Thursday, September 10, 2009

What Do To With Cord Blood?

Politisaur posted her birth plan last week and in it mentioned that they were not going to do cord blood banking. In the comments I suggested delaye cord clamping. I found out about this recently and am surprised not more people know about it. In the few birth books I have it's not really mentioned as an option, in fact a lot of the options you have with cord blood is not mentioned. So I wanted to do a post here listing the various options that you have.

As a soon-to-be parent you have a MILLION decisions to make. Where will your child be born? How will they be fed? What will they wear? Where will they sleep? It wasn't until recently that cord blood became one of these decisions. Now-a-days most soon-to-be-Mommys know about cord blood banking for personal use, but are there other options? Yes! You can now add "What am I going to do with my baby's cord blood?" to the list of other decisions you will be making in the coming months. Luckily you have a number of options you can make, most of which won't cost you a penny!

So here are your options (if anyone knows of any other options you'd like to mention please feel free to bring it up in the comments):

Private Cord Blood Banking (personal use)

How it works: Cord blood is collected from the umbilical cord after birth and stored in a private bank that allows only family members to use the cord blood.

The Pros: Stem cells contained in cord blood are immature cells that can both reproduce themselves and have the potential to turn into other types of cells. If a family member becomes ill with a certain disease -- like leukemia, lymphoma, and sickle cell anemia - they can be injected with these cells to replenish their blood supply with new, healthy cells. The stem cells can also help the body recover from some cancer treatments like chemotherapy or radiation. If a family member is already ill the cord blood can be used immediately to help that family member out. Or it can be stored for future use.

The Cons: Very expensive. Initial fees vary drastically from one place to another, but expect to spend about $1500-3500 initially for the collection and first year of storage, and between $100-300 per year after that. Most insurance companies do not cover the cost of cord blood banking. HOWEVER, if you already have a sick family member who can benefit from the cord blood their insurance may cover the collection and initial banking costs.. Also studies have showed that only one in 2,700 clients will need to use their cord blood which means it has the potential to just go to waste in storage.

And if you think of the big picture the cost could be well worth it. If you child or another child in your family falls ill the cord blood you stored could save their life and prevent them from enduring weeks or months on a donor list and from getting painful treatments. For some having the piece of mind is worth every penny.

Another con is the fact that there is only a 25% that the cord blood will be suitable for use by another child in your family and it's even less likely that the blood will be usable by the donating child.

Public Cord Blood Banking (donation)

How it works: Cord blood is collected the same as in private banking, but instead of going into a private storage bank it goes into a public bank that is open to the public so anyone can benefit from your baby's cord blood.

Pros: Your baby's cord blood could be responsible for saving the life of another child. You will never know who the blood goes to benefit, but chances of the cord blood being put to use is higher when stored in a public bank then in a private bank. Best of all, public banking is free to you! The public bank pays the collection and storage fees. You get the benefit of knowing the cord blood is not being wasted and not have to pay the costly fees associated with private banking.

Cons: A lot of hospitals do not participate in public cord blood donation programs making this option not available to you at all. Also if you ever need to use the cord blood it will no longer be available to you. However, if more people donate their cord blood in the future there might be a match for you in the bank that you can retrieve and use.

Donate Cord Blood for Medical Research

How it works: Similar to banking, the blood will be collected from the umbilical cord immediately after birth. But unlike banking, the blood will go to a research lab to be used for medical studies.

Pros: The stem cells found in cord blood can be used for various medical research which may help with advancements in treatments for various diseases including certain types of cancer. Since it's possible that your child's cord blood will not qualify for public donation (in the event that there is not enough cells) you have other options so that it doesn't go to waste. Since these stem cells come from a the umbilical cord of a live child and would otherwise go to waste it is considered to be ethical and a great way for research labs to obtain stem cells. Usually there is no cost associated with this option.

Cons: You will not be able to store the cord blood for personal use and it will not be used to directly treat another patient through the public bank. However, advancements can be made by using it for research which will benefit hundred and thousands in the future.

