What is cord blood banking?
Your baby’s umbilical cord blood contains stem cells that can be used to treat many diseases. Collecting cord blood after delivery is quick, painless, and safe. You can donate your baby’s cord blood to a cord blood registry – at no cost to you – making it available for anyone who needs it. Or, you can pay to bank your baby’s cord blood in a private (family) bank for your family’s use. If you decide you’d like to bank cord blood, be sure to let your doctor or midwife know when you discuss your birth plan so they can help you make the proper arrangements.
What is cord blood banking?
Cord blood banking involves collecting the blood left in your newborn’s umbilical cord and placenta following birth and storing it for future medical use.
For cord blood storage, you have two options:
- You can donate your baby’s cord blood to a public cord blood bank for anyone who needs it.
- You can pay to store your baby’s cord blood in a private cord blood bank for your family’s use.
How is cord blood collected?
Cord blood is collected right after birth, and is viable for future uses whether the birth was medicated or not, and whether you delivered vaginally or by c-section.
The collection process is painless and safe for you and your baby.
Here’s how it’s done:
Clamping and cutting the cord
After you’ve delivered your baby, the umbilical cord is clamped and then cut in the usual way – either by your partner or your medical provider.
The American College of Obstetricians and Gynecologists (ACOG) recommends a delay of 30 to 60 seconds between delivery and cord clamping for healthy, full-term babies; the World Health Organization (WHO) recommends one to three minutes; and many midwives and physicians may recommend a delay of two to five minutes, especially for premature babies. Delayed cord clamping allows extra blood to flow from the placenta to the baby and can have various benefits, including helping prevent anemia.
If you’re planning to delay cord clamping, talk to your healthcare provider ahead of time about your options. Note that while delayed cord clamping may be beneficial for newborns, it will affect the volume of blood and the quantity of stem cells collected for donating and storing.
Extracting the cord blood
After the cord is cut, your medical provider wipes it with disinfectant and inserts a needle into the umbilical vein on the part of the cord that’s still attached to the placenta. The needle doesn’t go anywhere near your baby.
The blood drains into a collection bag. Typically, 1 to 5 ounces are collected. The entire process takes less than 10 minutes.
Some family cord blood banks will accept a segment of the umbilical cord and possibly the placenta, too, in addition to the cord blood – umbilical cord tissue and placental tissue contain stem cells that are different from cord blood stem cells, and researchers are studying their possible use.
Storing the cord blood
The collected cord blood is carefully packed and shipped to your cord blood bank, where it’s tested to confirm that it meets medical quality standards for safe use. Following approval, the blood is processed and cryopreserved (preserved by freezing at a very cold temperature that stops cellular activity) for long-term storage.
Will collecting my baby’s cord blood interfere with delivery?
No. Collecting your baby’s cord blood won’t interfere in any way with your labor or delivery. The procedure takes place after the baby has been delivered and the umbilical cord has been clamped and cut, and it’s so quick and painless that often parents – caught up in holding and bonding with their new baby – are unaware it has even happened.
As mentioned above, collecting cord blood can be incorporated into most birth plans, but again, if you choose this option, be sure to discuss your plans with your doctor or midwife in advance and when you review your plan.
Who can collect
The person collecting the cord blood may be an obstetrician, a nurse, or a midwife – anyone who is experienced at doing a sterile blood draw. The training required to collect blood from the umbilical cord is the same skill used by the technicians (phlebotomists) who draw your blood for testing. You’ll definitely get a better cord blood collection with a more expert technician, so don’t hesitate to ask about the level of experience of the person assigned to the task in your case.
If you’re having a home birth, you won’t be eligible to donate the cord blood to public banks; to donate, you must give birth in an accredited hospital. This rule was set by public cord blood banks, which test, process, and store donations.
You can, however, have your baby’s cord blood collected at a home birth if you have arranged for private storage in a family bank. If you are planning to bank cord blood with a private company, you can bring that company’s collection kit with you to wherever the birth is set to take place. This option makes it feasible to collect cord blood from most home births for private storage. However, the draw will still need to be done by a nurse, or a midwife – anyone who is experienced at doing a sterile blood draw
What are the benefits of cord blood banking?
Cord blood is a rich source of blood stem cells. These stem cells are the building blocks of the circulatory and immune systems. They have the ability to develop into other types of cells, which in various ways help the body repair tissues, organs, and blood vessels and can be used to treat a host of diseases.
Unlike the stem cells in bone marrow or peripheral blood, stem cells in cord blood are immature, and thus haven’t fully learned yet how to attack foreign cells. It’s easier to match transplant patients with cord blood rather than other sources of stem cells because the patient’s body is less likely to reject the cord blood stem cells.
