Pregnancy: Should I bank my baby's umbilical cord blood?

Your options
• Have your baby's cord blood collected and sent to a private cord blood bank or a public cord blood bank.
• Do not bank or donate your baby's cord blood.

Key points to remember•
Doctors do not recommend that you bank cord blood on the slight chance that your baby will need stem cells someday. If your baby were to need stem cells, he or she would probably need stem cells from someone else rather than his or her own stem cells.1
• Although privately banked cord blood is not likely to help your baby, it may help a sibling who has an illness that could be treated with a stem cell transplant. These include leukemia, sickle cell disease, Hodgkin's lymphoma, and thalassemia. Doctors recommend that you bank your baby's cord blood only if a family member already has one of these illnesses.
• You might consider donating the cord blood to a public bank instead. You probably won't be able to use the blood, but it could be used for research or for another child.
• Private cord blood banking is expensive. You will pay a starting fee of about $1,000 to $2,000, plus a storage fee of around $100 a year for as long as the blood is stored.
• If you want to save the cord blood, you must arrange for it ahead of time. It is not a decision you can make at the last minute.
• Collecting the cord blood does not cause pain.

What is umbilical cord blood?
Cord blood is the blood left in the umbilical cord after birth. It contains stem cells. These cells have the amazing ability to grow into many different kinds of cells, like bone marrow cells, blood cells, or brain cells. This can make them valuable for treating some diseases.

Diseases that can be treated with stem cell transplants include leukemia, Hodgkin’s disease, and some types of anemia. When healthy stem cells are transplanted into a child who is ill, those cells can grow new bone marrow cells to replace the ones destroyed by the disease or its treatment. Stem cells from the child's own cord blood often cannot be used, because they may have led to the disease in the first place.

Much research is being done to see if stem cells can be used to treat more problems. For now, though, treatment is limited to diseases that affect blood cells.
Cord blood kept in a private bank is usually used to treat disease in a brother or sister. Cord blood stem cells are rarely used to treat adults, who normally need more stem cells than cord blood has.

What is cord blood banking?
The umbilical cord is usually thrown away after birth. But the blood inside the cord can be saved, or banked, for possible later use. The blood is drawn from the umbilical cord after the cord has been clamped and cut. Cord blood banks freeze the cord blood for storage.

You may save your baby's cord blood in a private bank or donate it to a public bank. Private banks charge a fee to store cord blood for your family's use. If you donate the cord blood to a public bank, the cord blood can be used by anyone who needs it.
During your pregnancy, you may get ads or brochures from private cord blood banks. Some of them suggest that parents should save the cord blood in case the baby should one day need a stem cell transplant. Be wary of banks that urge cord blood banking for this reason. It is not known how likely a child is to need a transplant of his or her own cells, but experts say the chances are very small.1

Private cord blood banks have collected hundreds of thousands of cord blood samples. But the blood has been used in only a small number of transplants.2 Most transplants of cord blood stem cells use cord blood donated by others to public banks.
One reason why donations to public cord banks are so valuable is that stem cells from cord blood do not need to be as perfectly matched for a transplant as do stem cells from adult bone marrow. Stem cells from cord blood are not as mature, so the transplant patient's body is much less likely to reject them.

What are the risks of cord blood banking?
Collecting a baby’s cord blood is quick and does not cause pain. But it does have a small risk. The umbilical cord must not be clamped and cut too soon. Clamping as soon as possible increases how much blood is collected. But if it is done too quickly, it could cause the baby to have less blood. This could lead to anemia.
It is very unlikely that anyone in your family will ever need your baby's cord blood. The only people likely to use privately banked blood are those who already have a child with an illness that could be treated with cord blood from a baby brother or sister.1
It costs money to store your baby’s cord blood. Private banks charge about $1,000 to $2,000 to start. Then you must pay yearly storage fees for as long as the blood is stored. The storage fees cost $115 to $125 a year. Health plans usually do not cover these costs. Only you can decide if the cost makes sense for you and your family.
Doctors worry that the advertising done by private cord blood banks may make some parents feel guilty if they do not want or cannot pay to store their baby’s cord blood. Pregnancy and childbirth are emotional times, so learn all you can ahead of time.

What other things should you consider?
The American Academy of Pediatrics says storing cord blood in a private bank without a medical reason is not wise. This group of doctors recommends that you consider it only if a family member has a disease that could be treated with a stem cell transplant.3
Some private blood banks will waive their fees for families who need the stem cells right away.
If you bank or donate your baby's cord blood, it will be tested for genetic and infectious diseases. What you learn from a genetic test can affect your life and that of your family in many ways.
• Learning that your child is likely to develop a serious disease can be scary or depressing. This information may also affect your relationships with other family members.
• If your child tests positive for a gene that will cause a disease, you may decide to use treatment, if available, to prevent the disease or to make it less severe. Although many treatments work well, others may be unproven or may even be dangerous.
• Some people worry that gene test results will make it hard to get insurance.

Private banking: If you decide to bank your baby's cord blood, make sure that the blood bank you use is approved by a reputable regulatory agency, such as the American Association of Blood Banks. Look for a bank that has tested and stored many cord blood samples and whose samples have been used successfully in transplants. Ask for a copy of the bank's policies and procedures.

Public banking: You may decide that you would like to donate your baby’s cord blood. Donating makes the stem cells available to others. It does not cost anything. Unfortunately, it is not yet an option in many communities. Call the hospital where you plan to give birth to find out if you can donate cord blood there.

Why might your doctor recommend banking your baby's cord blood?
Your doctor might recommend privately banking your baby's umbilical cord blood if:
• You have another child who has a disease that could be treated with a stem cell transplant.

Compare your options
Bank cord blood Bank cord blood
What is usually involved?
• Long before birth, you arrange to bank your baby's cord blood.
• The blood is drawn from the umbilical cord after the cord has been clamped and cut.
• A cord blood bank freezes the cord blood for storage.

What are the benefits?•
Cord blood in a private bank could be used for a sibling who has an illness that can be treated with cord blood from a baby brother or sister.
• Giving the blood to a public cord bank could help research or some other child who needs it.

What are the risks and side effects?
• If the cord is clamped and cut too soon, your baby may become anemic.
• Private cord banking costs a lot. Banks charge $1,100 to $1,750 to start storage, then fees of more than $100 a year.
• Cord blood is tested for diseases. You could find out about a gene that may one day give your child a disease. This news could affect health insurance and job options.
Don't bank cord blood Don't bank cord blood

What is usually involved?
• The umbilical cord is thrown away after birth.
What are the benefits?
• You save money by not putting blood in a private cord bank.
• You avoid the small risk that the cord could be clamped and cut too soon. With less blood, the baby may become anemic.
What are the risks and side effects?
• Your child could later get an illness that could have been treated with a stem cell transplant. But experts say the chance that a child will need a transplant of his or her own cells is very small.1

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