In 1999, approximately 322,700 ounces of milk were processed and distributed by the 7 member banks of the Human Milk Banking Association of North America. One new bank opened, and 2 medical centers in the United States are considering opening donor banks. The majority of the recipients were preterm and sick infants, but milk was also ordered for older babies and for children with a variety of medical needs, including metabolic disorders, severe food allergies or feeding intolerance, short gut syndrome secondary to necrotizing enterocolitis, growth failure on formula, and intractable rotavirus, and during chemotherapy for cancer. Donor milk was also ordered for adopted infants who did not have medical problems and for some adult cancer patients. Member banks serum screened 770 potential donors. One donor was excluded for a positive Hepatitis C test, and 3 were excluded for positive HTLV results. Further confirmatory tests were negative for these 4 potential donors.