What Is Cord Blood Banking?
Cord blood banking is a process of collecting potentially life-saving stem cells from the umbilical cord and placenta and storing them for future use. Stem cells are immature cells that can assume the form of other cells.
There are so many things to think about when you have a child. One of them is the blood from your baby’s umbilical cord (which connects the baby to the mother while in the womb). It used to be thrown away at birth, but now, many parents store the blood for the future health of their child. Should you do it?
What Can It Be Used For?
The fluid is easy to collect and has 10 times more stem cells than those collected from bone marrow.
Stem cells from cord blood rarely carry any infectious diseases and are half as likely to be rejected as adult stem cells.
How Do You Get It?
If you want the blood stored, after the birth, the doctor clamps the umbilical cord in two places, about 10 inches apart, and cuts the cord, separating mother from baby. Then they insert a needle and collect at least 40 milliliters of blood from the cord. The blood is sealed in a bag and sent to a lab or cord blood bank for testing and storage. The process only takes a few minutes and is painless for mother and baby.
The cord blood bank may also send tubes so that the mother’s blood can be taken, too. If so, the banking kit will have instructions along with blood collection tubes.
Where Is It stored?
There are three options:
Public cord banks don't charge anything for storage. Any donation made is available for anyone who needs it. The bank may also use the donated cord blood for research.
Private (commercial) cord banks will store the donated blood for use by the donor and family members only. They can be expensive. These banks charge a fee for processing and an annual fee for storage.
The American College of Obstetricians and Gynecologists (ACOG) neither recommends nor advises against cord blood banking. But along with the AAP and AMA, it cautions parents about private cord blood banking. Here's why:
- Collection and storage costs at private cord blood banks are high.
- Other effective treatments may be available that are less expensive.
- The chance of privately banked cord blood being used by your child is extremely low.
A stem cell transplant using an individual’s own cord blood (called an autologous transplant) cannot be used for genetic disorders such as sickle cell disease and thalassemia, because the genetic mutations that cause these disorders are present in the baby's cord blood. Other diseases that can be treated with a stem cell transplant, such as leukemia, may also already be present in a baby’s cord blood.
Because of these limits and the uncommon occurrence of the diseases that can be treated with a stem cell transplant, there have been just more than 400 autologous cord blood transplants in United States in the last 2 decades. In contrast, more than 60,000 unrelated donor cord blood transplants have been performed worldwide.
In short, the American Academy of Pediatrics and the American Medical Association recommend against storing cord blood as a form of "biological insurance," because the benefits are too remote to justify the costs.
Are there situations where private cord blood banking might make sense? Some parents choose to bank their child's blood if they don't know their medical background -- for instance, if a parent was adopted or the child was conceived with a sperm or egg donor.
Direct-donation banks are a combination of public and private banks. They store cord blood for public use. But they also accept donations reserved for families. No fee is charged.
Should You Bank Your Baby's Cord Blood?
It depends on who you ask. Although commercial cord blood banks often bill their services as "biological insurance" against future diseases, the blood doesn’t often get used. One study says the chance that a child will use their cord blood over their lifetime is between 1 in 400 and 1 in 200,000.
The stored blood can't always be used, even if the person develops a disease later on, because if the disease was caused by a genetic mutation, it would also be in the stem cells. Current research says the stored blood may be useful for only 15 years.
There are other things to consider if you have twins. If one of your twins is born with a genetic disorder or develops a childhood leukemia, the cord blood likely contains the same code that caused the problem in the first place. It cannot be used to treat either twin or any other person.
Cord blood cells from one healthy twin can be used to treat your other twin or another ill child, as long as the two are a good match. But this benefit is greatest when the two children have a slightly different genetic makeup. This means that if your twins are identical (monozygotic), they will make poor blood donors for one another. If your twins are fraternal (dizygotic), they have the same chance as any other sibling of making a good donor for the other twin. Regardless of whether twins are identical or fraternal, cord blood could be used to treat another ill sibling.
The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics don’t recommend routine cord blood storage. The groups say private banks should be used only when there’s a sibling with a medical condition who could benefit from the stem cells.
The AAP does recommend cord blood banking if an infant has a full sibling with a malignant or genetic condition treatable with cord blood transplantation. These conditions include:
- Immune deficiencies, such as severe combined immune deficiency (SCID)
- Lymphoma (Hodgkin's and non-Hodgkin's)
- Aplastic anemia
- Sickle cell anemia
- Krabbe's disease
- Other rare diseases
Even so, a brother or a sister has only a 25% chance of being a perfect genetic match. Thus, a sibling may require a bone marrow or cord blood transplant from an unrelated donor.
The AMA also suggests considering private cord blood banking if there is a family history of malignant or genetic conditions that might benefit from cord blood stem cells. But keep in mind that to find a suitable match for any type of transplant, 70% must look outside their family.
Families are encouraged to donate stem cells to a public bank to help others.
If you do decide to bank your baby’s cord blood, there’s one more thing to keep in mind: It’s best not to make it a last-minute decision. You should coordinate with the bank before your baby is born so nothing is left to chance.
What the Future Holds
No one knows how stem cells will be used in the future, but researchers hope they may be used to treat many conditions, like Alzheimer's, diabetes, heart failure, spinal cord damage, and others.
It's possible that storing your child's cord blood cells now may be useful one day in combating these diseases. For now, these treatments are only theories. It's also not clear if stem cells from cord blood -- as opposed to stem cells from other sources -- will be useful in these potential treatments.