Cord Blood Banking

It seems like in the last part of the 20th century, and definitely in this new 21st century, that fear is an overriding decisive factor in many decisions. In few other decision-making segments does this "fear factor" apply as much as it does to parenting decisions. My article "Prenatal Care or Paranoia" gives some examples of how a little information creates fear-based decision making.

So, we come to the decision of banking cord blood. For the uninitiated, cord blood is the few ounces of blood that remain in your baby's umbilical cord after it has been cut. The doctor collects this blood by syringe or blood bag after the umbilical cord has been clamped and cut. This isn't too difficult and only takes a few minutes to collect the cord blood after a routine vaginal delivery.

Collecting cord blood becomes complicated during a cesarean delivery, mostly because the doctor's primary focus at this surgery is tending to the mother's safety. Less cord blood is usually collected at a cesarean delivery, possibly because collection must wait until baby is safely delivered, mother's uterus has been sutured, and mother is stable.

What are some reasons for collecting and saving cord blood? The cord blood contains stem cells that are known to save a person with certain diseases. These diseases include leukemia, Hodgkins's ,blood disorders, and heart diseases. Research is currently being done using stem cells for other conditions as well. Stem cells are a closer match and easier to use for siblings and family members than bone marrow transplants, too.

Many parents are being urged by private cord blood banks to make this decision to save cord blood. The implication is that of course you would want to do the best for your child? How would you feel if he/she needed a bone marrow transplant down the road and you had failed to collect those precious few ounces of stem-cell rich cord blood? No parent wants to say "It's not worth it" even by their actions. But the American Academy of Pediatrics, as well as other medical organizations, are expressing concern that private cord blood banks may be capitalizing on the fears of new parents at a vulnerable time by providing misleading information and statistics.

The AAP is not recommending cord blood banking for families who do not have a history of diseases that would benefit from use of cord blood. They go so far as to condemn using the word "insurance" in regards to banking a supply of cord blood. The words "it's just like having insurance" is used quite freely in advertisements urging parents to bank their newborn's cord blood. The likelihood that a child would ever need those stem cells is very low; it hasn't even been confirmed that using self-donated cells is safer or more effective than cells from a family member or matching stranger.

Here are some other reasons not to just take it for granted that this type of "insurance" is necessarily the best or only option for your newborn.

Cost. Currently, it costs about $1500 to $2000 to store cord blood in a cryogenic facility. Maintenance fees are about $125 a year. That doesn't even count the several hundred dollars involved in a cord-blood collection kit, courier service to the storage facility, and processing fees.

Inconvenience. So far, cord-blood banking isn't routine in all deliveries or all hospitals. The decision and arrangements for collecting and transferring the cord blood needs to be made by about the 34th week of pregnancy.

Need. The odds that the average baby without known risks will ever use this banked cord blood is very low.
According to research, the odds of a child using his or her own stem cells is about 1 in 2,700; and the odds of a family member needing the cord blood is about 1 in 1,400. Family relationship does not ensure a match, either. Among siblings, there is a 25% chance that the cord blood will not match and about a 50% chance that the match will only be a partial one.

In addition, cord blood stem cell usage is still fairly new, so there is no accurate way of knowing how long the stored blood will last. Transplants have been done using stem cells that had been stored for 14 years with good results. There is no reason to believe that the cord blood will not be usable indefinitely; however, there is no assurance of it lasting indefinitely either.

Approximately 50 to 125 mls are extracted from each delivery. 75 mls is needed to ensure there are enough cells for a transplant. Each delivery runs the risk of not even having an adequate cord blood collection. And then consider that this amount is too small to be used on anyone but a baby or young adult. A larger-sized adult person requires more stem cells than an umbilical cord blood stem cell collection.

No matter what decision you make for you, your family, and your new baby, it is always a good idea to look at both sides of an issue rather than relying on fear-mongering advertising tactics.