November 22, 2009

Milk 2

In most of the First World, people have enough sense to appreciate the disease-prevention aspects of modern hygiene.  In most of the third world, parents sacrifice in ways we can’t imagine to get a hold of basic survival needs of their children, like clean water and pasteurized milk.

When I lived in Utah, I met people who actually believed that treatment of municipal water was, in fact, some sort of technique by which our government was trying to control its noncompliant population.  Before I moved to Utah, I thought this was a creative device sprung fully-formed from the creative genius of Stanley Kubrick and Peter George, who wrote Dr. Strangelove.  I thought I had been transported to a scene from this classic cold-war movie, in the early 1960’s.  Now that I think about it, there were a lot of things about Utah that made me feel that way.

I was asked to write a letter saying that there was a medical reason that a preschooler should not be compelled to drink raw milk.  And, in this case, raw cow colostrum.  Apparently, the raw milk just wasn’t raw enough.  Though I’ve been here in Berkeley for more than a decade, I had never heard of people drinking raw milk or giving it purposely to their children.  So I don’t know how relevant these two posts on the topic will be for normal people who live in normal places and make normal decisions.

A comment came to the previous post inquiring about the accusation that pasteurization kills the good bacteria along with the bad in milk, and doesn’t that leave us without an important source of crucial digestive flora?  I thought about how to answer this question, besides the obvious fact that very few kids drink raw milk, lots—thousands of times as many—kids drink pasteurized milk, and all those kids don’t have serious problems with their digestive ecosystems.  But I have another way to look at it.

It’s hard to study babies.  Most parents don’t want scientists messing around with their babies, and I’m not sure it’s ethical to be poking and hurting babies for the fulfillment of scientific curiosity.  But there’s one kind of study that usually flies through every committee and review board designed to protect patients from the voracious appetites of modern science.  The poop study.  Baby poop is plentiful, easily collected, doesn’t hurt the baby and is a more renewable resource than the greenest, fair-tradiest most organic product available.  When the supply in the lab runs low, it’s not that difficult to find more.  Just about everything about this miracle material that can be studied has been studied.

Meconium, the black tarry stuff that emerges shortly after the baby emerges, is sterile.  It’s what remains of the cells that have developed into the hoses and culverts of the baby’s digestive system.  Within 48 hours of birth, every gram of the fresh stuff (every 1/30th of an ounce) has about 1,000,000,000 bacteria.  Can you imagine how crowded it is down there after a year?  Yet, somehow, all of this population explosion happens without a drop of cow’s milk, raw or otherwise.  So how essential is it?

I was told that the good bacteria in raw milk act to fight off the bad bacteria, so pasteurization actually increases the risk of getting bad bacteria.  It was hard to understand this.  But it shows a serious weakness in critical thinking.  Let’s say that it works just like they say:  good bacteria keep the counts of disease-causing bacteria relatively low.  So how is this more effective than giving your kids the kind of milk with no bacteria?  How is hoping—assuming—that the dose of deadly infectious bacteria in the raw milk you’re serving won’t be high enough to kill your child better than giving your kid the kind of milk with no bacteria?  And what about the argument that if the cow is not a feedlot cow, and is raised in a relatively pristine environment, that raw milk can be the cleanest milk available?  A few such careful families decided to pool their resources and together buy a diary cow on a farm in Washington.  In 2005, after 4 cases of potentially lethal O157:H7 E. coli were found, an investigation found a total of 18 cases.  157 people were interviewed in the investigation, but nobody became ill who didn’t drink raw milk.  17 of the 18 affected people were either part of the cow-share or children of those families.  One child was a friend who had visited and was given raw milk.  Though the age range of those affected was 1-47 years old, the median age was 9.  All of the people hospitalized were 1-13 years old.  It’s not hard to figure out why.  Of those who drank 0-1 cup of milk a day, 4% got sick.  1-2 cups a day, 7% got sick.  Of those drinking 3 cups a day, 38% got sick.  Four people in this group got Hemolytic Uremic Syndrome, in which the kidneys shut down.  It’s not something you want your child to get.

In Pennsylvania in 2007, it was Salmonella Typhimurium from raw milk at a farm stand.  Sure, most people merely get extremely ill from it.  But the case-fatality rate (yes, that’s what it means) can be 5-10% in newborns or the elderly.

What if the raw milk is “certified?”  It was easy to find reports of infection from this unregulated definition.  In an outbreak in Germany, consumption of raw milk was the only food risk factor for children under 3.

And what about lactose intolerance?  Since both pasteurized and unpasteurized milk contains lactose, there’s no advantage there.  The enzyme needed to digest it, lactase, is more active in some people than others.  For the lactose-intolerant, who have low levels of lactase, drinking raw milk (which has just as much lactose as pasteurized milk) is not likely to be an improvement.

Giving young children raw milk is dangerous.  There are lots of websites with all kinds of testimonials to its benefits.  I looked for studies confirming some or any of the alleged benefits of drinking it, and found only reports of disease and death.

 The next time somebody suggests you give your child raw milk, ask them why, and then ask how they really know that it does what they claim. 

The magnificent photograph at top is by the late Harold Edgerton, a professor at MIT and inventor of the strobe light.  He discovered ways the world worked that we never had any idea about.

1 comment:

Please let me know what you think. Do you know a child or situation like this?