Cord Blood Banking

Parenting Issues

A photo of a newborn baby being cared for by an L&D nurse.
Should you bank your baby's umbilical cord blood?. Photo by Vincent Iannelli, MD

Expecting parents are faced with a lot of important decisions before their baby is born. These include the basics, such as what to name the baby, which pediatrician to go to, breastfeeding vs. formula feeding, etc. And more and more, they are having to consider the issue of whether or not to bank their baby's umbilical cord blood.

From ads in parenting magazines, direct mailings, and flyers in their obstetrician's office, expecting parents are repeatedly told of their 'once-in-a-lifetime chance' to save their baby's umbilical cord blood for possible use later to save his life.

Since it doesn't hurt to take a baby's umbilical cord blood and it would in fact be discarded anyway, you wouldn't think that there would be much of an issue with cord blood banking. What parent wouldn't want to do everything that they could to make sure that their baby grows up to be healthy?

But the issue isn't really with cord blood banking, which every parent should likely try to do. The issue is more about banking blood in a for-profit private cord blood bank for a family's own use. As an alternative, parents can donate their baby's umbilical cord blood in a public bank for free.

Cord Blood Banking

Umbilical cord blood stem cells can be used in transplants to treat a variety of pediatric disorders including leukemia, sickle cell disease, and metabolic disorders. Patients who need a cord blood transplant can currently try to find a match with a sibling or from an unrelated person. An autologous (self) transplant can also be done if a child's umbilical cord blood has been stored in a private cord blood bank, although you wouldn't do that for conditions like leukemia because of the genetic risk of the leukemia being in the cord blood too.

Cord Blood Banking - Do It

Parents who do bank their baby's umbilical cord blood privately often find the cost acceptable and feel that it is a kind or 'insurance' and a 'good investment' in case their child needs it.

Cord blood banking for their own use can be a good idea for families that have a child 'suffering from leukemia, lymphoma, other cancers, sickle cell disease, thalassemia or other transplant-treatable diseases', in which case they can donate and store their baby's cord blood for free in the Children's Hospital Oakland Research Institute Sibling Donor Cord Blood Program.

It may also be a good idea if another family member has a condition that can be treated with a bone marrow transplant.

Cord Blood Banking - Don't Do It

Although money shouldn't be a factor when it comes to saving a child's life, one of the biggest arguments against private cord blood banking is that it is just too expensive for many families. In addition to a large initial processing and banking fee, you then have to pay an annual storage fee. First-year fees can range from $595 to $1,835, depending on which private bank you choose. Annual storage fees are usually about $150.

That American Academy of Pediatrics sums up most of the cons against private cord banking nicely in their subject review of cord blood banking, in which they state that 'Families may be vulnerable to emotional marketing at the time of birth of a child and may look to their physicians for advice. No accurate estimates exist of the likelihood of children to need their own stored cells. The range of available estimates is from 1:1000 to 1:200,000.

Empirical evidence that children will need their own cord blood for future use is lacking. There also is no evidence of the safety or effectiveness of autologous cord blood transplantation for the treatment of malignant neoplasms. For these reasons, it is difficult to recommend that parents store their children's cord blood for future use.'

Also keep in mind that the AAP again, in a 2007 policy statement on cord blood banking titled Cord Blood Banking for Potential Future Transplantation, stated that 'private storage of cord blood as "biological insurance" should be discouraged.'

Also, if your child does get one of the conditions that an umbilical cord transplant is supposed to cure or treat, if you don't store your child's cord blood, that doesn't mean that no treatments will be available to him. In addition to more traditional treatments and bone marrow transplants, you may be able to find a cord blood match in a public cord blood bank, from which most cord blood transplants are currently being done.

Cord Blood Banking - Should You Do It?

In addition to non-profit cord blood banks and for-profit cord blood banks, like Viacord and Cord Blood Registry, parents are increasingly having more options for donating their baby's cord blood or if they later need a cord blood transplant. The Cord Blood Stem Cell Act of 2005 will work to create a 'National Cord Blood Stem Cell Bank Network to prepare, store, and distribute human umbilical cord blood stem cells for the treatment of patients and to support peer-reviewed research using such cells.' The Cord Blood Stem Cell Act of 2005 has been introduced in both the House and Senate, although it has not yet passed. Still, money has already been set aside to fund an Institute of Medicine report on how best to implement the national network, so hopefully it will be set up quickly one the legislation passes.

Public or free cord blood banks are already available as part of the National Marrow Donor Program (NMDP) Network in 12 major cities if you are interested in donating your baby's umbilical cord blood so that it is available to any child that needs a transplant. The AAP strongly encourages parents to donate their baby's cord blood to a public cord blood bank.

And of course, if you think the cost is acceptable and you would feel comforted or reassured if your baby's umbilical cord blood is available if needed, then you can always choose to go with a private cord blood bank.

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