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The following resources describe federal laws on the interstate sale and distribution of raw milk.

• • Federal regulation prohibiting the interstate sale of unpasteurized milk.

• • Federal regulation for the standardization of milk and cream in interstate commerce, defining "milk" as "the lacteal secretion" from cows.
  • Requires that milk be pasteurized and contain certain percentages of milk solids and milkfat.
    

• • Model ordinance establishing minimum standards and requirements for the production, processing, packaging, and sale of milk products.
  • Section 9 requires that only pasteurized milk shall be sold to consumers.

The following resources summarize state laws on the intrastate sale and distribution of raw milk.

• Map of State Laws Related to the Sale of Raw Milk, Public Health Law Program, Centers for Disease Control and Prevention (2019)
  • Presents a map of state laws governing the sale of unpasteurized milk to consumers as of 2019.
  • Indicates changes to state laws expanding or restricting access to unpasteurized milk from 2012 through 2018.
• Legal Status of the Sale of Raw Milk and Outbreaks Linked to Raw Milk, by State, 2013–2018, Centers for Disease Control and Prevention
  • Provides a map of the 50 states coded by type of state raw milk law and number of outbreaks, a resource of obÌåÓý's Raw Milk website.
• , National Conference of State Legislatures (2016)
  • Categorizes state raw milk laws based on legality of sale or distribution for different sites or modes (e.g., retail stores, on the farm, through cow share programs).
  • Links to an undated state-by-state summary of raw milk laws.

• , National Association of State Departments of Agriculture (NASDA) (2011)
  • Summarizes data collected by NASDA on the regulation and sale of raw milk in 50 participating states.

The following articles give historical background and policy analyses of raw milk laws, including legal challenges to and theories of recovery under those laws.

• , Cohen M. American Journal of Comparative Law 2017;65:469–526.
  • Provides historical background on the regulation of milk in the United States and France.

• , Zylberberg D. Georgetown Law Journal 2016;104:1377–403.
  • Discusses the effect of food ideologies and movements on government regulation, as well as governmental influences on the industrialization of milk.

• , Wiseman SR. Seattle University Law Review 2015;38:1299–315.
  • Discusses the argument that the right to choose the food one eats, even if the government deems a food unsafe, is a fundamental right under the Constitution.

• , David SD. Public Health Reports 2014;129(5):455–7.
  • Considers the outcomes of potential First Amendment challenges to 1) restrictions on raw milk advertising and 2) mandated warning labels identifying the risks of raw milk.

• , (Subscription required; link to abstract provided.), Hodge JG & Scanlon M. Annals of Health Law 2014;23:20–41.
  • Analyzes government product bans to protect consumer safety and devises a framework of essential elements to support passage (and prevent reversal) of product bans intended to protect the public's health.
  • Mentions raw milk among examples of bans on consumable products.

• , David SD. Public Health Reports 2012;127(6):598–601.
  • Explains federal laws governing the sale of raw milk and reviews two federal cases involving raw milk (i.e., Farm-to-Consumer Legal Defense Fund v. Sebelius (action challenging constitutionality of federal interstate ban), US v. Allger (action by FDA against Pennsylvania farmer engaged in interstate sale and cow share program).

• , Adams DC, Olexa MT, Owens TL, et al. Drake Journal of Agricultural Law 2008;13(2):305–46.
  • Provides a detailed examination of raw milk and the laws governing it.
  • Discusses legal theories for recovery of damages by persons sickened by raw milk (e.g., negligence, products liability, breach of warranty).

• , Coit M. Journal of Food Law & Policy 2008;4:45–70.
  • Examines federal and state raw milk laws, among other laws, in the context of consumer demand for locally-produced food.
  • Examines Colorado's law exempting cow share programs from state pasteurization requirements.

• , Weisbecker A. Journal of Environmental Health 2007;69(8):62–3.
  • Provides a brief history of the development of local, state, and federal laws governing the sale of raw milk from the early 1900s to 2006.
  • Focuses on FDA activity leading up to the FDA 1987 prohibition of the interstate sale of raw milk.

obÌåÓý defines a foodborne disease outbreak as “an incident in which two or more persons experience a similar illness after ingestion of a common food, and epidemiologic analysis implicates the food as the source of the illness.”M The resources below describe some of the outbreaks associated with raw milk reported from 2010 to present.

