Expert Advice

Cord Blood Banking 101

by Kim Walls

Who can I trust to honestly answer my questions about Cord Blood Banking? It seems like most of the informational sites and resources out there are either operated by, or sponsored by, the cord blood banks themselves.

Our Expert Team at Best Ever Baby provides parents with authentic, medically verified answers that show all sides of the issues around Cord Blood Banking. For parents who choose to bank their baby’s cord blood, we recommend our preferred cord blood banks. But we absolutely do not want to sway parents to make any particular choice.

“To bank or not to bank”, and “to bank privately or publicly”, are 100% personal choices made by parents on behalf of their families. Instead of promoting a certain choice, we provide the facts so parents can make their own informed decisions.

 

What is cord blood?

Cord blood is the blood that remains in the umbilical cord and placenta immediately after baby is born. What makes cord blood special is that it contains special stem cells (blood-forming and progenitor cells) that can reproduce themselves and diversify to potentially replace a person’s entire immune system.

 

What are umbilical cord blood stem cells?

Your baby’s cord blood contains an abundant source of stem cells that are genetically related to your baby and your family. Stem cells[1] contribute to the development of all tissues, organs, and systems in the body. They are the building blocks of the immune system and are able to transform into other types of cells in the body to create new growth and healing.

 

What does umbilical cord blood do?

While your little one is growing inside you, the umbilical cord blood provides necessary nutrients and oxygen to sustain life. After baby is born, the umbilical cord is cut and the remaining blood and tissues will be discarded as medical waste unless you plan to either donate the blood or bank it privately.

 

What is umbilical cord blood banking?

Umbilical cord blood banking refers to the collection, preservation and storage of stem cells from cord blood. It is a way to cryopreserve the stem cells in umbilical cord blood for later use in medical therapies such as stem cell transplants and clinical trials. A normal cord blood collection unit – preserved through cord blood banking – contains millions of these special stem and progenitor cells. By choosing to bank your baby’s cord blood, you are preserving potentially life-saving cells that would otherwise be thrown away after birth.

 

Why would I save my baby’s cord blood?

The reason people save umbilical cord blood is because the stem cells from this blood can be used to treat about 80 different diseases[2] and to develop regenerative therapies. Because cord blood stem cells have distinct benefits over sources of adult stem cells (like bone marrow and peripheral blood), they are regularly chosen by transplant physicians to treat many forms of cancer, blood disorders, and immune diseases.

 

What is cord blood banking used for?

Publicly donated cord blood could be used for transplants to anyone in need, or for medical research. Research might include clinical trials on patients as well as development of cell therapy drugs and devices.

Private/family cord blood banking is used to store the stem cells from your baby’s umbilical cord blood and placenta for private use by genetically-related people – including your baby, your other children, and other biological family members – if ever needed. Ideally, and most likely, you would not need to access your baby’s stem cells in order to address a medical concern. However, using a cord blood bank can provide peace of mind in knowing that you have the option if anyone in your family ever wants it.

Stem cells provide doctors with a way to treat leukemia and some inherited health disorders. The stem cells from your baby’s cord blood may also be effective in treating certain diseases or conditions of a parent or sibling.

Cord blood stem cells have similar ability to treat disease as do bone marrow cells, but with significantly less risk of rejection. That is why cord blood is often used as a substitute for bone marrow in stem cell transplants.

About 80-90 diseases are treated this way, including cancers, blood disorders, or genetic and metabolic diseases.

How is cord blood stored?

Your baby’s cord blood will be prepared, frozen, and then stored in a liquid nitrogen freezer at a laboratory facility, often referred to as a blood bank. If you choose private/family banking, then you can think of your “unit” of stem cells stored in a blood bank like cash stored in a safe deposit box at a financial institution.

Your baby’s cord blood stem cells are kept safely for you to access someday if you want to, assuming the bank stays in business.

Publicly banked blood is stored the same way – in a liquid nitrogen freezer. But it is added to a public registry that the medical community can access to find a match for someone in need. Or, they can use it for research or clinical trials.

 

How long can cord blood be stored?

There is medical confirmation[3] that cryogenically preserved stem cells have been viable after 23.5 years of being frozen. Lab studies show a high likelihood that cord blood can be frozen for decades and still be a potent source of cells. Essentially, the answer to this question is unknown because the cord blood banking industry has only been around for about 25 years.

 

Who can use cord blood?

Anyone in need of cord blood transplants or stem cell therapy can use cord blood. On average, 1 in 200 Americans[4] will have a stem cell transplant.

There are currently about 80-90 medical conditions for which cord blood provides meaningful treatments. The baby’s own cord blood stem cells are currently used to treat 4 of those 90[5] conditions. Someone else’s cord blood, which was most likely donated for public use, treats the rest.

The likelihood of someone in the immediate family needing a transplant increases with age. So, immediate family members – like siblings or parents – are more likely to use privately banked cord blood than the baby who provided it. The odds of a child benefitting from their own stem cells are currently 1 in 5,000. The odds of a child using their sibling’s cord blood are currently about 1 in 2,700[6].

