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Cord Blood. No, It’s Not a New Vampire Movie…


photo: jatawny m chatmon

As a new parent, we have a ton of choices to make. Find out the sex? Have a home birth or hospital one?  Vaccinate or not? Well, there is another decision to add to the mix that may not even be on our radar.

Should we store our baby's umbilical cord blood? I’m going to give you the lowdown on what it is exactly, and what your options are.

Cord blood is the blood that is drained out of the placenta and remaining umbilical cord, after the umbilical cord is cut. This blood is medically valuable because it is rich in baby's stem cells, which are immature blood cells that are able to change and mature into any type of blood cell as baby grows, just like bone marrow cells. When stored, these cells are preserved in a storage facility, ready for use if needed in the future.

The How.

When baby is born, and the umbilical cord is cut, the OB or midwife collects the blood from the remaining umbilical cord and placenta. The process is simple, painless, completely safe and non-invasive, and takes just a few minutes. Within hours the cord blood is picked up and shipped overnight or taken to the cord blood bank. Once there, it is processed. The stem cells are removed from the cord blood, and it is placed into deep freeze storage.

The Options.

When deciding what to do with your cord blood you have three choices: donate to a public bank, contract with a private bank or discard it as medical waste. A public bank (non-profit) like the American Red Cross takes in donations for use of the greater public. A private bank (for-profit) offers you the opportunity to bank your blood exclusively for you and your family, making the stem cells available when you need them most.

The Pros of Private Banking.

Cord blood stem cells have already been used to treat more than 75 diseases, including numerous types of malignancies, anemias, inherited metabolic disorders and deficiencies of the immune system, and a variety of pediatric disorders including leukemia, and sickle cell disease.

Cord blood stem cells are not just for your baby. It can be an investment for the whole family. Virtually all mothers and about half of siblings will be a suitable match for baby's stem cells. And while the chance that any family member will use the cord blood for cancer treatment is very low, the likelihood that it could be used to treat a variety of other diseases is considerable.

It’s good for:

Patients who need a transplant quickly, as the cord blood units are stored and ready to use, and no time is spent searching for a match.

Patients from racially or ethnically diverse communities, who often have uncommon tissue types, and subsequently, might have a hard time finding a matched bone marrow donor. Cord blood does not have to match a patient's tissue type as closely as donated bone marrow does.

In general, some of the diseases cord blood is being used to treat:

Cancer and other blood-related disorders, Multiple Sclerosis, Strokes, Nerve and Brain Damage, Vascular Disease, Coronary Artery Disease, and Heart Attacks.

Here is a very pro argument from Dr. Sears.

The Cons of Private Banking.

Although money shouldn't be a factor when it comes to possibly 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, or pay for a full 10 or 18 years in advance. First-year fees can range from $595 to $1,835, depending on which private bank you choose. Annual storage fees are usually about $95-$125.

The American Academy of Pediatrics sums up most of the cons against private cord banking 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.

"I think people are paying for nothing," said Dr. Eliane Gluckman, president of the European School of Hematology and the physician who did the world's first cord-blood transplant in 1988.

Although it can't hurt to save umbilical cord blood, many experts say the private cord banks are selling a costly service aimed at a scenario that is unlikely ever to happen. If a transplant is recommended, a match is nearly always found in the global public donor program, which has more than 300,000 units of cord blood banked.

Even if a child does have her cord blood stored, physicians wouldn't use it to treat her if she developed, say, sickle cell anemia, or leukemia. The blood would contain the same genetic defect.

The Choice.

If opting for a private bank, you must arrange for it ahead of time. It is not a decision you can make at the last minute.

Choose a bank you feel confident is going to be in business decades from now. Those cells need to stay frozen without interruption year after year after year. Three of the biggest, oldest and most experienced are Cord Blood Registry, ViaCord and StemCyte.

Ask how the kit, once it is packed with the cord blood, is going to be shipped to the company for processing and storage. Is it going to be sent through a medical courier with experience transporting blood products?

For how many transplants has the company supplied stem cells? Most companies with experience will tout that on their Web sites. Also look at whether the company tests units for infectious diseases or contamination.

Parents who choose not to bank their baby's cord blood through a private bank should strongly consider donating it to a public bank. There are several around the country, and some hospitals have programs set up for parents to donate. This makes the stem cells available to anyone who matches, and there is a huge need for this worldwide. Or they might be used for vital medical research.

The National Marrow Donor Program keeps a list of participating hospitals, as well as instructions for arranging donation yourself. Click here to learn if you can donate.

Thousands of patients with leukemia and other life-threatening diseases need a transplant and depend on the public Be The Match Registry for an unrelated matching bone marrow donor or umbilical cord blood unit.

If you donate cord blood to a public bank, the cord blood can be transplanted into any patient whose doctor selects the cord blood unit as the best match for that patient. Your baby may help save someone else’s child.

If you're still not sure what you want to do, talk to your doctor or midwife about the options. He or she will be best able to answer your questions based on your family medical history.

What are your thoughts? This is a hot topic, and I’d love to hear from all of you mamas out there. The more information we all have, the better!

As always, if you have a question of your own, email me, and I’ll do my best to answer it!

xo Melanie


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