As you prepare your birth plan in the months leading up to your due date, you’ll need to make many decisions, including whether to bank or donate your baby’s umbilical cord blood. Cord blood banking is an important consideration even if you don’t have a family member who is ill. According to the Health Resources and Services Administration, each year nearly 20,000 people stand to benefit from a potentially life-saving bone marrow umbilical cord blood transplant.
Your baby’s cord blood contains many types of stem cells. The stem cells taken from cord blood are hematopoietic progenitor cells, which are also found in bone marrow. These cells have the capability to turn into any other kind of cells, and can be used to treat many diseases, including cancer. Unlike bone marrow cells, cord blood cells can easily be collected — but they can only be collected immediately after birth.
Cord blood stem cells from your baby can be genetically similar to the stem cells of other siblings and can potentially help save a sibling’s life. This is why cord blood banking appeals to many families. But this similarity does NOT extend to the parents, for reasons explained in greater detail below.
The cost of banking your baby’s cord blood can be high. If you are interested in donating your cord blood to help another family or to benefit scientific research, you can do so if you qualify as a donor, and as long as your doctor and birthing hospital are willing to do the cord blood collection.
The Value of Cord Blood Banking
Since the first successful umbilical cord blood transplant in 1988, stem cell transplants have been used to treat at least 80 different diseases and have become the standard of care for many life-threatening blood disorders, such as leukemia, myelodysplastic syndromes, and lymphomas. Stem cell transplants are also used as therapies in clinical trials for autoimmune disease and diseases of the central nervous system, and as experimental treatments.
Paying for private cord blood banking can be worthwhile for families with a history of illness. It may also benefit families who are adopting a newborn or using donor eggs or sperm. If your adopted child needs stem cell treatments in the future, you may not have access to a biologically related family member.
If the mother and father come from different ethnic backgrounds (which means that they have less DNA in common with each other), cord blood banking can make sense, since finding genetically matching tissues from an unrelated donor for transplant is far less likely.
Of course it is impossible to predict whether your child will need his or her own stem cells to treat a medical condition in the future, and the child’s stem cells may not be good match for a family member. In some instances, the stem cell transplant may not be able to treat or cure the disease.
The Genetics of Cord Blood Transplant
Babies inherit half of their DNA from their mother and half from their father. There are six genes that are known to affect the body’s ability to accept an organ transplant. These are called the HLA genes. One set of three genes comes from the mother and the other set of three genes comes from the father. A six-out-of-six match is the best predictor of success for an organ transplant, and when they are used as part of a bone marrow transplant, cord blood stem cells are the “organ” being transplanted.
Due to the biology of inheritance, a child can match zero, three, or six out of six with a sibling. In fact there is a one in four chance that any sibling will be a six out of six match for any other sibling, but you would never know unless you tested all the children for their HLA genes. Unfortunately, for the same reason, a child will always be a three out of six match for either parent, and thus their cord blood would not be useful for a parent who needed a bone marrow donor.
Collection and Storage of Cord Blood
A few minutes after your baby is born, the umbilical cord is clamped on both sides and cut (either before or after the delivery of the placenta). A nurse or your practitioner will collect the blood from the umbilical cord either by drawing the blood with a syringe and bag system or by elevating the umbilical cord so that the blood drains into a collection bag. This painless procedure takes just a few minutes.
The blood is then transported or shipped to a private or public cord blood bank, where it will be tested. The stem cells are extracted from the cord blood and then frozen and stored in liquid nitrogen. Stem cells can be stored in this condition for many years. There are reports of stem cells remaining viable after 30 years of storage, and researchers suspect that they can be preserved for much longer.
Saving Cord Tissue
Most cord blood banks now also provide the option to save a segment of the umbilical cord itself. The cord tissue (particularly the Wharton’s jelly component, which is the stiff material surrounding the cord blood vessels) is rich in a different type of stem cell, one that has promise for treating diseases in the future other than blood or bone marrow type conditions.
Private Cord Blood Banking
Families who choose to pay for private cord blood banking do so for many reasons. In private cord blood banking, the family makes all decisions about how the baby’s cord blood is used. Typically, the baby’s cord blood is banked for his or her own use in the future or for use by a family member (like a sibling).
After you have chosen a private bank to store your baby’s cord blood, the company will send you a collection kit that you must bring to the hospital or birthing center at delivery. Your nurse or practitioner will be responsible for collecting the blood. Then it’s packed in the pre-labeled collection kit for shipment through a designated courier, or for pickup if the company within driving distance. After the bank receives the blood, it will be tested and then frozen and stored in liquid nitrogen. Disease screening and a blood test called human leukocyte antigen typing (which determines whether the blood is a match for a particular patient) are not performed on the blood until it is needed for use.
There are many private cord blood banks. Before deciding on one, it is important to do some research. Ask about the bank’s informed consent process, processing and storage technology, and how you can access the blood if you need it. The bank should comply with national accreditation standards.
Cost of Private Cord Blood Banking
The cost of private cord blood banking varies from one bank to another, but generally ranges from $1,000 to $2,000 for the initial collection of the blood, followed by annual storage fees of around $100 a year.
Monthly payment plans for the upfront cost may be available. Depending on your family’s medical needs, some cord blood banks may offer free or discounted rates if, for example, if a sibling or other close family member is likely to need a transplant in the near future. In this instance, your medical insurance may pay the costs for cord blood collection but typically this cost is not covered by insurance.
Choosing a Private Cord Blood Bank
Cord blood banking is an expensive service, and there are nearly 100 cord blood banks out there marketing themselves to pregnant women. But some cord blood banks cannot be trusted to safely prepare and store these precious cells so that they will still be viable if you ever need them. How do you know if a cord blood bank can be trusted? Think of them like a life insurance company. Do you trust that the company will be able to honor your claim, which could be many years from now?
Questions to ask a private cord blood bank:
- How long have you been in business?
- How many specimens do you have in storage?
- How many have been used for transplant? What percentage of those were still viable after being thawed out?
- Do you own your own facility, or do you lease space from another company?
Donating Cord Blood
In most cases, donating cord blood is free. A public cord blood bank will pay for the collection and storage of the blood. Most public cord blood banks require the mother to register by the 34th week of pregnancy. The cord blood bank will review the maternal and family medical history to determine whether your donation should be used for research or placed on a national registry. There are some cases in which you may not be eligible to donate.
Once the blood is collected, it is typed and screened for infectious diseases and hereditary blood disorders. If the donation meets the size threshold for transplant use, it will be stored and then listed on a registry that can be searched by patients who need stem cell transplants.
When you donate your baby’s cord blood, you sign away all rights to it. The cord blood bank owns the blood. If you or a family member needs it in the future, there is no guarantee that it will be available for your use.
To donate your baby’s cord blood, you have two options:
- You give birth at a birthing hospital that accepts donations. However, there are few large birthing hospitals in the United States that accept donations. To locate a donation site, go to: https://parentsguidecordblood.org/. This web site features a map of the United States that shows all the donation centers and their contact information.
- You use a mail-in donation program. If your birthing hospital does not accept donations or there is no donation center in your state, you can contact a mail-in donation program. The term “mail-in” does not mean that you actually mail in the cord blood. You receive a cord blood collection kit in the mail that you take with you to the hospital when you deliver your baby.
Before signing up to donate your baby’s cord blood, you should find out whether your doctor or hospital charges any fees for cord blood collection.
Other Resources:
Cord Blood Registry (Newborn Possibilities Program) – 888-932-6568
LifebankUSA – 877-543-3226
Viacord (Sibling Connection Program) – 800-998-4226