Should I bank my baby's umbilical cord blood?
Content provided by Healthwise
Introduction
This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.
Key points in making your decision
Banking your baby's umbilical cord blood means having it saved and stored for future use. Cord blood can be used for stem cell transplants to grow new bone marrow and other tissues. Storing your baby's cord blood is a personal decision that only you can make. Consider the following when making your decision:
- Banked cord blood is not likely to be helpful to your baby, but it may help a sibling who has an illness that could be treated with a stem cell transplant, including leukemia, sickle cell disease, Hodgkin's lymphoma, or thalassemia. Doctors recommend that you bank your baby's cord blood only if a family member already has one of these illnesses.
- Doctors do not recommend that you bank cord blood on the slight chance that your baby will have a disease that could be treated with stem cells. If that should happen, your baby will probably need stem cells from someone else rather than his or her own stem cells.
- You might consider donating the cord blood to a public bank instead. You 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 $1,500, 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 is painless. It does not harm your baby.
Medical Information
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.
Banked cord blood 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.
During your pregnancy, you may get ads or brochures from 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 units. 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 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 painless. 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 exception is the very few families who already have a child with an illness that could be treated with cord blood from a baby brother or sister.2
It costs money to store your baby’s cord blood. Banks charge $1,100 to $1,750 to start. Then you must pay yearly storage fees for as long as the blood is stored. The storage fees run from $115 to $125 a year. Health plans usually do not cover these costs. Only you can decide if the expense makes sense for you and your family. Other uses for the money—such as saving for college or paying for health insurance for your baby—might be better for you.
Doctors worry that the advertising done by 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. Don't base your decision on guilt.
What other things should I consider?
The American Academy of Pediatrics says banking cord blood without a medical reason is not wise. The academy recommends that you consider it only if a family member has a disease that could be treated with a stem cell transplant.1
Some banks will waive their fees for families who need the stem cells right away.
If you bank 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 disease-specific gene, you may decide to use treatment, if available, to prevent the disease or to reduce its impact or severity. While many treatments are effective, others may be potentially dangerous or of unproven value.
- Many people worry that genetic information released to insurance companies may affect future employment options or the cost or availability of insurance.
Private banking: If you decide to bank your baby's cord blood, make sure that the blood bank you use is accredited 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.
Donating cord blood: 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. Contact the hospital where you plan to give birth to find out if you can donate cord blood there.
Your Information
Your choices are:
- Arrange to have your baby's cord blood collected and sent to a cord blood bank.
- Do not bank your baby's cord blood.
The decision about whether to bank your baby's cord blood takes into account your personal feelings and the medical facts.
| Reasons to bank cord blood | Reasons not to bank cord blood |
|---|---|
Are there other reasons you might want to bank your baby's cord blood? |
Are there other reasons you might not want to bank your baby's cord blood? |
These personal stories may help you make your decision.
Wise Health Decision
Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about cord blood banking. Discuss the worksheet with your doctor.
Circle the answer that best applies to you.
| I have a young family member who will probably need a stem cell transplant in the future. | Yes | No | Unsure |
| I do not think banking the cord blood would be a wise investment. | Yes | No | Unsure |
| The cost of banking the cord blood is not a concern for me. | Yes | No | Unsure |
| I do not like the idea of the stem cells going to waste, so I will donate the cord blood if I can. | Yes | No | Unsure |
| I like the idea of banking the cord blood for the future, "just in case." | Yes | No | Unsure |
| We plan to have more children, and there is leukemia, Hodgkin's, or sickle cell disease in our family. | Yes | No | Unsure |
Use the following space to list any other important concerns you have about this decision.
|
|
What is your overall impression?
Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to use or not use cord blood banking.
Check the box below that represents your overall impression about your decision.
| Leaning toward banking your baby's cord blood | Leaning toward NOT banking your baby's cord blood |
Return to the topic:
Other Places To Get Help
Organizations
| American College of Obstetricians and Gynecologists (ACOG) | |
| 409 12th Street SW, P.O. Box 96920 | |
| Washington, DC 20090-6920 | |
| Phone: | (202) 638-5577 |
| E-mail: | resources@acog.org |
| Web Address: | www.acog.org |
American College of Obstetricians and Gynecologists (ACOG) is a nonprofit organization of professionals who provide health care for women. The ACOG Resource Center publishes manuals and patient education materials. The Web site has information on many women's health topics, including quitting smoking. | |
| American Pregnancy Association | |
| 1425 Greenway Drive | |
| Suite 440 | |
| Irving, TX 75038 | |
| Phone: | 1-800-672-2296 |
| Fax: | (972) 550-0800 |
| E-mail: | questions@americanpregnancy.org |
| Web Address: | www.americanpregnancy.org |
The American Pregnancy Association is a national health organization committed to promoting reproductive and pregnancy wellness through education, research, advocacy, and community awareness. You can call a toll-free helpline or use the Web site to request patient education materials. | |
| National Bone Marrow Donor Program | |
| 3001 Broadway Street Northeast | |
| Suite 500 | |
| Minneapolis, MN 55413-1753 | |
| Phone: | 1-800-627-7692 |
| Web Address: | www.marrow.org |
The National Marrow Donor Program helps people who need a life-saving marrow or blood cell transplant. The program connects patients, doctors, donors, and researchers to resources they need. | |
Related Information
References
Citations
American Academy of Pediatrics (1999). Cord blood banking for potential future transplantation: Subject review. Pediatrics, 104(1): 116–118.
Steinbrook R (2004). The cord-blood-bank controversies. New England Journal of Medicine, 351(22): 2255–2257.
Other Works Consulted
American College of Obstetricians and Gynecologists (1997, reaffirmed in 2004). Routine storage of umbilical cord blood for potential future transplantation. ACOG Committee Opinion No. 183. International Journal of Gynaecology and Obstetrics, 58(2): 257–259.
Annas GJ (1999). Waste and longing—The legal status of placental-blood banking. New England Journal of Medicine, 340(19): 1521–1524.
Cord blood banks (2001). Medical Letter on Drugs and Therapeutics, 43(W1114B): 84–86.
Moise KJ Jr (2005). Umbilical cord stem cells. American Journal of Obstetrics and Gynecology, 106(6): 1393–1407.
Private cord blood banks (2004). Medical Letter on Drugs and Therapeutics, 46(1178): 21–22.
Credits
| Author | Kathe Gallagher, MSW |
| Author | Lila Havens |
| Editor | Kathleen M. Ariss, MS |
| Associate Editor | Michele Cronen |
| Primary Medical Reviewer | Joy Melnikow, MD, MPH - Family Medicine |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | Kirtly Jones, MD - Obstetrics and Gynecology |
| Last Updated | December 19, 2005 |
Print This
| Last updated: | December 19, 2005 |
|---|---|
| Author: | Lila Havens |
| Reviewed By: | Kathleen Romito, MD - Family Medicine, Kirtly Jones, MD - Obstetrics and Gynecology |
| Editors: | Kathleen M. Ariss, MS, Michele Cronen |
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