/cheese sales and "pet food sales" meant for human consumption clearly illegal.
2. Raw milk should not be sold in grocery stores or across state lines – the risks of mass production and transportation are too great. The risk of a casual purchase by someone who misunderstands the risks is too great, as well.
3. Farms should be required to have insurance coverage sufficient to cover reasonable damages to their customers.
4. Practices such as outsourcing (buying raw milk from farms not licensed for raw milk production) should be illegal.
5. Colostrum should be regulated as a dairy product, not a nutritional supplement.
6. Warning signs on the bottles and at point-of-purchase should be mandatory. An example: "WARNING: This product has not been pasteurized and may contain harmful bacteria (not limited to E. coli O157:H7, Campylobacter, Listeria and Salmonella). Pregnant women, infants, children, the elderly, and persons with lowered resistance to disease (immune compromised) have the highest risk of harm, which includes diarrhea, vomiting, fever, dehydration, Hemolytic Uremic Syndrome, Guillain-Barre Syndrome, Reactive Arthritis, Irritable Bowel Syndrome, miscarriage, or death, from use of this product."
Bill’s suggestions for regulating raw milk – particularly about outsourcing and warning signs – are a good start at coming up with a consistent approach. I disagree with his first two points about requiring sales from farms and not allowing retail sales, since it’s impractical to require consumers to travel sometimes an hour or more each way to a farm to buy milk. Raw milk is being safely transported all over California, a huge state, and sold in retail stores to thousands of customers every day. Same thing in Maine, Pennsylvania and Connecticut. Let’s be realistic and treat raw milk like any other food, and let the marketplace determine whether it might be sold across state lines or in retail stores. Most consumers of raw milk today are highly informed and educated, and my guess is they will mostly prefer to buy their milk from smaller local producers in any event.
SGT: Question #5
Would broader legalization of raw milk be good for the local food movement?
It would. First and foremost, it would be good for local economies by keeping more revenues in local communities. Consider this: Farmers selling milk for pasteurization receive between $1 and $1.50 a gallon, and lose money at that rate. They have to cut back on all spending. Farmers who sell milk unpasteurized get $5 to $10 a gallon, and then spend those revenues in their communities, on tractors, vet services, new clothes or painting their houses. Everyone wins.
A 2009 study by the Massachusetts chapter of the Northeast Organic Farming Association (NOFA/Mass.) found that not only has the number of Massachusetts raw-milk dairies increased sharply (from 10 in 2006 to 27 today), but that the revenues generated by the dairies tends to remain in local communities, since the milk is sold directly to consumers, without the economic spillage to out-of-state corporations like Dean Foods inherent in conventional distribution and retailing models.
Keep in mind as well that milk sales keep people coming back for other foods, since milk supplies have to be replenished every week or two. When consumers return to a farm or farmers’ market for their milk, they buy other things as well – meat, eggs, veggies, cheese. Once again, everyone wins because people are buying more locally produced food, and encouraging expansion of the local food movement.
Wider availability of raw milk would also be much more equitable than our current system, which penalizes people according to where they live. There’s something wrong with a system in which people who live in California or Connecticut can go out to a local grocery store and purchase all the raw milk they want, and those who live in Florida or Georgia or Maryland can’t.
If legalization of raw milk proceeds the way it is now, in a state-by-state process that produces wildly different rules in different areas and a largely unregulated product, I think we’ll see a lot more outbreaks, sicknesses, even deaths. Then people who have put their trust in raw, unprocessed foods will take a hard look not only at raw milk, but at other local products as well. More outbreaks could drive the raw milk movement underground, which would only mean more illnesses. If a national regulation is put into place, and information about the dangers associated with raw milk is widely disseminated, perhaps we can avoid all those sick kids. I certainly hope so.
I think the scary scenario Bill portrays could be avoided by having more involvement by agriculture and public health regulators in working with small dairies to ensure safe production. For example, there could be extension courses and seminars for farmers on “best practices” for producing safe and high-quality raw milk. Let’s try cooperation and education instead of the hostility and arrogance that have characterized regulator behavior toward raw milk.
David’s responses seem reasonable to me – sideswipes at Public Health aside. I think we just both come at the issue from differing perspectives. David sees the low risk, in part, thankfully, because he has not seen the devastation of these illnesses first hand. I see the illnesses all too well and all too often – not all from raw milk.
So, where to find common ground? There have been nearly 10 recalls and less outbreaks related to raw milk since January. As demand increases and more folks have access to it, those numbers may well rise, if there is not some type of movement (governmentally or privately) to clamp down on producers who take short cuts. This is true for raw milk as it is in the broader context of food safety. As people see profits to be made, many times their focus becomes making a buck – not keeping their product safe. I think David is right, there are probably raw milk producers that are doing a great job that we never hear about – because they do not sicken anyone. The raw milk movement needs to move away from the anti-government, anti-science rhetoric (the “teat” party) and embrace that the risks are real and should not be denied or ignored.
I appreciate Bill's concerns about possible increases in illnesses, and think the emerging raw milk industry needs to take this bull by the horns. I'd like to see a raw dairy association established that would set and enforce safety and health standards, much like what now exists in the leafy greens and other food areas. Members who abide by the standards would get to say so on their milk labels. I hope such an association would be part of a movement toward greater cooperation among producers and government regulators, to move past the suspicion and even hostility that has been a hallmark of recent years.