Milk

This week, once again, I have had the privilege of performing a duty only those of us working in the rarefied atmosphere of Berkeley California (and places like it) get to do.  I had to write a note to a preschool principal requesting—insisting, actually—that one of my patients be served only pasteurized milk.

Remember the wax paper containers that we had in elementary school?  It was never clear which side you should open, though it did seem that one side opened easier than the other.  Often enough, for inexplicable reasons, both sides got open and the container, now missing apparently key elements of its structural architecture, would become floppy.  Drinking from it became difficult.  I’m not, just so it’s clear, nostalgic for those little containers.

To most stories, there probably are at least two sides.  The great leaders of history weren’t always the nicest people.  Certainly, along the way, history must have gotten a few of the details wrong, with the result that some of the people we admire were probably not so admirable in real life.  Here’s the thing with really big hit movies, too.  Maybe they didn’t sound so appealing when they were first released.  Maybe you weren’t so impressed when you first saw the movie.  But when not just a few but people from all over the world are seeing the movie and loving it, again and again, it must have something appealing.  So the next time you look through a list of the top 100 movies of all time, maybe you should take a chance and rent the ones you haven’t seen.  I don’t believe that the public at large is usually right about things.  But when great works of art, great people and their discoveries, stand up to the rigorous tests of time and repeated scrutiny, there’s probably a reason.

I’m willing to cut Louis Pasteur some slack.  He’s got a really famous institute named after him, and his tomb is mighty fancy.   That’s not enough.  In the last quarter of the 19th century, New Yorker Jacob Riis wrote about baby ‘farms’ in which some poor adults would, for money, take in babies from families who couldn’t afford to care for them.  The milk they were given wasn’t good, and these caretakers would give them opium to keep them quiet until they died.  This freed up space to take in more babies.  None of this particularly attracted attention, both  because of the poverty of the families involved and the brutal routine nature of this kind of illness.  This was chronicled in How the Other Half Lives, which Riis published in 1890.  In 1891 the infant mortality rate in New York City was 240 per 1000 births.  That’s about 1 in 4.  After a lot of controversy and debate, and after a major typhus epidemic blamed on raw milk, New York started enforcing rules about pasteurization.  Within a few years, the mortality rate for infants had dropped to 71 per 1000, 1 in 14.
The bacterium E. coli is in all of us.  It’s a normal component of our digestive system.  One subspecies of E. coli that has turned to the dark side is called O157:H7.  It’s a bad thing to get, and can make people very sick.  It can kill you.

During a 20-year period, from 1982-2002, about 4% of all O157:H7 cases were from raw milk products and colostrum.   Think about that.  It’s hard to get raw milk in most places.  Much, much less than 4% of the population eats raw milk products.  That means that those who do have a very high risk, compared with the population as a whole, of getting this potentially deadly infection.  Do I need to say that children are particularly vulnerable?
The first time I saw a case of Hemolytic Uremic Syndrome [HUS] I was in training and working in a children’s hospital.  It’s not something you would have seen outside of an intensive care unit.  The 4-year old I watched over was on dialysis and waiting for a kidney transplant.  She got O157:H7, was sick for no more than a couple of days before her kidneys shut down.  Even with the dialysis, without her kidneys working her body found it hard to regulate important functions like blood pressure.  There was no happy ending.

I know this is a pretty dark way to come back to the blog after a week and a half or so.  But this isn’t about disease, infection, Louis Pasteur, poverty, or organic produce.  It’s about parenting.

I believe that every caring parent has the best interests of their child at heart.  But parenting requires the use of a brain, as well.

I asked the parents who requested the letter from me to ask the people at the school why, exactly, it was so important for every child to have raw milk.  They called me and said that they were told it was simply better for the child and that there were a lot of health benefits.  ‘Like what?’ they asked.  Better nutrition they were told.  ‘Really?  More vitamins or what?’  But that was as much as they could get.  This very superficial scratching of the surface of belief revealed a hollow center.

Ask me why your child shouldn’t have raw milk and I’ll tell you what I know, what I’ve seen with my own eyes, what I’ve read a dozen times from independent sources and studies all over the world—it can be lethal.  Now ask that nice person in the mom’s group why it’s worth risking your child’s life.  What precisely are the benefits that are so overwhelming to make up for that?