Most people who invest in saving their baby’s cord blood are doing so because they are confident that the future will continue to be bright for the development of stem cell therapies.

Stem cell science is indeed advancing very quickly. There are several studies in late stages (many close to becoming standard therapies) where one’s own stem cells can be used, including Crohn’s Disease, traumatic brain injuries (the #1 cause of childhood death in the US), and heart issues like stroke and myocardial infarction.

 

How do you save cord blood after birth?

To save your baby’s cord blood, you’ll need to pick a public or private/family blood bank before going into labor. Making this decision about three months[7] before baby is due gives you time to talk with your healthcare provider and your hospital. As of 2016, the deadline for making your decision is up to 34 weeks gestation[8].

The cord blood bank provides a blood collection kit for you to take in your hospital or labor bag. Some hospitals are equipped to allow you to make this choice on the spot, but most of them are not.

If you plan to donate your blood, check with your hospital to see if they support collections directly for public banks. If they don’t, you can still donate your baby’s cord blood by registering for a mail-in donation program.

The collection process is simple, safe, and painless. It usually takes less than five minutes. Cord blood collection does not interfere with delivery and is possible with both vaginal and surgical deliveries. However, cord blood may only be collected during the first 15 minutes after the cord is cut and must be processed by a laboratory within 48 hours of collection.

At the time of collection, you don’t have to do anything differently. Your healthcare providers will do all the work. All you need to do is make a decision about what you want, and then be prepared with your collection kit. Your cord blood banking decisions should be represented in your birth plan.

Are there any health risks to mother or baby?

No. There are no health risks related to cord blood and tissue collection. Cord blood is retrieved from the placenta and umbilical cord after the cord has been cut, thus preventing any pain, discomfort, or harm. This process is completely safe. For baby’s best health, it is important to wait 3-5 minutes or until the cord stops pulsing before cutting the umbilical cord.

 

Can I store my baby’s umbilical cord blood regardless of where and how I choose to birth – hospital, birth center, home, vaginal or surgical (cesarean)?

Yes. Whether you have a vaginal or surgical birth, or have it at home or in a hospital, your baby’s umbilical cord blood can usually be safely collected. Just make sure to have your collection kit with you, wherever you birth.

 

Can I still save my baby’s cord blood if I opt for delayed cord clamping?

Yes. World Health Organization recommends waiting at least 1–3 minutes[9] before cutting the cord. Many professionals strongly recommend waiting even longer – until the cord stops pulsing. This generally takes 3 to 5 minutes, but could take longer.

Delaying umbilical cord clamping/cutting has proven to increase iron stores, blood volume, and brain development in infants[10]. Though delayed clamping reduces the overall volume of blood that can be collected, it does not interfere with stem cell collection.

Scientists have now established ways to multiply the stem cell count from a smaller collection. There are so many stem cells in the placenta and cord blood that a smaller amount of blood still offers a very high count of stem cells. If cord blood collection can be done after the placenta is delivered, even more blood is available than can be collected from just the umbilical cord.

According to most cord blood banking companies, about half of your baby’s stem cells (many millions, if not billions) are generally still inside the placenta and umbilical cord after it stops pulsing. These are easily collected for preservation. There are anecdotal stories of families who have waited over an hour to cut the cord then collected cord blood and retained a wealth of viable stem cells.

In any case, cord blood needs to be collected within about 15 minutes of cutting the umbilical cord (before the blood starts to coagulate), then processed within 48 hours.

Remember that if you’re giving birth in the hospital or birthing center, this decision needs to be included in your final birth plan, and the collection kit needs to be on your hospital bag checklist!

 

[1] https://parentsguidecordblood.org/en/what-is-cord-blood

[2] https://parentsguidecordblood.org/en/diseases

[3] https://www.ncbi.nlm.nih.gov/pubmed/21393480

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2531159/

[5] https://parentsguidecordblood.org/en/diseases

[6] https://parentsguidecordblood.org/en/odds

[7] http://bloodcell.transplant.hrsa.gov/cord/options/donating/index.html

[8] https://parentsguidecordblood.org/en/faqs#q-18447

[9] http://apps.who.int/iris/bitstream/10665/120074/1/WHO_RHR_14.19_eng.pdf

[10] http://apps.who.int/iris/bitstream/10665/120074/1/WHO_RHR_14.19_eng.pdf

 

To learn more about parenting decisions before birth, download our free Birth Plan eBook now. After three years of research, collaboration with more than 100 childbirth experts and resource centers from Healthy Child Healthy World to the American Association of Neonatal Nurses, the Best Ever Baby Birth Plan Guide is available for a free download.

This new resource for pregnant families is a compilation of top tips and advice from more than 20 nationally-recognized experts in the field including renowned pediatrician, Dr. Alan Greene and GraceFull Birthing founder, midwife Elizabeth Bachner. These trusted experts offer thoughtful guidance for whatever type of birthing experience parents want, in whichever setting they choose.

 

Published: December 10, 2016 | Reviewed by: The Best Ever Baby Expert Team | Last reviewed: December, 2016

Kim WallsCord Blood Banking 101

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