• , Burakoff A, Brown K, Knutsen J, et al. MMWR Morbidity and Mortality Weekly Report 2018;67(5):146–148.
  • Describes an outbreak of 12 confirmed and 5 probable cases of Campylobacter infections associated with milk from a single herdshare dairy.
  • Highlights risks of raw milk consumption by herd share members and difficulties encountered by local public health officials trying to contain herdshare outbreaks.
• , Costard S, Espejo L, Groenendaal H, et al. Emerging Infectious Diseases 2017;23(6):957–64.
  • Estimates outbreak-related illnesses from contaminated dairy products.
  • Finds that "unpasteurized milk, consumed by only 3.2% of the population, and cheese, consumed by only 1.6% of the population, caused 96% of the illnesses caused by contaminated dairy products."
• Campylobacter jejuni infections associated with raw milk consumption—Utah, 2014, Davis KR, Dunn AC, Burnett C, et al. MMWR Morbidity and Mortality Weekly Report 2016;65(12):301–5.
  • Reviews a 2014 outbreak of campylobacteriosis in three patients who had consumed raw milk from a dairy in Utah, where raw milk sales from the farm are legal.
  • Notes that raw milk from the dairy had passed state testing requirements prior to outbreak.
• , Mungai EA, Behravesh CB, Gould LH. Emerging Infectious Diseases 2015;21(1):119–22.
  • Finds that the number of outbreaks associated with raw milk increased over the 6-year period from 2007 to 2012, paralleling increased legal availability of raw milk for human consumption.
  • Finds that 81% of outbreaks were reported in states where sale of raw milk was legal.
• , Castrodale LJ, Gerlach RF, Xavier CM, et al. Journal of Food Protection 2013;76(5):744–7.
  • Analyzes outbreak of four Campylobacter cases related to milk obtained from a cow share program.
  • Discusses the importance of timely notification of those at risk.
• , Centers for Disease Control and Prevention. MMWR Morbidity and Mortality Weekly Report 2013;62(34):702.
  • Identifies six confirmed and two probable cases of campylobacteriosis in persons who consumed raw milk from a dairy certified to sell raw milk by the Pennsylvania Department of Agriculture.
• , Langer AJ, Ayers T, Grass J, et al. Emerging Infectious Diseases 2012;18(3):385–90.
  • Compares outbreaks from consumption of pasteurized dairy products to those caused by unpasteurized dairy products.
  • Examines the association between outbreaks caused by unpasteurized dairy products and state laws, finding fewer outbreaks in states where sale was restricted.
• , Guh A, Phan Q, Nelson R, et al. Clinical Infectious Diseases 2010;51(12):1411–7.
  • Presents results of a study of an E. coli outbreak associated with raw milk sold from one Connecticut dairy farm store. Of 14 cases, 5 required hospitalization and 3 experienced hemolytic uremic syndrome though the dairy had met all state regulatory standards.
  • Estimates put the combined cost of outbreak investigation and hospitalization expenses of case patients at more than $400,000.

The resources below discuss both emerging concerns and well-established risks associated with drinking raw milk, focusing primarily on risks posed by raw dairy in the United States. Articles assessing comparative risks and benefits are also included under this heading.

• , Koski, L, Kisselburgh, H, Landsman L, et al. Epidemiology & Infection 2022; 150:E183.
  • Presents the results of a study that analyzes the number of outbreaks and outbreak-associated illnesses over time.
  • Compares outbreak numbers in states where the sale of unpasteurized milk is legal to states where it is prohibited.
• , Negrón ME, Kharod GA, Bower WA, et al. MMWR Morbidity and Mortality Weekly Report 2019;68:185.
  • Discusses and characterizes the emerging threat of antibiotic-resistant Brucella abortus RB51 from consumption of raw milk.
  • Attributes the source of RB51 in raw milk to the vaccine used to protect cattle from B. abortus.
• , Sfeir MM. Journal of Medical Microbiology 2018;67:681–2.
  • Highlights the importance of proper diagnosis and treatment of persons infected with Brucella abortus RB51, a potentially life-threatening emerging infection associated with consuming raw milk.
• , Boor KJ, Wiedmann M, Murphy S, et al. Journal of Dairy Science 2017;100:9933–51.
  • Presents a historical analysis of the improvement of milk safety through pasteurization and other microbial controls.
  • Assesses future challenges and underscores need for the dairy industry to implement updated science-based food safety practices to protect public health.
• (Subscription required; link to abstract provided), Christidis T, Pintar KD, Butler AJ, et al. Journal of Food Protection 2016;79(10):1775–83.
  • Estimates the prevalence of Campylobacter spp. in raw milk through a systematic review and meta-analysis of relevant literature.
• , Lucey JA. Nutrition and Food Science 2015;50(4):189–93.
  • Discusses the prevalence of pathogens in raw milk and critically evaluates some suggested benefits.
• , American Academy of Pediatrics. Pediatrics (2014);133(1):175–9.
  • Reviews the risks and suggested benefits of consuming raw milk, especially for pregnant women and children.
  • Endorses a ban on the sale of unpasteurized milk.
• , Davis BJK, Li CX, Nachman KE. Johns Hopkins Bloomberg School of Public Health, Center for a Livable Future, 2014 report.
  • Evaluates scientific literature (1999 to 2014) on the comparative health benefits and risks of raw and pasteurized milk, pursuant to a request from Maryland legislators considering a bill to legalize distribution of raw milk via cow shares.
  • Concludes that known hazards of drinking raw milk outweigh any evidence of potential benefits and advises against legalization.
• , Robinson TJ, Scheftel JM, Smith KE. Emerging Infectious Diseases (2014); 20(1):38–44.
  • Explains how the number of cases from outbreak data significantly underrepresents the total number of persons made ill from pathogens in raw milk.
• , Jay-Russell MT. Clinical Infectious Diseases 2010;51(12):1418–19.
  • Challenges the advocacy of raw milk in a commentary on the Guh et al. study (see Outbreaks section, above) describing the 2008 Connecticut E. coli O157 outbreak.
• , Lejeune JT, Rajala-Schultz PJ. Clinical Infectious Diseases. 2009;48(1):93–100.
  • Discusses pathways and sources of raw milk contamination, methods used to control contamination, and trends in raw milk consumption and associated disease outbreaks in the United States.
  • Counters purported disadvantages of pasteurization and emphasizes that avoiding consumption of raw milk is critical to disease prevention.
• , Oliver SP, Boor KJ, Murphy SC, et al. Foodborne Pathogens and Disease 2009;6:793–806.
  • Reviews literature on the prevalence of pathogens in raw milk in the United States (2000–2009), summarizes outbreak data (2000–2008), and describes state laws allowing sale of raw milk.
  • Argues there is scant data to support contentions of raw milk proponents, while hazards are well established.

