
On October 5, 2026, the American Academy of Pediatrics published a policy statement in Pediatrics calling for a ban on the sale and distribution of raw milk and raw milk products, including raw milk cheeses, and telling pregnant people and children to consume only pasteurized dairy. It arrived while 13 people in nine states, more than half of them five years old or younger, are sick with E. coli O26:H11 from Graziers raw milk cheese made by Sierra Nevada Cheese Company of Willows, California. Eight are hospitalized. Three have hemolytic uremic syndrome. CDC last updated that count on September 25.
The pediatricians renewed a position they first took in 2014 and added bird flu to the list.
The statement, written by Adam J. Ratner, Anne Sardi and Mark R. Corkins for the Academy’s Committee on Infectious Diseases and Committee on Nutrition, replaces the January 2014 policy statement of the same two committees, which the Academy reaffirmed as recently as June 2025. The core has not moved in twelve years: unpasteurized milk and milk products from cows, goats and sheep continue to be a source of Listeria monocytogenes, E. coli O157, Salmonella, Campylobacter and Brucella infections, pasteurization greatly reduces that risk, and the claimed health benefits of raw milk lack evidence. What is new is H5N1. As News-Medical summarized the statement, the Academy notes that during the 2024 dairy cattle outbreak the virus turned up in close to a quarter of raw milk samples tested in affected areas and can stay detectable in refrigerated raw milk for weeks, though no human infection from drinking it has been confirmed. The same summary carries the two numbers that matter most to a parent: nearly half of raw dairy illnesses occur in people under 20, with a significant share in children under five, and listeriosis runs roughly 12 to 14 times more common in pregnancy than in the general population. I could not reach the full text through the journal’s site this morning, so the statistics above rest on the published abstract and on that report rather than on my own reading of every table.
Every risk the pediatricians describe has a name in this year’s outbreak files.
The Academy writes in the language of relative risk. The outbreak pages write in children. In the Graziers outbreak the median age is five, nine of nine people interviewed ate the cheese, and the company recalled every Graziers raw milk product in late September without lot codes because it could not say which batch was contaminated. Three of the thirteen developed HUS, the kidney failure that follows some Shiga toxin infections and that I wrote about on September 26 when the outbreak was announced. Last week ProPublica told the story of two little girls with HUS after raw goat milk from an unlicensed Riverside County dairy. The Academy’s statement does not mention either case. It does not need to. The children it is written for are the same ones.
Four outbreaks in thirty-one months came from cheese that followed the sixty-day rule.
Federal law has allowed raw milk cheese in interstate commerce since 1949 on one condition, found at 21 CFR 1240.61: the cheese must be aged at least sixty days. The Graziers labels read “Aged at least 60 days.” The table below is the record of the last four Shiga toxin E. coli outbreaks in cheese that met that rule, built from the agency pages linked in each row.
| Outbreak | Cheese | Sick | Hospitalized | HUS |
| Raw Farm, February 2024 | Raw cheddar, E. coliO157:H7 | 11 | 5 | 2 |
| Twin Sisters Creamery, October 2025 | Aged raw milk cheese, E. coli O103 and O26 | 10 | 1 | 0 |
| Raw Farm, March 2026 | Raw cheddar, E. coliO157:H7 | 9 | 3 | 1 |
| Sierra Nevada Graziers, September 2026 | Raw milk cheddar and jack, E. coli O26:H11 | 13 | 8 | 3 |
| Total | 43 | 17 | 6 |
Table 1. Shiga toxin-producing E. coli outbreaks in raw milk cheese aged sixty days or more, February 2024 to September 2026. Sources: FDA and CDC outbreak pages and Washington State Department of Health, as linked, read October 6, 2026. Check: 11 + 10 + 9 + 13 = 43 sick; 5 + 1 + 3 + 8 = 17 hospitalized; 2 + 0 + 1 + 3 = 6 HUS.
Forty-three sick, seventeen in the hospital and six with kidney failure is what sixty days of aging bought. FDA knew this was coming. In 2013 it published, with Health Canada, a quantitative risk assessment that put the per-serving listeriosis risk from raw milk soft-ripened cheese at 50 to 160 times that of the pasteurized version, and in August 2015 it opened a docket to reconsider the sixty-day rule. Eleven years later the rule is unchanged and the docket is quiet.
Twenty-seven states allow the sale, and the package says nothing.
The Academy counts at least 27 states that permit raw milk sales in some form. Whatever a state decides about milk, the cheese travels. Graziers went to retailers nationwide and online. FDA’s labeling rule at 21 CFR 101.17requires a warning statement on unpasteurized juice and a safe-handling statement on shell eggs. It requires nothing on cheese made from unpasteurized milk. California’s warning rule exempts cheese aged sixty days, and Washington’s covers milk only. A parent standing at a cheese counter is given the age of the cheese and not the reason the age exists.
A ban and a warning label are not competing answers.
The pediatricians ask legislators for a prohibition. I am asking FDA for a sentence. The citizen petition I published on September 27 asks the agency to require a prescribed warning statement on cheese made from unpasteurized milk, including cut-to-order, imported and online sales, and to finish the sixty-day reevaluation it announced in 2015. The draft petition is online, and because so many of you wrote in, I extended the comment period to October 15 and will file shortly after. The Academy’s statement will go into the record as support, because the two asks rest on the same facts and differ only in who is being asked. Congress and twenty-seven legislatures can debate a ban for years. FDA can put a warning on a label under authority it already uses for juice. A choice made without the material fact is not really a choice, and a label puts the fact where the decision is made.
Here is what a parent can do today without waiting for either of us.
Do not give raw milk or raw milk cheese to a child under five, to anyone who is pregnant, or to anyone with a weakened immune system; that is CDC’s standing advice and now the Academy’s. Treat “aged 60 days” as a legal minimum, not a safety claim. If you have any Graziers raw milk cheese, the recall covers every product in every size with no lot codes, so throw it out. If a child has diarrhea that turns bloody, see a doctor the same day and ask for a stool culture; do not give antidiarrheal medicine, and let the doctor decide about antibiotics, which can raise the risk of HUS in Shiga toxin infections. I have been doing this since 1993, and the family I now represent in the Graziers outbreak did not get that paragraph on the package. The pediatricians and I would both like it there before the next one.









