02/05/2026
Some facts for the pro-raw milk crowd that are up in arms in the comment section of my last post (although most have been deleted because misinformation doesn’t stand on this page)
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Listeria infection during pregnancy can cause serious harm to the baby, including miscarriage, stillbirth, premature birth, and severe newborn infections. Raw (unpasteurized) milk is one of the highest-risk foods for Listeria contamination and should be completely avoided during pregnancy.[1]
Pregnant women are about 13 times more likely than other people to get Listeria infection from contaminated food.[1][2] When a pregnant woman gets infected, the bacteria can spread to the baby, causing devastating consequences that are far more severe than what the mother experiences. Approximately one in five pregnancies with Listeria infection result in miscarriage or stillbirth, and about two-thirds of babies who survive develop serious infections after birth.[1] The overall death rate for babies (either before or after birth) is 29% when the mother has Listeria infection.[1]
Raw milk poses a particularly high risk for Listeria contamination. Studies show that about 3-4% of raw milk samples in the United States contain Listeria bacteria.[3][4] Pasteurization—the process of heating milk to kill harmful bacteria—is highly effective at eliminating Listeria, achieving at least an 11-log reduction (meaning it kills 99.999999999% of the bacteria).[5][6] In contrast, raw milk consumed by only 3.2% of the population causes 96% of all dairy-related outbreak illnesses.[7]
The mother's symptoms are often mild—fever, muscle aches, back pain, and headache, sometimes with diarrhea or stomach upset beforehand.[1] Some infected pregnant women have no symptoms at all.[1] However, the baby can develop severe complications including blood infections (sepsis), brain infections (meningitis), and death.[1]
The American College of Obstetricians and Gynecologists specifically lists raw (unpasteurized) milk as a food pregnant women must avoid.[1] Other high-risk foods include unpasteurized soft cheeses (such as feta, queso blanco, queso fresco, Brie, and blue-veined cheeses), deli meats and hot dogs (unless heated until steaming hot), refrigerated smoked seafood, and unwashed raw produce.[1]
When babies are infected, they can develop two different patterns of illness. Early-onset disease, which occurs in about 70% of infected newborns, typically appears as a blood infection with breathing problems shortly after birth. Late-onset disease, seen in about 6% of cases, presents as a brain infection (meningitis) that develops later.[8] Among infected newborns studied, 70% had abnormal health status at birth, with more than half experiencing acute breathing difficulties.[8]
The timing of treatment makes a critical difference in outcomes. When mothers receive antibiotics at least one day before delivery, their babies have significantly less severe disease.[8] This finding supports starting antibiotic treatment promptly when Listeria infection is suspected during pregnancy, even before test results confirm the diagnosis.
References
1. Management of Pregnant Women With Presumptive Exposure to Listeria monocytogenes. American College of Obstetricians and Gynecologists (2014).
2. Pregnancy Myths and Practical Tips. Caro R, Fast J. American Family Physician. 2020;102(7):420-426.
3. Prevalence of Listeria Monocytogenes, Salmonella Spp., Shiga Toxin-Producing Escherichia Coli, and Campylobacter Spp. In Raw Milk in the United States Between 2000 and 2019: A Systematic Review and Meta-Analysis. Williams EN, Van Doren JM, Leonard CL, Datta AR. Journal of Food Protection. 2023;86(2):100014. doi:10.1016/j.jfp.2022.11.006.
4. Prevalence of Listeria Monocytogenes in Milk and Dairy Product Supply Chains: A Global Systematic Review and Meta-Analysis. Li X, Zheng J, Zhao W, Wu Y. Foodborne Pathogens and Disease. 2024;21(9):526-535. doi:10.1089/fpd.2024.0029.
5. Predictive Modelling of Inactivation of Listeria Spp. In Bovine Milk During High-Temperature Short-Time Pasteurization. Piyasena P, Liou S, McKellar RC. International Journal of Food Microbiology. 1998;39(3):167-73. doi:10.1016/s0168-1605(97)00131-1.
6. Pasteurization of Milk: The Heat Inactivation Kinetics of Milk-Borne Dairy Pathogens Under Commercial-Type Conditions of Turbulent Flow. Pearce LE, Smythe BW, Crawford RA, et al. Journal of Dairy Science. 2012;95(1):20-35. doi:10.3168/jds.2011-4556.
7. Outbreak-Related Disease Burden Associated With Consumption of Unpasteurized Cow's Milk and Cheese, United States, 2009-2014. Costard S, Espejo L, Groenendaal H, Zagmutt FJ. Emerging Infectious Diseases. 2017;23(6):957-964. doi:10.3201/eid2306.151603.
8. Neonatal Listeriosis Presentation and Outcome: A Prospective Study of 189 Cases. Charlier C, Kermorvant-Duchemin E, Perrodeau E, et al. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America. 2022;74(1):8-16. doi:10.1093/cid/ciab337.
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