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Healthy Children

with Steven Parker, MD

This blog is now retired. Dr. P passed away on Monday, April 13, 2009. The WebMD Community will dearly miss his kind, caring, and often humorous manner.

Monday, October 27, 2008

Should You ‘Bank’ Your Newborn’s Cord Blood?

As if life weren’t complicated enough, many expectant parents are now being confronted with a wrenching question: to bank or not to bank? If you haven’t dealt with this question, let me explain.

Turns out that the umbilical cord blood has a goodly store of stem cells, those magical immature cells which can reconstitute a bone marrow as part of transplant treatment (e.g., for leukemia, sickle cell or some metabolic diseases). To date close to 7,000 umbilical cord transplants have been successfully performed, with excellent results.

Or perhaps one day they might be cajoled into transforming into any manner of needed tissues – nerve cells, skin, intestines, ears. The medical community is justifiably excited about the potential for these cells to be used in the future to cure a variety of diseases.

So the idea is to “bank” (meaning, freeze) these cells from the cord blood and save them for a rainy day when they might be needed to work their magic.

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There are two kind of cord blood banks: public banks that, following a thorough screening process, make your baby’s stem cells available to anyone who is luckily a match and might need it.

And there are private, for-profit banks that store the cells specifically for your baby or for a family member. The cost is about $1,000-$1,500 for the initial procedure and then about $100-150 / year to keep it on ice.

Perhaps you read about or were offered these options when you had your baby. The private bank is an appealing idea. If, someday in the future, your infant (or a close relative) were to contract a disease that required a transplant, a perfect (or close to perfect) match could be obtained. Who would not, for a mere few thousand dollars, want to protect their child from some future catastrophe with such “biological insurance”?

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Not me. Here’s why:

  • The odds of the cells actually being useful some day are very very low – variously estimated at 1 in 1,000 (the odds of dying in a fire), up to 1 in 80,000 (the odds of dying from lightning strike), to 1 in 200,000 (the odds of dying from an asteroid hitting you).
  • It’s expensive.
  • It’s not clear how effective the stem cells might be after being frozen for a very long period of time.
  • By the time they might be needed, other ways to derive stem cells from our bodies may exist, so the newborn stem cells would not even be necessary.
  • If the cells are to be used to cure a genetic disease, these same cells will contain the genetic defect and may not be appropriate treatment.
  • What happens if the banking company goes out of business?

On the plus side:

  • It makes sense to do so when there is a sibling with a medical condition that could benefit from a stem cell transplant.
  • Who knows what advances in the future might render these stored cells useful to your now adult or aged baby?

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Dr. P Opines
Banking cord blood is akin to purchasing lightning insurance. Sure, it’s not impossible it might be helpful some day, but really the odds are very slim.

And, if let’s say one in 50,000 infants will actually benefit from doing so, that leaves 49,999 cord blood specimens languishing in the freezer, making a profit for the freezing company, when they potentially could have been used as a match for a needy fellow human.

About 4,000,000 babies are born each year in the U.S. whose precious cord blood is discarded with the garbage. If parents agreed to bank their cord blood in public banks, the chances of everyone – including your family members – finding a much needed match someday would greatly increase. It’s an example of doing something for the greater good that also benefits the individual.

So I vote NO to private banking (except for the immediate benefit of an ill family member). Instead, take the $3,000 you would have spent and invest it over the next 18 years to pay for your baby’s college education, for which, I hope, the odds are much better than someday needing a stem cell transplant.

And a big YES to public banking of your baby’s precious cord blood, as precious a gift as s/he may ever give.

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If you are interested in donating your baby’s cord blood to a public bank and for heartwarming stories of how such donations have helped others, check out National Marrow Donor Program: Donate Cord Blood.

For the position of the American Academy of Pediatrics on this, see Cord Blood Banking for Potential Future Transplantation

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Posted by: Steven Parker MD at 3:30 pm

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