Pediatricians Renew Warning That Raw Milk Carries Serious and Emerging Infection Risks

The American Academy of Pediatrics has issued a renewed and emphatic warning that unpasteurized milk, cheese, and other so-called raw dairy products are unsafe to consume, particularly for young children, pregnant people, and those who are breastfeeding. The updated guidance, published online on October 5, 2026 in the journal Pediatrics and titled “Consumption of Unpasteurized (Raw) Milk and Milk Products by Pregnant People and Children,” updates a policy statement last issued in 2014 and reaffirmed in 2025. Written by the Academy’s Committee on Infectious Diseases and its Committee on Nutrition, the statement reflects a growing body of evidence that raw dairy remains a documented source of severe foodborne illness and may now carry an entirely new threat: highly pathogenic avian influenza, known as H5N1, which research suggests can pass from infected dairy cattle into milk and persist there for weeks.

The Academy did not stop at advising families to avoid raw dairy. It renewed its call for a ban on the sale and distribution of raw milk and raw milk products, including raw cheeses, arguing that their consumption increases the risk of life-threatening infections. The policy statement also directly confronts one of the most persistent marketing claims surrounding raw milk: that it offers superior health benefits compared with pasteurized products. According to the Academy, those claims are not supported by scientific evidence. Pasteurization, a process of heating and then cooling milk that has been in use for more than a century, dramatically reduces the risk of infection without stripping away the nutritional value that families rely on from dairy.

The numbers behind the Academy’s concern are striking. Lead author Adam J. Ratner, MD, MPH, FAAP, noted that nearly half of illnesses caused by raw dairy consumption occur in people under the age of 20, and that a significant share of those cases are in children under 5. These illnesses, he emphasized, can be severe and can lead to life-threatening complications. The vulnerability of young children is not incidental: their immune systems are still developing, their body weight is small relative to the dose of pathogen they may ingest, and complications such as severe dehydration from diarrheal illness or kidney failure from certain strains of E. coli can escalate quickly in pediatric patients.

Unpasteurized milk is a well-documented carrier of some of the most dangerous foodborne pathogens known to medicine. The policy statement lists Listeria, E. coli, Salmonella, Campylobacter, and Brucella among the serious organisms transmitted through raw dairy. Each of these bacteria can cause hospitalization, life-threatening illness, miscarriage, or death, and the risks are concentrated in young children, pregnant people, and individuals with weakened immune systems. Listeria monocytogenes is particularly formidable because it can grow even at refrigerator temperatures, meaning contaminated dairy stored properly in a home kitchen can still become more dangerous over time. Salmonella and Campylobacter are among the most common causes of bacterial gastroenteritis worldwide, while Shiga toxin-producing E. coli can trigger hemolytic uremic syndrome, a condition that destroys red blood cells and can cause kidney failure in children.

Pregnant people face especially high stakes from foodborne infection. The policy statement notes that the incidence of listeriosis is estimated to be 12 to 14 times higher during pregnancy than in the general population, a reflection of the immune changes that pregnancy induces. Listeria infection during pregnancy can result in miscarriage, stillbirth, premature delivery, or severe illness in newborns, outcomes that make even a low probability of contamination unacceptable from a public health standpoint. Because Listeria can cross the placenta, a mother may experience mild or even unnoticed symptoms while the fetus suffers devastating consequences. This asymmetry between maternal illness and fetal harm is a central reason obstetric and pediatric guidelines consistently single out unpasteurized dairy as a food to avoid entirely during pregnancy.

The most consequential update in the new statement concerns H5N1, the highly pathogenic avian influenza virus that has swept through poultry populations globally and, beginning with the 2024 United States dairy cattle outbreak, demonstrated an ability to infect cows. The Academy highlights emerging evidence that H5N1 may represent a new and potentially serious risk associated with raw milk. Research indicates the virus can be transmitted from infected dairy cattle into milk, where it can reach high concentrations and remain detectable in refrigerated raw milk for up to five weeks. That persistence is unusual and troubling: a virus surviving for more than a month in a chilled, nutrient-rich medium has ample opportunity to reach consumers, especially in distribution chains that lack pathogen testing.

