10 Things to Know About Cord Blood Banking
Current treatments, clinical trials, storage options, and more.
There are many decisions to make when preparing for a new baby, including which pediatrician your little one will see, what type of feeding or sleeping arrangements you’re comfortable with, what name you will give your child, and perhaps, whether or not to bank baby’s cord blood. The cord blood banking process involves collecting a small sample of stem cell-rich blood left in baby’s umbilical cord after birth that can potentially be used to treat certain diseases and disorders.
As stem cell research continues to make exciting advances, more conditions will hopefully be treated successfully. However, banking baby’s blood isn’t a choice to make lightly, as it comes with its fair share of logistical, financial, and emotional considerations. Before you decide whether or not banking is right for your family, we can help you understand how cord blood can be used.
1. Cord Blood Is the Blood That Remains in the Umbilical Cord After Birth
It happens to be an ample source of stem cells—specifically hematopoietic progenitor cells (HPCs), the body’s building blocks. These master adapters have the ability to transform into other types of cells to further new growth. They contribute to the development of tissue, organs, blood, and the immune system. For example, if a person’s immune system is compromised, the HPCs can be transplanted into the body, where they will hopefully begin producing new, healthy cells.
Additionally, cord tissue is a primary source of unique stem cells that form multiple cell and tissue types. They’re being studied for their potential in treating degenerative diseases of the lungs, liver, muscle, nerves, and pancreas, as well as autoimmune diseases including type 1 diabetes and multiple sclerosis. Many banks offer the option of saving both of these stem cell-rich parts.
2. Cord Blood Has Promising Potential
The umbilical cord contains blood-forming cells that have been used in more than one million transplants worldwide to treat more than 80 diseases, including those of blood, immune system, and metabolic disorders. These stem cells are also used to offset the effects of cancer treatments on the immune system. Most of the treatment options are for genetic disorders and typically require a transplant to infuse new stem cells into a patient’s bloodstream. Like any other transplant, the patient is literally carrying around the donor’s blood and immune system.
According to Be The Match, the following conditions are treatable with stem cell transplants:
- Leukemias and lymphomas, including acute myelogenous leukemia (AML) (the most common type of acute leukemia in adults) and acute lymphoblastic leukemia (ALL) (the most common type of leukemia in children under 15).
- Bone marrow diseases, including severe aplastic anemia and pure red cell aplasia.
- Inherited immune system disorders (a group of disorders that are present at birth and can become life-threatening within a year of life), including severe combined immunodeficiency (SCID) and Wiskott-Aldrich syndrome (WAS).
- Hemoglobinopathies (diseases with poorly functioning red blood cells), including sickle cell disease (SCD).
- Inherited metabolic disorders, including Krabbe disease and Hurler syndrome.
- Myelodysplastic syndromes and myeloproliferative disorders (MDS), which affect the blood and bone marrow; about 19,000 people in the United States are diagnosed each year.
- Multiple myeloma and other plasma cell disorders.
Several other conditions can also benefit from stem cell transplants. See the full list here.
3. Research on the Uses for Cord Blood Is Ongoing
Opportunities are being explored to use stem cells for the treatment of cerebral palsy, brain injuries, lupus, and more. Studies on the impact of cord blood infusion on children with autism and the potential benefits of cord blood and tissue for premature infants are also underway. In fact, there are currently 276 clinical trials using cord blood and 464 trials using cord tissue stem cells to explore new treatment options for various conditions.
But you might be wondering what makes cord blood stem cells preferable to those found in the bone marrow. Although they do the same thing, cord blood is much easier to get to and involves a simpler extraction process. A bone marrow transplant requires a surgical procedure to withdraw liquid marrow from the back of the pelvic bone via a hollow needle. (It sounds scary, but the incision is small enough that stitches aren’t even required.) With cord blood, the acquisition is non-invasive and involves no risk to the donor.
4. Cord Blood Collection Won’t Disrupt Your Birth Plan
Cord blood stem cells can be collected during one brief window: right after delivery. It’s a painless process for both the birth parent and baby and is an option whether you deliver vaginally or via C-section. Cord blood collection is also considered feasible and safe in preterm babies.
Soon after your little one is born, their umbilical cord will be clamped and cut. After the midwife or OB cleans the cord, the blood is transferred into a special bag and transported to a lab for processing and storage in either a public or private facility, depending on what you choose. The entire collection process typically takes less than five minutes.
If you have delayed cord clamping written into your birth plan, banking can still be an option. There’s only so much blood left in the umbilical cord and placenta, but it’s possible to briefly delay clamping and still collect a cord blood sample. And speaking of birth plans, make sure you let the medical staff know right away that you plan to collect baby’s cord blood, so they’re prepared to tackle the process when the time comes.
5. Siblings Are Most Likely To Benefit From Banked Cord Blood
The stem cells from your baby’s cord blood are special in that they are genetically unique to them and their immediate family members. This means that now or years later, these same cells could be effective in treating that child or a close relative. However, it’s important to know that when using their own cord blood, your baby can be treated for only a small number of non-genetic diseases, such as brain tumors or severe aplastic anemia, because any genetic defect in the patient is also present in their cord blood stem cells. But when it comes to treating a sibling, there’s a higher chance of using the stored cord blood for additional conditions.