Delayed Cord Clamping

How it works: This is a relatively new thing in American birth. Previously it was customary to clamp the cord immediately after birth to cut the umbilical cord. Delaying clamping is just how it sounds- when the cord is left in tact until it has finished pulsing. Then is it clamped off and cut.

Pros: Once the baby is born, its entire circulatory system undergoes an amazing transformation to allow the baby to receive oxygen via its lungs rather than through the umbilical cord - a valve in the heart closes, the lungs perfuse with blood and eventually a first breath is taken. When this delicate balance is interrupted by prematurely severing the child's lifeline, its umbilical cord, numerous undesirable side effects can occur. The reasons for cord clamping are mostly not medically backed, but convient for the doctor. This article does a great job of explaining the dangers in immediate cord clamping that will amazing.

Also when you delay clamping the cord blood is immediately used by the baby, and they receive the benefits of the cord blood immediately. While it won't cure any future diseases they may have, there are great benefits to this blood being in their system at birth.

Cons: Delayed cord clamping should not be done in cases of placenta previa or a torn cord. It is also something that may not even be available to you as some hospitals do not allow you the option of delayed cord clamping. If the cord is not clamped the cord blood within the umbilical cord will be used right away by the baby and will not be able to be stored for private or public use.

Finally, it takes about 15-20 minutes for the cord to stop pulsing. During this time you will still be physically connected to your child. For many, this is not ideal or even possible (hospital protocol, short cords, or distress with the baby are a few reasons why it may not be possible). For others, it's a huge pro to be able to hold and bond with your child for this long after birth. In most hospital settings the doctors prefer to weigh, measure, clean, and wrap the baby shortly after birth and give the mother a few moments to rest, but some mothers do not want to hand over their child that soon after delivery and will appreciate the time this gives them.

Do Nothing

How it works: The cord is clamped and cut immediately after birth and the umbilical cord, cord blood, and placenta are disposed.

Pros: This is the easiest option. It requires no effort on your part, goes along with most hospital protocols, and costs you nothing. No additional paper work will be required when you choose this option.

Cons: The cord blood will most likely go to waste and it's benefits will be lost.

Resource Links

Viacord.com Cord Blood FAQs
Marrow.com Cord Blood Donation FAQs
GentleBirth.org Benefits of Delayed Cord Clamping
The National Cord Blood Program
Wikipedia Cord Blood Article with References and Links

1 comment:

  1. Thank you Rockasaur for your comments regarding cord blood banking.
    It’s evident that you have taken the time to research this subject and have listed the options that each family have regarding their baby’s cord blood quite nicely. During my nursing career, I have been a nurse on a Labour and Delivery Unit, and have had the opportunity to learn about this subject first hand.

    -I do know that using a private cord blood program is not quite as expensive as you have indicated. The costs range from $1125-1500 for the first year and $125-$150 each year after that.

    -There is a 1/400 chance that the child themselves may need to use their umbilical stem cells (USC). Also, there is a 1/200 chance that the cells may be needed for a family member. I have included a footnote referencing the article so that you can see where I got those stats. They are used widely by many health professionals.
    Something I must point out is these statistics are talking about using the cells for bone marrow transplants. The odds that the cells may be used goes up dramatically when you take into account the future promise of treatment for other diseases like Type I Diabetes, and Cerebral Palsy.
    In the US, there are ongoing clinical trials and there have been notable results.

    Being informed is especially important when it comes to your pregnancy and impending birth, (As shown by this blog).To that end, I encourage you to check out this website:
    http://www.parentsguidecordblood.org Here you will find factual, unbiased information regarding cord blood banking.
    Not all cord blood programs are the same. There are significant differences and I suggest that you do your research on the different companies prior to making your decision.
    Most companies do offer Parent Educational sessions and that is an easy, convenient way for you to find out basic information on cord blood banking, and more detail on the companies themselves.

    Maureen Kardash RN
    Clinical Consultant
    http://www.insception.com

    Pasquini MC, Logan BR, Verter F, Horowitz MM, Nietfeld JJ. The Likelihood of Hematopoietic Stem Cell Transplantation (HCT) in the United States: Implications for Umbilical Cord Blood Storage. Blood 2005; 106(11): 1330.

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