The New York Times - December 13
Stacey Okun

Cynthia was a healthy 3-week-old when her parents adopted her from Colombia. But suddenly she began losing a pound each week. At 10 months she was admitted to North Shore University Hospital, in Manhasset.

Doctors could not find a formula the baby could digest, and Cynthia, in dire need of nourishment, was put on the critical list by Christmas.

The Callows, of Massapequa, had one last resort - mother's milk. "It's perfect for the human baby the way cow's milk is perfect for the calf," said Judy Palsgraf, the nursing coordinator of the milk bank. "Any species digests its own milk the best."

Although Mrs. Callow could be taught to lactate, the process takes weeks and time was crucial. "I started to panic," she said.

But one of the hospital's doctors, Concepcion Sia, a neonatologist, had an idea. Why not get donors to provide the milk for Cynthia? The Callows made a public plea.

They received 1,200 offers from mothers in the New York area, far more milk than Cynthia needed. The suplus was stored in freezers. And that was the beginning of the milk bank.

Today, the milk bank is the only such center in the Northeast. But it has supplied babies as far away as Texas. The milk bank has 46 depots -in hospitals, churches and private homes - in New York, New Jersey and Connecticut. Over the last seven years the bank has collected 170,000 ounces of milk, which has gone to 154 babies.

There are several other free milk banks in other parts of the country. The only other East Coast milk bank, in Delaware, sells the milk commercially, however.

The milk bank has a screening process for potential donors. They must fill out a questionnaire, be interviewed and release their medical records. Within a year the bank will begin requiring women to give blood to test for several viruses that can be transmitted in mother's milk, including the AIDS (acquired immune deficiency syndrome) virus.

"It is possible for infections to cross a mother's milk," Dr. Sia said. "The general population is scared of AIDS, and it's a reflection of our times that we, too, take extra safety precautions. "

But despite the precautions, Dr. Sia said it is possible that some women can be incubating the fatal AIDS virus and it would not necessarily be detected in the milk bank's tests.

"AIDS is going to get a lot worse because there's incubating people out there now," she said. "A negative test today could convert in five or so years. You just have to remember there is no guarantee in medicine or in life."

No children have gotten AIDS through the bank's milk, she said.

Milk bank donors are interviewed by Mrs. Palsgraf, who investigates their medical histories to insure that they have not used illegal drugs. Donors may not have a history of serious disease and must be free from infection at least 48 hours before giving milk.

"Our mothers are very concerned with their responsibility," Mrs. Palsgraf said. "Sometimes they'll call us first thing in the morning and say, 'I inhaled cigarette smoke at a party last night. Can I still donate?' "

Dr. Sia will not reject any mother who wants to donate milk, however. Milk unfit for infants is used in research at local hospitals. "When women want to donate and be useful, we don't like to turn them down," she said.

Dr. Sia said the milk bank never turns away a child in need.

"Dr. Sia's theory is 'Never say no,' " Mrs. Palsgraf said. "Sometimes our cupboard will literally be bare, but she always says that God will provide and somehow milk turns up."

In what the staff dubbed a "long-range mercy mission," Mrs. Palsgraf once had milk flown in from Vermont. A lactating woman who had heard of the bank called Mrs. Palsgraf and offered 20 gallons. The woman's husband, a pilot, flew it to Long Island MacArthur Airport, where Mrs. Palsgraf and her son met him on the runway with four freezer chests in tow. "You don't just turn down an offer like that," she said.

The milk bank's two large freezers, set at zero degrees Fahrenheit, have recently been filled with small laboratory bottles and plastic pouches of mother's milk. But this is not always the case.

"The milk donor is not like a blood donor," Dr. Sia said. "It's a limited condition, only to be filled by lactating women."

Women lactate for about six months after giving birth. The milk bank often runs low during the Christmas season, when many women are too busy to donate.

When the bank is running low, priority is given to premature infants, babies with kidney infections and those, like Cynthia Callow, with intolerances to other forms of nutrition who need fresh milk to fight infection. The infants require the milk anywhere from a few months to as long as a year and a half, and must ingest about six to eight ounces each day.

The price for an ounce of milk is $1, but the hospital makes special arrangements for families that cannot afford bills that can amount to $48 a day and more than $300 a week. Insurance does not cover milk bank use, because the substance is categorized as a food, not a drug, Dr. Sia said.

She said she is protesting this policy, because although milk will still be given to a baby whether its parents can afford the cost or not, it puts a strain on the milk bank. The bank is financed in part by grants from the March of Dimes Birth Defects Foundation and the hospital.

"Since feeding the babies the milk they need to get healthy sends them home earlier, the short stay in the hospital actually saves money" for the insurer, she said. "Besides, it's better for the baby to go home earlier."

Dr. Sia hopes that the increased interest in breast-feeding in recent years will help her find donors. The milk bank has had about 600 donors since it started, including some mothers who give milk each time they have a child.

"I only see the natural process expanding in the next decade," she said, and more milk banks and lactation education centers opening.

"Unfortunately, I see obstacles like AIDS worsening, too," she added. "We just have to be prepared to work along with these risks."

One beneficiary of such risks is Cynthia Callow, now a rambunctious 8-year-old. "I look at my daughter," Mrs. Callow said, "and say thank goodness."

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