Banking Baby’s Blood
You may recall my article from a few weeks ago entitled, “Living in the 3rd Dimension,” when I wrote about my sister-in-law and the 3D Ultrasound she was planning for her baby. I wrote about her experience (which was, technologically speaking, not without problems but resulted in some great pictures of my future nephew Max), the experience my wife and I had with it and our own baby, and the possible applications of the technology in other areas of medicine. As expectant parents, my wife and I were more aware of the advertisements for this service as our baby’s due date approached, and excited at the prospect of getting a glimpse of our baby before he was actually born.
The same sister-in-law and I were having a conversation the other night and we talked briefly about banking her baby’s umbilical cord blood. I remember being bombarded with information about this procedure from a variety of places, including books, magazines, doctors and parenting web sites. I never really paid it much attention, as it seemed to me that most of the advertisements were for private companies looking to store the blood for you for an undefined amount of time as an “insurance” measure for any future diseases your child or other children in your family may have or someday develop.
Umbilical cord blood is special because it is rich in hematopoietic stem cells, which are unspecialized blood cells that could eventually adapt themselves to perform specific functions within the blood system of the child. The blood at this stage is useful because of its potential to treat a variety of genetic or oncologic diseases though stem cell transplantation with a matching donor. Most of the research has been encouraging, but it is still early and there are many factors which dictate whether the blood is acceptable for use in treatment.
Private blood cord banks such as VitaCord and Cord Blood Registry (CBR) have made big business out of the practice of saving umbilical cord blood. Though I don’t have complete information on VitaCord, CBR charges approximately $2000 for the initial year of storage, and $125 annual fee thereafter until the child is 18. You can see more information on CBR’s pricing structure here. The procedure is most often advertised as a kind of “biological insurance,” an analogy I’ve seen echoed by people on internet parenting forums who invested in the system. Obviously this is a pretty significant up-front cost for cord blood storage, especially for first-time parents who might be just starting out and might not have the money readily available to pay for such a service.
In addition to the potentially prohibitive cost of the procedure, the American Academy of Pediatrics (AAP) does not support the use of private storage as simply “biological insurance.” Not communicated by the private firms is that there is little or no scientific evidence to show that the donor will ever benefit from a transplant of his or her own cord blood, known as autologous transplantation. In fact, the only time such private storage would be advisable by the APP is if there is a family member with a “current or potential need to undergo a stem cell transplantation.” (1) This might be the case for someone suffering with leukemia, for example.
What the AAP does support, however, is the philanthropic donation of blood, at no cost to the expectant parents, to public banks that can direct the use of the blood for research or for use by a possible recipient who may closely match the donor’s blood type. There is anecdotal evidence that there is a greater chance of the blood being used in this type of scenario than if it were to be stored in a private blood bank, which some estimate to be 0.1% to 0.002% chance over the child’s life. (2) Cord blood stored at public banks is treated as community blood; if a child or his or her relative should need a transplant of cord blood in the future, it is unlikely that he or she will be getting his or her own. However, because the public banks are set up to screen and identify matches for cord blood, it is more likely that patients will receive a matching transplant.
For our son, my wife and I discussed the possibility of storing his cord blood in a bank and paying the yearly fee to maintain it in a freezer somewhere. There is powerful literature suggesting that “no cost” is worth the life of your child. But I am mathematical by nature, and the possibility that first, his cord blood would be needed in the future and second, he’d be able to use his own cord blood is a considerably slim margin, especially given our family history and our own relatively good health.
We considered the benefits of donating his cord blood to a public bank, but at that point in the pregnancy it seemed to be more of a hassle to set it up than it was worth.
With the onslaught of articles that were advertised in baby magazines, articles sent in mailers and a wide range of opinions from parents discussing the topic on the web, a small part of me couldn’t help but wonder if I was letting an opportunity pass that might make a difference in our son’s life in the future. But after taking this careful opportunity to look back and review the information that’s available out there, I’m more confident that we made the right decision. Private storage hasn’t gotten to the point that I’m convinced that it would help us or my present and future children.
Public cord banking, however, seems to have more potential for benefiting us in the future. Adding cord blood to this type of bank, that may possibly be used for future research in improving treatments for disease, does have an appeal to me, as I’m sure it does my wife. And the lack of a fee to harvest and store the blood is likely more appealing to parents still trying to establish themselves.
In either case, if you or someone you know is an expectant parent, your decision should be well-informed and one that you feel is right for you. You are not obligated to have the cord blood of your child harvested, and any attempt to do so without your consent is both immoral and illegal. Know and understand your decision before your bundle of joy comes into this world — there won’t be any time once you go into labor!
How does this make you feel? Did you have a situation where you opted to bank cord blood, either publicly or privately? What was your experience? Have you ever been in a situation where you actually had to use banked blood, either public or private?
Please, let me know!
(2) See “Cord Blood Banking,” by Dr. Vincent Iannelli, on About.com
