Small was born at Gibraltar in Clarendon, Jamaica, the daughter of a sugar plantation overseer. Like many Jamaican singers of the era, her career began by winning the Vere Johns Opportunity Hour talent contest, which she won at the age of twelve. Wishing to pursue a career as a singer she moved to live with relatives in Love Lane in Kingston. In her teens, she recorded a duet with Owen Gray (“Sugar Plum”) in 1962 and later recordedwith Roy Panton for Coxsone Dodd‘s Studio One record label as ‘Roy and Millie’.They had a local hit with “We’ll Meet”.
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