There are many decisions that tug at an expectant mom's heart. One is whether to bank her newborn’s umbilical cord blood. It’s a decision that needs to be made early in pregnancy, and can only be completed successfully 10 to 20 minutes after birth. Should you do it?
Here’s what the experts have to say:
Why save the cord blood?
Because it is full of stem cells that can be used to treat genetic disorders or blood cancers, said Charis Ober, co-founder of Save The Cord, a nonprofit foundation and advocacy group. There are two ways to bank cord blood: privately, for the donor’s own family use, and publicly, where it is donated to a national registry.
What is the difference between public and private banking?
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Private banking is when a family banks a baby's blood for their own use. Public banking is a donation that allows anyone in need to use it. There are significant cost differences between the two. Private cord blood banking can cost a few hundred to two thousand dollars to collect, plus an annual fee for storage, Ober said. Public cord banking is conducted at no cost to the donor family.
How is cord blood used?
Whatever the avenue chosen, cord blood can be used in stem cell transplants to treat 80 genetic diseases and blood cancers, and it is being used in regenerative medicine, to treat and reverse certain maladies, such as cerebral palsy, Ober said. It is also used in research.
Can cord blood banking save my child’s life?
With a private donation, where you bank it for your family, it’s not collected to use on the donor child, because you wouldn’t want to reintroduce diseased stem cells, said Mary Roberts, director of maternity at Memorial Hospital West. But it could be used to treat a family member who falls ill.
In 2007, The American Academy of Pediatrics recommended against private cord blood banking as “biological insurance” to save a donor child’s life.
“Physicians should be aware of the unsubstantiated claims of private cord blood banks made to future parents that promise to ensure infants or family members against serious illnesses in the future by use of the stem cells contained in cord blood,” the opinion said.
However, the academy did recommend private cord blood storage if “a full sibling in the family with a medical condition (malignant or genetic) could potentially benefit from cord blood transplantation,” and it recommended cord blood banked for public use.
Roberts said Memorial has taken a strong stand to educate expectant mothers about donating cord blood.
“With a public donation, you’re donating for the whole world, adding more possibilities for people in need of a match,” Roberts said. “It increases the pool of stem cells.”
Why are public donations needed?
Worldwide, about 50,000 stem cell transplants are conducted a year, according to the National Marrow Donor Program.
People in a minority who have cancer have a more difficult time finding a stem cell match, because there are not enough minority donors, Roberts said.
“At Memorial, we made a commitment to do this because the population is so diverse in South Florida. Our gene pool is diluted here, so it’s a great community to donate from,” she said.
But many expectant mothers do not know about public cord blood banking, Roberts said.
“That’s the crime. [If it’s not collected,] it goes in the trash, and it’s gone, and it could have saved someone’s life,” she said.
How many people do this?
“There are four million births a year in the U.S.,” Ober said. “Only 5 percent have cord blood collected; 95 percent of them are thrown away as medical waste.”
The numbers are small, Ober said, because many doctors are not familiar with the banks and the collection process.
Neither are many expectant mothers.
“Some have never heard of it. Some did it with their older kids. It’s like anything. There’s a wide variety of knowledge out there,” said Kim Zimmerman, director of obstetrical services at South Miami Hospital.
How is the cord blood collected?
It is a painless process that hurts neither the mother nor the baby. A few minutes after the birth, blood is collected from the umbilical cord and placed in the collection kit supplied by the bank. The blood is shipped overnight to the bank, where is it processed and frozen, Ober said.
Genetic and infectious disease testing is performed on the cord blood and if abnormalities are identified, the mother is notified.
Can I bank my cord blood from any hospital?
For a private bank, a mother obtains a collection kit and brings it to the delivery room. The blood is collected and given to the family to ship to the bank.
The three maternity hospitals in Memorial Healthcare System in Broward, and South Miami and Baptist hospitals in Dade, partner with Cord:Use, a public cord blood bank. If you donate to the public bank there, the staff takes care of sending the collected blood.
Of 11,000 babies delivered a year at Memorial’s three maternity hospitals, about 7-10 percent opt for private cord blood banking, with about 10-12 percent choosing public donations, Roberts said.
At South Miami Hospital, of the 4,300 births a year, about 16 percent have chosen private cord blood banking and 20 percent choose public cord blood donations, Zimmerman said.
Another option for women wanting to donate to a public bank is LifeForce Cryobank. Its Cord for Life public bank accepts cord blood donations from anywhere in the United States. Participating mothers can sign up for the program, get screened and receive a collection kit to bring to the hospital.
What would exclude me from donating cord blood?
Exclusions include if you are under 18, are having a multiple birth, if there is a question of paternity or if the baby is born prematurely, Roberts said. Cord blood also cannot be donated if you have a sexually transmitted disease or family history of certain diseases. A 15-page screening questionnaire, similar to one given when you donate blood, also is given to the mom to see if she is a good candidate, Roberts said.
An expectant mother who is interested in banking cord blood should have that conversation with her doctor early in her pregnancy, to allow time for screening, Zimmerman said.
How should I choose a private bank?
“Look at it like any other bank you would put your wealth in,” Ober said. How long has it been in business? Does it look like it will be in business for 20 years? What do other parents say?
Don’t just judge by price, she said. A cheaper bank may not have all the services, or be financially stable.
“We advocate for both public and private banking,” Ober said of Save the Cord, which keeps a database of public and private banks. “Parents will pay $1,000 for a crib. This is a medical resource that can save lives; can change lives. To me, spending money on this is a great investment.”