Cord Blood: To Bank or Not to Bank?

Since the day I walked out of my OB office with my “Congratulations, you’re going to be a mom!” goodie bag, I’ve been bombarded by pamphlets, emails and contests related to cord blood banking.  Just making my first purchase at a maternity store or registering for baby related items resulted in more pamphlets and emails. (Although they also resulted in free bottles, formula samples, diaper and wipes samples…)  I had no idea what the heck cord blood banking even was – I guess just one of many things that is foreign to a first time parent?

So what is CBB anyway?  Well, cord blood is the blood that is in the umbilical cord and placenta following birth.  It is rich in stem cells which are used in a variety of potentially life saving procedures such as stem cell transplants for leukemia patients.  Sounds like awesome stuff right?  Who wouldn’t want to bank their child’s stem cells as a sort of insurance plan for the future?  Let’s explore that a bit shall we?

First up and the usual reason parents give for not banking is: cost.  The yearly costs vary from private bank to private bank but average somewhere between $100-150 per year.  That is per year until you use it or forever if you don’t.  That doesn’t sound too bad really if it can help your child later in life right? Oh, but you also have the initial costs which include collection, shipping, processing… and those average around $2,000-2,500 at the time of delivery.  You may also incur a fee from your facility and/or OB for their part in the collection process.  At a time when you have poured every extra dime into purchasing things like cribs and changing tables, the thought of another two grand in expenses seems like too much.  Besides, new parents are not generally thinking about the potential health problems that lie ahead for their precious, perfect little baby.

So let’s say you have no problems coming up with the extra money.  Probably still thinking that banking sounds like a really great thing to do for your baby?  Let’s take a look at what the medical field has to say of private cord banking.

The American Academy of Pediatrics have a policy that says there is currently no strong evidence to recommend banking.  Although, they do say it should be considered in cases where a sibling has a condition that could be cured by a stem cell transplant because the chance of a sibling match is greater than one from an unrelated donor.

The American Medical Association tends to agree with the AAP.  They advise that this decision needs to be made well ahead of delivery with consents signed before labor begins so that an informed decision is made.  They encourage the donation of cord blood to public banks but in the case of a family predisposition to specific medical conditions a private bank can be considered.

The American College of Obstetrics and Gynecology doesn’t encourage public over private banking but provides a few good points to think about when considering either option. First thing that stands out is that a child may not even benefit from their own stored cells. If a child is born with a genetic disorder, the child's cord blood cells will also have that disorder programmed in.  This is also true in cases of leukemia which is not generally thought of as a genetic disorder but one’s genes provide the same mutation that caused the disease in the first place.  The other thing that stands out to me is that there is no current data on how long cord blood can be successfully stored and used.

In addition to these statements, there was a study in 2009 published in Pediatrics that points out private banks are rarely used in cases of stem cell transplants for various reasons and few physicians who perform transplants would recommend it.

So if you decide private banking isn’t for you and your family, you still have choices.  You can choose to donate your child’s cord blood to a public bank to possibly help someone else facing a life threatening disease. (public banks are where most stem cell transplants originate from) Or you can choose to do things the old fashioned way and not worry about banking at all – also known as birth, clamp cord, cut cord, done. Or you can choose to delay cord clamping and cutting just a bit.

Why would you choose to delay the clamping/cutting of your baby’s cord? There is some evidence that a delay in clamping helps prevent neonatal anemia and an extra dose of those stem cells stored in the blood going directly into baby.  ACOG has a good article that discusses delayed clamping in both term and pre-term babies. Basically they say more research is needed on this subject but give a couple things to think about.  Currently in term babies, there is insufficient evidence to support more than a 60 second delay in clamping, but within 60 seconds of delay a child can receive extra iron stores to ward off anemia and jaundice.  In pre-term babies, they say the evidence supports delaying clamping because of the anemia prevention and also because it can reduce cases of infant intraventricular (brain) hemorrhage.

Lots of things to consider!  And if you are a first time mom-to-be like me, your head is already swimming with all these new decisions to be made.  I don’t know what we plan to do just yet but doing some research has at least armed me with information to make this decision just a bit easier.

So what did you or are you choosing to do?