Should I save my baby’s cord blood?

I’ve been a pediatrician for over 20 years, and I routinely answer questions about what to expect when baby is born, how much to feed baby, and vaccine safety. And now, parents want to know if they should save their baby’s cord blood.

Only 22 percent of pediatricians speak about umbilical cord blood banking to prospective parents, yet it’s an important and complex discussion to have; and parents need guidance in making this decision. Indeed, a quick google search quickly leads to advertisement for a private cord bank site that will make you, an already nervous new parent, feel like you made a big mistake by not using their services. But wait… before you act out of fear of the unknown, I want to offer up some information and clarification about storing and using your baby’s umbilical cord blood for future potential life-saving procedures.

Here are 7 common questions about cord blood banking, answered.

1. What is cord blood? The cord blood is the blood that’s in baby’s umbilical cord after baby is born. What is different about this blood is that they are stem cells that are undifferentiated and can grow and become tissues, organs and blood vessels. Umbilical stem cells can treat many conditions, such as certain blood disorders, severe immune deficiencies and even rare metabolic abnormalities. They also can be used to treat side effects from radiation and chemotherapy, which also kills the good cells found in the bone marrow. Healthy stem cells can replace defective cells and produce healthy new blood cells that can then boost immunity, which in turns can help a child heal from a life-threatening disease.

2. How is cord blood collected? After your baby is born either vaginally or by c-section, doctors clamp and cut the umbilical cord as usual. They can then collect blood from the part of the umbilical cord that is still attached to the placenta. They usually draw blood up in a large needle that is inserted into the umbilical vein (it’s nowhere near your baby and does not cause any pain at all). The amount collected is somewhere between 1 to 5 ounces. It’s a fast procedure and does not interfere with the excitement, joy or initial bonding with baby. The umbilical cord blood is then sent to a cord bank to be processed and stored.

3. Can I use my baby’s cord blood if they develop leukemia? This is probably the most common question about using baby’s umbilical cord blood. The answer, unfortunately, is no. Many parents believe that if they store their infant’s umbilical cord blood, they can use it if their child develops leukemia later in life. However, we now know that the initial cord blood stems cells are already “infected;” which means that if you treat leukemia with a child’s own stem cells — a procedure called autologous transplant –, the illness is likely to persist or come back. The best way to treat leukemia would thus be with a donor’s stem cells. Right now, autologous transplants can only be used for certain diseases like multiple myeloma, aplastic anemia, and some solid tumors like medulloblastoma, retinoblastoma and neuroblastoma. What’s more, it’s important to know that the small amount of stem cells that can be harvested from cord blood is often not enough to treat adults.

4. Can umbilical cord blood be used for siblings? Yes. Using cord blood from a matching donor — whether it is a sibling or an unrelated donor — is called an allogenic transplant, and it is a much more common use of cord blood. And you can actually use donated stem cells for many types of leukemia, lymphomas, anemias, severe immune deficiency disorders and many inherited metabolic disorders. In fact, parents are twice as likely to use their baby’s stem cells for a sibling as they are for their own baby. So if you have another child or someone in your family that you know could benefit from a stem cell treatment, cord blood banking could be the right path for you.

5. What is private cord blood banking? Parents have options when it comes to cord blood banking. You can pay for private storage, which means only you and your family have access to your baby’s umbilical cord blood. This could be a great option if you know that a family member has an illness that could be treated with cord blood. But storing cord blood in a private cord blood bank can be very expensive, with a yearly maintenance fee to store the stem cells; and it is not covered by insurance. This means that you would need to pay out of pocket for storing cord blood that you may never use.

6. What is public cord banking? This is a depository that would be accessible to everyone in need of blood cells. The blood is screened, stored, and given to someone who is a match and needs stem cells for a life-saving treatment, free of charge. Conversely, you and your family could also access to a donor’s stem cells to treat illnesses like leukemia, which autologous transplants do not cure. Since it makes stem cells available to the public, this donation system insures less waste. Indeed, an infant’s cord blood cells is 30 times more likely to be used in a public cord bank than it is in a private one. Unlike private cord banks, which are not subject to federal guidelines and oversight, public cord banks are strictly and highly regulated.

7. So should I choose a private or public cord blood bank? There are certain circumstances that warrant a preference for private cord blood banking, and if you want that added insurance of “what if something new comes along,” private cord banking may be the right decision for you. But remember that there is little chance that your baby will use his or her own stem cells later in its life; and even if he or she does, the procedure isn’t a cure-all. Though I ultimately think it is a personal decision to make, I tend to advocate for public cord banking. Because if we all banked our newborns cord blood publicly, it would save the lives of many other people, and especially little ones.

Dr. Jen Trachtenberg is a nationally renowned parenting expert, author, board certified pediatrician, spokesperson for the American Academy of Pediatrics and assistant clinical professor of pediatrics at The Icahn School of Medicine. She has run a successful private pediatric practice in New York City for more than 22 years and is mother to three children. She is the creator of Pediatrician in Your Pocket: the only science-based, mom-tested, no-judgement, video guide for new parents.