Cord Blood Banking - Simple Answers to a Difficult Question: 

Photo courtesy: Sara Kalish Photography 

We understand that you are nervous about caring for and protecting your baby. Private cord blood banks also recognize this vulnerability and will market to you heavily during your pregnancy with promises of “biological insurance.” This puts expectant parents in a position of making sense of something that even many doctors have difficulty explaining. 

So, we’re going to make it easy to digest by giving you guidelines based on the American Academy of Pediatrics recommendations: 

First, the premise behind banking: Umbilical cord blood is rich in stem cells and has been used to treat a variety of pediatric genetic, blood, and cancer-related disorders. Compared to donor transplants (of marrow or donated stem cells) one’s own stem cells are more likely to be accepted and effective. This advantage has made cord blood stem cell transplants for pediatrics successful in roughly 5,500 cases in a twenty year period. What we don’t know about banking stem cells is worth considering. There could be advances made in the next few decades which will draw on stem cells as cures for life-altering illnesses and disorders. 

Option 1: 

Don’t do anything with the cord blood. 

The blood from a baby’s umbilical cord was never assigned any value until very recently -- a mere blip in time, considering the history of childbirth. In a hospital setting this blood would be considered “human waste” and disposed of properly. Millions of babies born in recent years have had their cord blood discarded and that is one acceptable possibility for parents to consider. 

Option 2: 

Publicly bank the cord blood. 

When we are in need of a blood transfusion during surgery, we do not request our individual blood supply for the job. Doctors rely on utilizing blood from those who have previously donated it for the greater good of our population. The same should be said for cord blood, except that a very tiny part of our population publicly banks this resource, compared with regular blood. However, this is an excellent option in that your donation will be first analyzed for any genetic issues, then put to use if there is a recipient match. If the blood is not needed it goes to research, which as stated earlier, is what might lead scientists to bigger and more effective uses. You will not be able to claim that cord blood once it is donated. Hospitals are not generally set-up for public banking so we suggest you do some research or ask when you do a hospital tour.

Option 3: 

Privately bank cord blood with a reputable agency. 

Taking the “possibility of future scientific developments” out of the conversation, we are left with the likelihood of your child needing her own stored stem cells in the future. The range of estimates is anywhere from 1 in 1,000 to more than 1 in 200,000.* Be aware that there are many unsubstantiated claims made by private cord blood banks in order persuade family members to protect their child against serious illnesses - these claims should be put in perspective. It’s important to understand that when there were any mutations in a child’s DNA that would cause a malignant or genetic condition that mutation is still present in their own cord blood. Therefore, your “biological insurance” would be for a different child. Some genetic counselors recommend cord blood banking for families with genetic or oncological histories - that is something to discuss with your doctor. This makes banking privately your only guaranteed access to this vital material connected to your own child’s genetics. 

In Summary: 

Given the high cost of private banking and slim likelihood of needing access to your child’s stem cells, the AAP discourages private banking and encourages public banking. Riverside advises you to consider your family history and speak with a genetic counselor if necessary should you have specific medical concerns. Always research the reputation and accreditation of the cord blood bank you choose, if you are selecting private banking. 

*Johnson FL. Placental blood transplantation and autologous banking: caveat emptor. Pediatr Hematol J Oncol.1997;19 :183– 186 CrossRefMedlineWeb of Science