Should I bank my baby's cord blood?

This post was originally published in August 2013 

Along with pregnancy comes an overwhelming number of decisions that must be made in preparation for baby’s arrival. If you’ve been to an obstetrician’s office lately, you’ve likely seen advertisements for cord blood banks.

What is cord blood?

Simply stated, cord blood refers to the blood that remains in your newborn baby’s umbilical cord after birth. This blood contains stem cells, which can sometimes be used to treat immune, genetic and blood disorders or certain types of cancer in children. Cord blood is collected immediately after birth and can be obtained after vaginal or cesarean deliveries.

When discussing the uses of cord blood, it is helpful to separate these uses into two categories: current therapeutic uses of stem cells and their potential for the future. Currently, stem cells obtained from cord blood can be used for transplantation in the treatment of certain types of leukemias, lymphomas, severe anemias, and immune system disorders. (Keep in mind this isn’t an exhaustive list of all clinical indications). However, much of the interest in cord blood hinges on the potential for the future. Ongoing research is focusing on the potential use of stem cells in the treatment of a variety of diseases- ranging from Alzheimer’s disease to autism. While this is certainly a reason for optimism, it should be noted that these future uses are still speculative.

What is a cord blood bank?

Public banks store cord blood for use by individuals who have a medical need for transplant. Those in need of stem cells undergo a donor matching process, similar to (but more extensive than) the matching required for blood transfusions. A private cord blood bank, though, allows you to store your own cord blood for your own (or your family’s) future use. You pay an initial fee and an ongoing monthly fee for the bank to store your sample.

Before you make your decision, consider:

Opportunities to use the cord blood

Often, the use of a private cord blood bank is seen as an “insurance policy” of sorts: in case the unthinkable happens and my child is diagnosed with a disease, perhaps the cord blood we secured at birth will be able to cure it. However, the reality is that there are very specific and very rare instances where children need and are able to utilize this “insurance.” Even in cases where a child has an illness and a stem cell transplant is necessary, it is not always medically advised for the child to utilize their own stem cells. Sometimes it is best to find a sibling match or an unrelated donor match; it depends on the patient’s specific circumstances. For the average family, the need for a private cord blood supply is probably very low.

For those families, though, that have a family member with an existing condition that may require a transplant, it may be advantageous to bank the cord blood of any future children.

Private banking versus donation

For many parents, the fear of a child facing any type of disease will drive us to do whatever we can to protect them. It’s important, though, to recognize that there are more options than utilizing a private cord blood bank. You also have the opportunity (at no cost) to donate your baby’s cord blood, which will be stored and utilized in a public bank to help those in need of stem cell transplants. In the rare case that your child becomes ill and in need of a stem cell transplant, you have access to the public database of donors. The larger the public banks are, the more likely each patient in need will find a matching donor.

Cost

For many families, the cost of using a private cord blood bank is prohibitive. The initial cost for collection of the cord blood and storage for the first year is around $2,000. After the first year, you must pay a yearly storage fee between $100-$200. This service is typically not covered by insurance plans.

Is it recommended by the experts?

In 2009, a survey of pediatric stem cell transplant physicians in the United States and Canada was conducted to determine whether the experts in this field would recommend private cord blood banking. Overwhelmingly, these physicians were in agreement that unless there were a family member who had a disease requiring a stem cell transplant, they did not feel that it was advantageous for families to use a private cord blood bank. A few of these physicians (11%) felt that if the parents of the child were of different ethnicities, they may be more likely to recommend private cord blood banking since donor matching is more difficult for mixed ethnicities.

The American Academy of Pediatrics does not recommend private banking of your baby’s cord blood. Instead, they recommend donating your baby’s cord blood for individuals in need.

If you have questions about private cord blood banking, talk with your obstetrician and/or your pediatrician to discuss which option is right for your family.

Did you decide to bank your baby’s cord blood? Why or why not?