Cord Blood Banking

Cord blood banks promise that saving your baby's cord blood is an important form of insurance for his/her health. But cord blood banking can be expensive, and medical experts question the value of banking for most families. It's important to understand what cord blood is and how it's used before making a decision about cord blood banking.

Cord blood is the blood remaining in the placenta and umbilical cord after the umbilical cord is cut. It is rich in a special kind of stem cells which are similar to ones found in bone marrow. These hematopoetic (blood-making) stem cells can make all the different kinds of blood cells that a person needs.

Cord blood can be used to treat many of the same diseases as a bone marrow transplant. These include leukemia, lymphoma, and certain genetic and immune system diseases. Cord blood does not require as close a genetic match as bone marrow, so doctors will sometimes use it when a bone marrow donor can not be found.

In the past, cord blood was simply discarded after a baby's birth. But as doctors have discovered its value, techniques have been developed to store it for future use.

Some parents choose to donate their baby's cord blood to a national registry, so it will be available to any family who needs it. Others choose to pay a private bank to store it. In most cases, the cord blood is still discarded, either because parents do not choose to save it, or because the birthing place is not equipped to do so.

Unfortunately, if a child develops an illness requiring a transplant, odds are that the seeds of the illness are already present in that child's cord blood. Genetic problems, for example, are in all of the child's cells, including the cord blood. And most doctors won’t use a child's own cord blood to treat leukemia, because cells predisposed to leukemia may already exist in the cord blood.

Certain adult diseases could, in theory, be treated with a person's own cord blood. But there may not be enough blood cells in the sample for an adult. In the future, technology may exist to multiply the cells. It's also possible that, someday, cord blood will be useful in ways we don’t yet understand.

For now, if a child needs a cord blood transplant, it's more likely to come from a sibling or be donated by another family.

When a patient needs a bone marrow transplant, doctors look to family members first. Bone marrow transplants require a very close match of certain genetic markers. There is a one in four chance that a sibling will match perfectly. Because it doesn't have to match as closely, a healthy sibling's cord blood is even more likely than bone marrow to be a good match.

At least for now, cord blood can't be used in all cases requiring bone marrow transplants. Also, there's still a chance it won't match even if it is needed. However, some parents feel that it's worth making the effort to store the cord blood.

Cord blood is frozen at very low temperatures. No one knows for sure how long it lasts, because cord blood banking is still relatively new. Samples have been thawed and found usable after ten years of storage. Theoretically, if it's properly frozen, cord blood should last much longer.

There is no charge if you donate your baby's cord blood to a public registry. If you choose to save the cord blood for your own family, charges begin around $1,500 for collection and storage. You can expect to pay an annual fee of about $125.

If you have a child or other family member who needs a cord blood transplant, and you are expecting a baby, talk with your insurance provider. If a transplant is appropriate, insurance may cover both harvesting of the cord blood and the transplant itself.

If you have a child with an illness that makes the need for transplant likely, there are a few organizations which will provide free preparation and storage of your new baby's cord blood. The National Marrow Donor Program maybe be able to connect you with an organization that can help.

The American Academy of Pediatrics does not recommend private cord blood banking unless it's clear that the child or someone in the family is likely to need the blood. Instead, they recommend donating the cord blood to a public registry.

Families of minority or mixed ethnic backgrounds can sometimes have a hard time finding a matching donor. Families like this may want to donate cord blood so that it will be easier for others to find a match. Or they may choose to keep the cord blood, in case a family member needs it.

You should do your own research and discuss the issue thoroughly with your doctor before making a decision.

• The National Marrow Donor Program. Visit the Center for Cord Blood for FAQ's and other information.
• The Childrens Hospital Oakland Research Institute. Look under Research Centers and Services for the Sibling Donor Cord Blood Program.
• A Parents Guide to Cord Blood Banks. A very extensive site by a mom who lost a child to cancer.

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