title: Consumption of unprocessed cow's milk protects infants from common respiratory infections.
abstract: BACKGROUND
  Breast-feeding is protective against respiratory infections in early life. Given the co-evolutionary adaptations of humans and cattle, bovine milk might exert similar anti-infective effects in human infants.
  
  
  OBJECTIVE
  To study effects of consumption of raw and processed cow's milk on common infections in infants.
  
  
  METHODS
  The PASTURE birth cohort followed 983 infants from rural areas in Austria, Finland, France, Germany, and Switzerland, for the first year of life, covering 37,306 person-weeks. Consumption of different types of cow's milk and occurrence of rhinitis, respiratory tract infections, otitis, and fever were assessed by weekly health diaries. C-reactive protein levels were assessed using blood samples taken at 12 months.
  
  
  RESULTS
  When contrasted with ultra-heat treated milk, raw milk consumption was inversely associated with occurrence of rhinitis (adjusted odds ratio from longitudinal models [95% CI]: 0.71 [0.54-0.94]), respiratory tract infections (0.77 [0.59-0.99]), otitis (0.14 [0.05-0.42]), and fever (0.69 [0.47-1.01]). Boiled farm milk showed similar but weaker associations. Industrially processed pasteurized milk was inversely associated with fever. Raw farm milk consumption was inversely associated with C-reactive protein levels at 12 months (geometric means ratio [95% CI]: 0.66 [0.45-0.98]).
  
  
  CONCLUSIONS
  Early life consumption of raw cow's milk reduced the risk of manifest respiratory infections and fever by about 30%. If the health hazards of raw milk could be overcome, the public health impact of minimally processed but pathogen-free milk might be enormous, given the high prevalence of respiratory infections in the first year of life and the associated direct and indirect costs.
authors.affiliation: Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. Electronic address: georg.loss@med.uni-muenchen.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Loss
authors.affiliation: Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Depner
authors.affiliation: FrieslandCampina, Amersfoort, The Netherlands.
authors.forename: Laurien H
authors.initials: LH
authors.lastname: Ulfman
authors.affiliation: FrieslandCampina, Amersfoort, The Netherlands; Cell Biology and Immunology, Wageningen University, Wageningen, The Netherlands.
authors.forename: R J Joost
authors.initials: RJ
authors.lastname: van Neerven
authors.affiliation: Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Hose
authors.affiliation: Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
authors.forename: Jon
authors.initials: J
authors.lastname: Genuneit
authors.affiliation: Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Karvonen
authors.affiliation: Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Hyvärinen
authors.affiliation: Department of Respiratory Disease, UMR/CNRS 6249 chrono-environment, University Hospital of Besançon, Besançon, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Kaulek
authors.affiliation: Children's Hospital, University of Zürich, Zürich, Switzerland; Christine Kühne Center for Allergy Research and Education, Davos, Switzerland.
authors.forename: Caroline
authors.initials: C
authors.lastname: Roduit
authors.affiliation: Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany.
authors.forename: Juliane
authors.initials: J
authors.lastname: Weber
authors.affiliation: Christine Kühne Center for Allergy Research and Education, Davos, Switzerland; Children's Hospital of Eastern Switzerland, St Gallen, Switzerland.
authors.forename: Roger
authors.initials: R
authors.lastname: Lauener
authors.affiliation: Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University of Marburg, Marburg, Germany; Member of the German Center for Lung Research, Munich, Germany.
authors.forename: Petra Ina
authors.initials: PI
authors.lastname: Pfefferle
authors.affiliation: Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland; Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Pekkanen
authors.affiliation: Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Outi
authors.initials: O
authors.lastname: Vaarala
authors.affiliation: Department of Respiratory Disease, UMR/CNRS 6249 chrono-environment, University Hospital of Besançon, Besançon, France.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Dalphin
authors.affiliation: Children's Hospital, Schwarzach, Austria.
authors.forename: Josef
authors.initials: J
authors.lastname: Riedler
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Braun-Fahrländer
authors.affiliation: Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research, Munich, Germany.
authors.forename: Erika
authors.initials: E
authors.lastname: von Mutius
authors.affiliation: Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research, Munich, Germany.
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Ege
mesh_terms: D000818:Animals; D004326:Drinking; D005060:Europe / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000517:prevention & control*; D006358:Hot Temperature; D006801:Humans; D007223:Infant; D008297:Male; D008892:Milk; D016017:Odds Ratio; D010031:Otitis / Q000453:epidemiology; D061352:Pasteurization; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000517:prevention & control*; D012220:Rhinitis / Q000453:epidemiology
keywords: C-reactive protein; Respiratory infections; epidemiology; fever; infancy; inflammation; milk; otitis; prevention; rhinitis