At some point during your pregnancy someone at your OB’s office or at the bus stop might ask you what you’re doing about cord blood banking. When someone first asked me this there were audible crickets in the background. Cord blood whaaaaa? That’s a thing?!
Cord blood banking is when blood from inside the umbilical cord is collected just after a baby is born and then stored. Cord blood contains blood-forming stem cells—which are a magical type of cell that can reproduce into bone, heart, muscle, or nerve cells. Because stem cells haven’t decided what type of cell they will be yet, they can be used to treat a bunch of serious illnesses that require stem cell transplants, such as some nasty types of cancer, like leukemia. These illnesses often require harsh treatment, such as chemotherapy, that kills diseased and healthy cells—so these sick people often need a blood cell transplant to get strong again. New stem cells can grow into red blood cells, white blood cells, or platelets, thereby making the sick person recoup some of those lost healthy cells and build up a stronger immune system. The research on the use of stem cells is rapid and new uses for these types of donations are still being discovered.
The actual collection of cord blood is totally painless. After your wee babe is born and the umbilical cord is clamped and cut, a special kit is used to drain the blood out of the cord. After collection the blood is rushed to a blood bank, given an ID number, and frozen for a future transplant.
In terms of what kind of bank to use there are two options – public and private.
If you’re interested in public banking then your OB or midwife should be able to tell you how it will work at your delivery. (If they don’t facilitate the donation themselves, they might have info on local companies that will come to your hospital/house and collect the cord blood.) The upshot of public banking is that it’s completely free and you’re doing a really good deed for someone who is seriously sick. (That’s some good karma right there.) Donating to a public bank is a lot like donating during a blood drive—you won’t know when or if the donation is used. Your baby’s stem cells are tested and typed and then if someone needs a stem cell transplant the doctor can look up potential matches in a national registry or database. So the downside of public donation is that you may not be able to later retrieve the donation—it belongs to the masses.
There are a TON of private banks if you want to go that route. The deal with this type of banking is that your baby’s stem cells are being privately frozen and held just for your family’s use. So in the horrible event that one of your future kids needs a stem cell transplant, a sibling’s blood cells are right there, ready to use! And close family members are often the best match because doctors want blood cells that are a close match for transplants. For that reason, if you have someone in your family who is currently ill and in need of a stem cell transplant then private banking is a great option.
The downside is that private banking costs a lot of cabbage—usually a couple thousand dollars to initially bank the blood and then an annual storing fee on top of that. Ouch.
In recent years the American Academy of Pediatrics and The American Society for Blood and Marrow have advised families to publicly bank for several reasons.
First, private banking costs some serious mula so it’s just not a financial possibility for many families. Second, unless someone in your family is already ill, the chance that you or one of your relatives will need a stem cell transplant is very slim. Third, a lot of these private banks prey on the fears and insecurities of new parents, which is just kind of a dick move.
Overall, there doesn’t seem to be a big downside to donating cord blood. If you decide to go for it you should get the ball rolling in your second trimester so you have plenty of time to choose what kind of bank to use and make all the necessary arrangements.
But wait—what about delaying cord clamping
Delaying cord clamping means that, rather than clamping the umbilical cord right after birth, the cord is clamped and cut a full two or three minutes after birth. Research has shown that if left to pulse for those additional minutes, the umbilical cord can deliver an additional 20-40mL of blood from the placenta to the baby. This means the newborn may get some extra iron from those few extra minutes attached to the ol’ placenta, which may help reduce anemia.
So the relevant question here is—can you delay cord clamping but still have enough cord blood remaining to bank? There seem to be a LOT of contradicting opinions about this on the Interwebs so I decided to ask someone who actually works in a hospital where cord blood is collected. I will preface this part by saying that her answer was very complicated and she is smarter than I and I only understood about 25% of it, but here goes. She told me the two most important things on the recipient side of a cord blood donation are:
- volume of blood donated and
- number of stem cells in that blood.
There is a minimum volume of blood and stem cells required for a transplant to occur, and delaying clamping *could* impact whether or not the cord blood can be processed for donation. I know, still kind of a vague answer because so much depends on the recipient of the donation, which in most cases is unknown. Smaller patients (like kids) weigh less so they don’t need as much blood or as many stem cells for a donation to work. Adults could require blood from two cords. So basically, if you feel very strongly about both delaying clamping AND banking cord blood, your best bet is asking whatever company is doing your cord blood collection if they think delaying the cord clamping will screw up the banking process and see what they say. And then can you explain it to me? Because this shit makes my brain hurt.