During the 2024 U.S. dairy outbreak, infectious H5N1 virus was detected in nearly one-quarter of raw milk samples in affected areas. To date, there are no confirmed human cases of H5N1 infection resulting from the consumption of raw milk, and the Academy is careful to state this. Nevertheless, it characterizes the virus as a credible, emerging threat. The distinction between documented transmission and credible risk is important in virology: influenza viruses are capable of crossing species barriers, and the mammary gland infections observed in dairy cattle established a novel route by which a respiratory pathogen of birds could contaminate a staple food. Pasteurization, which inactivates influenza viruses effectively, closes that route for conventional dairy, but no such barrier exists for raw products.

The regulatory landscape in the United States remains fragmented. Despite the well-documented health risks, the sale and distribution of raw milk products remain legal in at least 27 states. Raw milk is defined as milk obtained from cows, goats, or sheep that has not undergone pasteurization, the heating process designed to eliminate harmful bacteria and other pathogens. Federal law prohibits the interstate sale of raw milk for human consumption, but intrastate sales fall under state jurisdiction, producing a patchwork in which a family’s exposure to raw dairy risk depends largely on geography. The Academy’s renewed call for a ban on sale and distribution is aimed squarely at this patchwork, arguing that voluntary warnings have not eliminated a preventable source of severe illness.

The scientific case for pasteurization rests on both microbiology and nutrition. The process typically involves heating milk to a temperature sufficient to inactivate vegetative bacterial pathogens and enveloped viruses, followed by rapid cooling to slow the growth of any surviving organisms. Decades of comparative studies have found no meaningful nutritional deficit in pasteurized milk relative to raw milk; the proteins, calcium, and vitamins that make dairy a dietary staple survive the treatment essentially intact. What pasteurization removes is the microbial load, including organisms that may be present even in milk from healthy-appearing animals, since udder infections and fecal contamination during milking can introduce pathogens without any visible sign. Co-author Mark R. Corkins, MD, FAAP, addressed the perception gap directly, saying that parents may choose raw milk because they have heard it is healthier or more natural, but that the scientific evidence tells a different story. Pasteurized dairy products, he said, provide the same essential nutrients without exposing children and families to preventable infections from dangerous bacteria and viruses, and for infants, children, and pregnant people they are clearly the safest choice.

The policy statement was developed through the Academy’s standard process, in which statements written by medical experts reflect the latest available evidence and undergo several rounds of peer review before approval by the AAP Board of Directors and publication in Pediatrics. It will be featured during a presentation on October 5 at the AAP 2026 National Conference and Exhibition in San Diego, where Dr. Ratner is scheduled to discuss the policy during a Meet the Red Book session at the San Diego Convention Center. For families navigating conflicting claims about raw dairy, the Academy has also published a consumer-facing resource, “Raw Milk: What Parents Need to Know About the Risk,” through its HealthyChildren.org platform. The core message of the updated guidance is unambiguous: whatever the appeal of raw milk on the shelf, the pathogens it can carry, from Listeria and E. coli to a potentially pandemic-capable influenza virus, are preventable hazards, and pasteurization remains one of the most effective and time-tested public health interventions in the food supply.

Subject of Research: Health risks of unpasteurized (raw) milk and dairy products for children and pregnant people, including emerging H5N1 avian influenza contamination

Article Title: American Academy of Pediatrics warns of dangers in consuming raw milk, dairy products

Article References: American Academy of Pediatrics warns of dangers in consuming raw milk, dairy products. (n.d.). Original publication

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Keywords: raw milk, pasteurization, American Academy of Pediatrics, H5N1 avian influenza, foodborne illness, Listeria, E. coli, Salmonella, pregnancy, children's health, dairy cattle, public health policy