By David Wencer, originally published October 21, 2009
How John Ross Robertson improved the lives of Toronto’s children
In the first decade of the twentieth century, the quality of Toronto’s milk varied greatly. Milk came from many different private dairies, and not all chose to pasteurize. For those that did, there was no guarantee that the process was performed properly. It was also not uncommon for companies to use the term “pasteurized” misleadingly, actually selling milk that had been inadequately heated (if at all).
As such, the health of Toronto’s citizens in 1909, particularly that of its infants, was subject to several diseases whose bacteria thrived in raw milk; the newspapers are rife with reports of scarlet fever, typhoid, and tuberculosis, the latter of which was sometimes referred to as “the white plague.” In one Annual Report of the Hospital for Sick Children, the extent of the problem is clear: “in a large city there can be found districts that are filled with weak and puny children…who begin life improperly nourished, underfed because of poverty…The poor mothers of small babies always look forward to the summer with dread. They fear not only the effect of the heat on the child, but danger lurking in the milk supply.”
For the Hospital for Sick Children, obtaining clean milk was quite difficult. Before constructing its own pasteurization facility, the hospital solicited tenders from local dairies, choosing ones which offered the best combination of quality and value. The hospital’s trustee minutes, however, reveal that the quality of this milk fluctuated from year to year, and was a growing matter of dissatisfaction for the staff.
In North America, pasteurization’s great champion was Nathan Straus, a wealthy department store owner turned philanthropist, who was privately funding milk pasteurization in New York City. Throughout 1909, Straus toured the United States, stressing the benefits of milk pasteurization and urging other cities to take greater measures in improving the quality of milk sold within their boundaries. Straus’ campaign caught the interest of Toronto philanthropist John Ross Robertson, whose many causes included the Hospital for Sick Children, then located at 67 College (now occupied by Canadian Blood Services).
In October of 1908, Robertson announced plans to build a milk pasteurization plant in connection with the hospital, based on the Straus plant in New York, which would give the hospital access to safe milk which it could regulate itself. Aware of the immediacy of the hospital’s need, Robertson also invested in a temporary facility, located at 253 Elizabeth Street, described in a hospital publication as “an unpretentious, two-storey house.” This first site opened in October of 1909, and provided safe, pasteurized milk for the hospital until the purpose-built pasteurization plant was ready in January of 1914.
The pasteurization plant at SickKids purchased only “certified milk,” a term awarded by the Milk Commission of the Academy of Medicine to the highest grade of milk available, based on the combination of a low bacteria count and exemplary dairy farm conditions. This milk came from local dairy farms by wagon, packed in ice paid for by the hospital, whereupon the milk was promptly removed to ammonia-coil refrigerators until ready for pasteurizing.
By 1909, the scientific community had isolated the ideal range of temperatures and heating times that kill harmful bacteria without compromising the milk’s nutritive value. SickKids worked within this range; once poured into sterilized bottles which were sealed with sterilized stoppers, the milk was heated at 145F for twenty minutes. The bottles were then chilled rapidly and subsequently stored in refrigerators. Some were then sent on to the formulation room where modifications were made for children with specific dietary requirements.
In 1914, the purpose-built plant at 54 LaPlante Avenue opened to the public. The building had frontage of 67 feet and a depth of 32 feet. A key feature was the dairy counter, where milk was dispensed to the public and bottles were returned (the hospital had its own bottles, and to encourage their return, the bottoms were rounded making it impossible to stand them up).
There was more, however, to the Sick Kids pasteurization campaign than just the mechanical process. The hospital took up the cause to educate the public about the pasteurization process, and about the various diseases transmitted through unclean milk. Pamphlets explained the pasteurization process and also covered topics such as proper milk storage so as to keep it clean from bacteria (a particularly important point in an era where home refrigerators were less common). The hospital also provided instructions on how people without direct access to pasteurized milk could safely pasteurize milk at home. These pamphlets were printed in several languages, ensuring that the information reached the non-English-speaking immigrants living in Toronto at this time.
In April of 1914, Toronto passed a law requiring that all milk be pasteurized. As a result, the quality of the city’s milk improved significantly, and the hospital ceased most pasteurization operations by 1928 (a key exception was made for breast milk).
The actual effects of the hospital’s milk pasteurization plant are difficult to gauge, as most diseases spread through infected milk were also communicated by other means. One telling statistic, however, may be the average length of stay at SickKids: in the first decade of the twentieth century, the average stay was consistently over forty days. By 1920, the average stay was consistently under twenty.