FREEHOLD, N.J. — Fighting brain cancer, little Giada Demma was lying in her pediatric hospital bed, her tiny body virtually swimming in a drab green hospital gown.

Her cousin Giuliana Demma remembers looking at the 1-year-old and thinking how sad the scene was: a small child awash in an ugly gown several sizes too big for her.

''I thought to myself,' 'Why does she have to wear this? Why can't she wear something nicer?''' Giuliana said.

Inspired by that moment, Giuliana Demma, 13, and her 11-year-old sister Audrina have sewn and donated more than 1,800 brightly colored, playfully patterned gowns to hospitalized children in 36 states. They've even sent them to Uganda, with three other African nations set to get them in the fall.

''I wanted to do something to help kids like (Giada) and give them hospital gowns that have nice patterns, that are colorful, that they can feel comfortable in while they're going through a rough time,'' Giuliana said.

Their family hired a seamstress to make a custom Disney princess gown for little Giada, who was hospitalized in 2017 and is doing well now. But as Giuliana grew over the next four or five years, she developed an interest in sewing, and remembered how lost her little cousin looked in a drab, ill-fitting gown years earlier.

Once Giuliana learned to sew, her cousin was no longer hospitalized. But she started making cheerful gowns for other sick kids. Her first creations were gowns with flamingos and Paris-themed patterns for a child with cancer that her aunt knew.

No child is ever charged for one of her gowns, which are paid for by donations of money and material. The Starbucks Foundation gave the project a $3,000 grant this year. A hospital linen company, ImageFIRST in Clifton, New Jersey, cleans all the garments for free before they are sent to hospitals, and a women's group at a nearby housing development and a church youth group help out with about 40 volunteers cutting fabric for the girls.

Giuliana gets help from her sister, who also loves sewing. Audrina will pitch in when Giuliana has homework to do, heading to the basement of their home in Freehold, New Jersey, not far from the Jersey Shore, that has been taken over by the sewing operation.

Audrina's specialty is sewing small pillows for young patients. They are sent with boxes of markers so that the recipients can color them as they like while they're in the hospital.

Audrina made 100 pillows as part of an effort to earn her Girl Scout Bronze award, packaged them and sent them off to hospitals. She makes seasonally themed pillows for St. Patrick's Day, Valentine's Day and other special times; last winter she made 100 snowman pillows.

They are often part of packages the girls create that include rubber duckies and other toys, and a local pediatric cancer charity, LIV Like a Unicorn, includes them in boxes they send to children battling cancer. The Minnesota charity Children's Surgery International took 60 of the gowns to hospitals in Uganda in February with more headed to Gambia, Liberia and Ethiopia in the fall.

Some of the recipients write back to thank the girls for the gowns and pillows.

''I like seeing the smiles on the kids' faces, even though they're going through such a hard time,'' said Audrina, who wants to be a veterinarian.

The girls have recently begun sewing zippers into brightly colored T-shirts to accommodate infusion ports for chemotherapy or other drugs that could allow young patients not to have to wear a gown at all while hospitalized.

Samantha DiSimone's son Vito was hospitalized in January in New York for a heart valve ailment at 9 months old. Hospital staff brought in a sealed package with a gown Giuliana made from material with a pattern from the ''Cars'' movie.

He broke out in a big smile when they unpackaged the garment.

''I was so emotional,'' Samantha DiSimone said. ''You're in a hospital praying that your child will make it through the surgery, and to see him in the gown with a big smile on his face is an amazing thing.''

Soft-spoken yet entirely at ease recounting her efforts, Giuliana has the poise and maturity of someone beyond her years, though she just graduated from middle school. She wants to be a cancer surgeon, and said she loves hearing from recipients of the gowns.

''I'm really happy I can help make a difference for them during this tough time,'' she said. ''I want them to feel confident and know that they're an inspiration, they're loved and they're strong and they're brave. They can wear these gowns and have something to cheer them up.''

Melissa Demma, Giada's mother, said the drive by her child's young cousins to make and give away gowns ''blows me away and touches me each and every day."

''They're young girls and this is what they choose to do, spending their time helping others,'' she said. ''If everyone could be like this, our world would be a better place. It makes me feel better for the future and what this world could be.''

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Follow Wayne Parry on X at www.twitter.com/WayneParryAC