Sharing stem cells with a sibling is also helpful when it comes to the body’s immune system. According to Americord, a blood, cord, and tissue bank in the United States, transplants require the stem cells from the donor to genetically match with the patient’s in order to be accepted by their body’s immune system. Aside from the patient’s own cord blood, a sibling would offer the second highest chance of a genetic match.
6. There Are Two Options for Storing Cord Blood: Private and Public Banks
In the U.S. there are more than 5 million cord blood units stored in private banks as compared to 800,000 cord blood units stored in public banks. When a family chooses a private facility to store their baby’s cord blood, that blood is “on reserve” for personal use in the future. In the case of public storage, the cord blood is considered “donated” for use by the public at large. There is a chance that the blood will be available should you need it, but it’s far from guaranteed.
The American Academy of Pediatrics (AAP) and the American Society for Blood and Marrow Transplantation recommend donating cord blood to a public cord blood bank because the use of privately stored cord blood for therapy rarely occurs. The March of Dimes states that the chance of your baby or a family member needing to use your stored cord blood is very low—about 1 in 2,700.
Additionally, blood stored in public banks can be used for research purposes and to help other families. The AAP says a cord blood unit is 30 times more likely to be utilized for transplantation in public banks than in private banks. Publicly donated cord blood is retrieved for use when a search for an in-need patient is performed to locate the most closely matched donor. So, although storing your baby’s cord blood publicly will not necessarily benefit your family directly, there is still a possibility that it could save a life.
Private storage is an option that families with a history of certain diseases may want to consider more seriously—it ensures that they have access to the cord blood that is most likely to be a good match for blood relatives if they need it. Additionally, families made up of one or more ethnic minorities might want to investigate family storage—Asian, Hispanic, and Black or African American patients have a harder time finding a good match in the public cord blood supply.
7. Private Cord Blood Storage Is an Investment
The price tag of private storage is a factor that many parents weigh heavily when making their decision between family storage and donation. Parents who choose to privately bank can expect to pay two fees: The initial fee covers the cost of enrollment, collection, processing, and typically storage for the first year. The second is a smaller annual storage fee. A ballpark figure for private storage is approximately $2,000 upfront, plus $100-$175 in annual fees.
Just like any other investment, there are ways to budget and get creative if cost is a concern. Most storage facilities offer monthly payment plans, gift registry options that allow friends and family to contribute, and various discounts for prepaid or family storage plans. If your family has a child who has been diagnosed with a disease that’s treatable using sibling cord blood, you could qualify for banking services free of charge.
8. You’ll Need To Decide Before Labor Whether You’re Going to Save Baby’s Cord Blood
It’s not a decision you can put off until the big day. The labor and delivery ward is not part of the registration process, nor does it distribute the collection kits. Plus, the last thing you want to have to deal with on your baby’s birthday is more paperwork. For parents hoping to store or donate cord blood, it is recommended that the registration process be completed prior to the third trimester in order to receive the necessary collection kit and paperwork before delivery. That means the conversation about whether to bank—and, if so, where—should begin as early as the first trimester. It’s a big decision that might take some time.
9. All Cord Blood Storage Facilities Are Not Created Equal
If you’ve decided to save baby’s cord blood, the next step is choosing where to store it. While price is a compelling motivator, it’s not the only question you should be asking. You’ll want to make sure your facility of choice is accredited by the American Association of Blood Banks (AABB) and that it’s been in business for a while, so you know the bank will still be there should you need it. Check its track record to see how many successful transplants have been performed using stored units, and while you’re at it, ask how many units it has stored. (The number should be in the thousands.) Of course, you’ll want to ensure the bank works with the hospital or birth center where you’ll be delivering as well.
It’s also worth noting that while private banks must register with the Food and Drug Administration (FDA), they do not have to follow the same rigorous safety measures as public storage banks.
In the AAP policy statement on cord blood banking, the emphasis on quality control and accreditation of cord blood banks is considered extremely important. Guidelines on proper cord blood receptacles, processing times, conditions for efficient freezing and storage of blood and tissue units, and other standards are critical for obtaining a quality cord blood sample and for the safety of the potential recipient. However, only 25% to 40% of collected umbilical cord blood units meet the criteria for storage in a public bank, and some research indicates that cord blood stored in private banks may be of lesser quality in terms of sample viability.
Of course, you’ll want to do your own research on any potential facility before choosing to store your baby’s cord blood. When considering private banks, here are a few questions to cover:
- How long has the facility been in business?
- How many units does the facility currently have in storage?
- How many successful transplants has the bank participated in?
- What kind of research is the bank participating in for future stem cell use?
- How can parents be sure that their collection will be properly collected, transported, and stored?
- How can the facility guarantee that the cord blood will be available and viable if needed?
- Is blood screened for defects before storage? What happens if one is found?
- What accreditations does the bank hold?
- What contingency plans does the facility have in place for a natural disaster?
- Is the bank affiliated with any hospitals or research institutions?
These answers will hopefully help guide you in finding a facility you’re comfortable with before making a decision.
10. Only You Will Know What’s Right for Your Family
Parenting isn’t a one-size-fits-all endeavor, and neither is cord blood banking. Different families will do the same research and come to different conclusions about what’s best. Maybe you’ll go public, maybe you’ll go private, or maybe you’ll just let it go. No matter what camp you end up in, if you’ve done your research and made an informed decision based on what you think is best for your family, you made the right call.