Advocates for raw milk emphasize benefits of drinking raw milk related to nutrition, allergies, and lactose intolerance.N While there is some evidence connecting raw milk to the "farm effect"—an association between children growing up on farms and reduced allergies—evidence of other benefits is lacking.O Furthermore, the scientific literature in this area routinely acknowledges that even if raw milk plays a role in, for example, preventing allergies, the risk of serious infection far outweighs possible benefits.P The following resources address potential benefits of raw milk consumption.

• , Sozanska B. Nutrients 2019;11(2):469–80.
  • Reviews the current understanding of the role of raw milk in allergy prevention.
  • Asserts that unique components of raw milk can affect immune function but acknowledges need for additional research to understand protective effect on allergies.
• , Wyss AB, House JS, Hoppin JA, et al. Thorax 2018;73(3):279–82.
  • Reports novel results of a study suggesting an association between improved pulmonary function in adulthood and early-life ingestion of raw milk.
• , Yu JE, Miller RL. Journal of Allergy and Clinical Immunology 2016;137:1701–8.
  • Discusses research on the role of fatty acids and microRNA as potential biological mechanisms for the protective effect of raw milk against allergies and asthma but concludes that present safety concerns warrant consumption of only pasteurized milk.
• , Loss G, Depner M, Ulfman LH, et al. Journal of Allergy and Clinical Immunology 2014;135(1):56–62.
  • Presents results of a study on the effects of raw and pasteurized milk consumption on early infant infections.
  • Finds stronger correlation between raw milk consumption and reduced risk of infant fevers and respiratory infections.
• , Mummah S, Oelrich B, Hope J, et al. Annals of Family Medicine 2014;12(2):134–41.
  • Finds that drinking raw milk did not reduce symptoms of lactose intolerance in adults positive for lactose malabsorption.
  • Notes that evidence of raw milk's positive effects on lactose malabsorption remains anecdotal.
• , Loss G, Apprich S, Waser M, et al. Journal of Allergy and Clinical Immunology 2011;128(4):766–73.
  • Investigates the farm milk effect to determine milk components associated with the apparent protective effect of early-age raw milk consumption on asthma.
  • Finds that whey protein fraction may be responsible.
• , MacDonald LE, Brett J, Kelton D, et al. Journal of Food Protection 2011;74(11):1814–32.
  • Presents the results of a systematic review of published literature on purported benefits of raw milk related to nutrition, cancer, allergies, and lactose intolerance.
  • Concludes that literature supports the beneficial effect of raw milk consumption on allergies but says the effect may have many factors.

Raw milk consumers themselves occasionally have been the subject of studies to determine their characteristics and motivations. The following articles present the results of some raw milk consumer studies.

• (Subscription required; link to abstract provided), Bigouette JP, Bethel JW, Bvbjerg JG, et al. Food Protection Trends 2018;38(2):104–10.
  • Summarizes questionnaire responses from a survey of raw milk consumers to determine perceived benefits from and reasons for drinking raw milk.

• (Subscription required; link to abstract provided), Sillence E, Hardy C, Medeiros LC, et al. Appetite 2016:200–10.
  • Presents the results of research examining how website design and content affect milk consumers' attention to and trust in that content, using websites offering information either for or against the consumption of raw milk.

• , Mullin GE, Belkoff SM. Global Advances in Health & Medicine 2014;3(6):19–24.
  • Examines the health-related motivations of individuals for consuming raw milk, testing a hypothesis that preference for raw milk would be related to lactose maldigestion.

• (Subscription required; linked to abstract provided), Buzby JC, Gould LH, Kendall ME, et al. Journal of Consumer Affairs 2013; 47(1):153–66.
  • Analyzes sociodemographic data from FoodNet Population Surveys (1998–1999, 2002–2003, and 2006–2007) to identify characteristics of raw milk consumers.
• , Headrick ML, Timbo B, Klontz KC, et al. Public Health Reports 1997;112:418–22.
  • Describes patterns of raw milk consumption in California, where the sale of raw milk is legal.
  • Examines demographics of respondents who drank raw milk, and the prevalence of raw milk consumption in California in 1994.