The AAP said raw dairy products pose the greatest risk to young children and people who are pregnant or breastfeeding.
The organisation has renewed its call for a ban on the sale and distribution of raw milk and dairy products, including raw cheeses, citing the increased risk of life-threatening infections.
It added that claims that raw milk provides superior health benefits are not supported by scientific evidence.
Despite these concerns, the sale and distribution of raw milk products remain legal in at least 27 states across the USA. Raw milk is milk obtained from cows, goats or sheep that has not undergone pasteurization, the process of heating milk to eliminate harmful bacteria and other pathogens.
The policy statement from AAP called “Consumption of Unpasteurized (Raw) Milk and Milk Products by Pregnant People and Children,” gives updated guidance highlighting emerging evidence that H5N1, or highly pathogenic avian influenza, may represent a new and potentially serious risk associated with raw milk.
Research suggests 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.
“Nearly half of illnesses caused by raw dairy consumption occur in people under age 20 and a significant share of those cases are in children under five,” said Adam J. Ratner, MD, MPH, FAAP, lead author.
“These illnesses can be severe and lead to life-threatening complications. Pasteurization, a safe, effective process of heating and cooling milk before consumption that has been used for more than a century, dramatically reduces the risks without taking away the nutritional value families rely on.”
During the 2024 US dairy outbreak, infectious H5N1 virus was detected in nearly one-quarter of raw milk samples in affected areas, the AAP said meaning it “remains a credible, emerging threat.”
Unpasteurized milk is already a well-documented source of serious pathogens including Listeria, E. coli, Salmonella, Campylobacter, and Brucella. These infections can lead to hospitalisation, life-threatening illness, miscarriage, and death, particularly in young children, pregnant people, and those with weakened immune systems.
Those who are pregnant face especially high risks from foodborne infections, the AAP said. The incidence of listeriosis, for example, is estimated to be 12 to 14 times higher during pregnancy than in the general population. Infection can lead to miscarriage, stillbirth, premature delivery or severe illness in newborns.
“Parents may choose raw milk because they have heard it is healthier or more natural, but the scientific evidence tells a different story,” said Mark R. Corkins, MD, FAAP, co-author of the policy statement.
“Pasteurized dairy products provide the same essential nutrients without exposing children and families to preventable infections from dangerous bacteria and viruses. For infants, children and pregnant people, pasteurized dairy products are clearly the safest choice.”
This policy statement updates guidance last provided in 2014 and reaffirmed in 2025.
At the end of 2024 a new federal order in the US Department of Agriculture ordered mandatory testing of raw milk to bolster surveillance of H5N1.