This makes cord blood an even more hopeful resource for ethnic minorities, for whom it is harder to find stem cell matches in the registry of adult bone marrow donors. In 2020, 31 percent of umbilical cord blood transplants were for patients of color.
More and more adults are receiving cord blood transplants, too, sometimes involving two cord blood donations if a single one doesn’t contain enough cells.
What is cord blood used for?
Each year, about 3,000 cord blood stem cell transplants are performed worldwide.
Cord blood stem cells have been used successfully to treat more than 80 different diseases, including:
- Some cancers, such as leukemia, Hodgkin’s disease, and non-Hodgkin’s lymphoma
- Blood disorders, such as aplastic anemia, thalassemia, and sickle cell anemia
- Genetic disorders
- Neurologic disorders, such as cerebral palsy
- Immune deficiencies, including, in rare instances, HIV
- Rare metabolic disorders that would otherwise be fatal for infants, such as Krabbe disease,
- Sanfilippo syndrome, and irritable bowel disease
In addition, surgeons who operate on children born with congenital heart defects often use the child’s cord blood in the heart-lung bypass machine because it’s more compatible than donated blood and promotes healing.
Studies are underway around the world exploring new ways of using cord blood, and have added knowledge for promising treatments of other serious health conditions and disorders, including cerebral palsy, HIV, and autism.
Treatments for adults
Much of the promising stem cell research in adults that uses cells from bone marrow may one day use stem cells from cord blood. Current studies registered with the U.S. federal database are treating people with conditions as varied as diabetes, spinal cord injuries, heart failure, stroke, and neurological disorders such as multiple sclerosis. In addition, years of research to “expand” cord blood units so that they can be used to provide transplants to adults are finally coming to fruition.
The website of the Parent’s Guide to Cord Blood Foundation has pages listing the current clinical trials with cord blood or cord tissue.
Cord blood centers: donations versus private banks
Frances Verter, founder and executive director of the nonprofit Parent’s Guide to Cord Blood Foundation, estimates that about 5 percent of parents now bank their baby’s cord blood. Of that amount, 90 percent goes to family banks and 10 percent goes to public banks.
Cord blood donation
When you donate your baby’s cord blood, it’s stored in a public bank for anyone who needs it. Unlike private (family) banks, public banks don’t store donations for a particular person. Instead, cord blood donations that make it onto the national cord blood registry are available to anyone, anywhere in the world, who needs a cord blood transplant.
According to the U.S. Department of Health and Human Services, each year about 18,000 people, ages 0 to 74 years, might benefit from a potentially lifesaving bone marrow or umbilical cord blood transplant.
Be The Match is a nonprofit organization that supports public cord blood banks’ efforts to encourage donations. It maintains the largest public listing of donated cord blood available for transplantation in the United States. The organization has facilitated more than 14,000 unrelated cord blood transplants since the year 2000. Scientists estimate the chances of a pediatric patient finding a cord blood donor on the Be The Match Registry at over 90 percent, for all ethnic backgrounds.
If a potential donor mother meets eligibility requirements and her baby’s cord blood is determined to be suitable for transplant, it’s stored in a public cord blood bank, and the cord blood unit is listed on the Be The Match Registry. (Most blood found not suitable for transplant is used for further research.)
Private (family) cord blood banking
When you pay to store cord blood in a private bank (also called a “family” bank), it’s reserved exclusively for you and your family. Over 2 million units of cord blood are stored in family banks in the United States.
For a fee, a family cord blood bank will process, and preserve your baby’s stem-cell-rich umbilical cord blood at their bank for your family’s future medical use.
Those who advocate storage of cord blood in a family bank say that a child whose cord blood is stored today will have more medical options in the future. Private cord blood banking may especially be worth the investment, proponents say, if you or a family member is at risk for a medical condition that can be treated with cord blood – for example, leukemia, lymphomas, sickle cell anemia, and immune deficiency diseases.
Similarly, a family with a history of neurodegenerative disorders (such as multiple sclerosis or Alzheimer’s disease), for which research with stem cells offers hope, may decide to include family cord blood banking in their birth plan.
You can find descriptions of family cord blood banks around the world on the Parent’s Guide to Cord Blood Foundation website
How to arrange to donate cord blood
To donate cord blood, ideally you sign up when you’re between 28 and 34 weeks pregnant (although some hospitals will take donations at the last minute). Most U.S. public cord blood banks and hospitals need several weeks before your baby arrives to check your health history and eligibility to donate.
Not every hospital collects cord blood for public donation. To find out if yours does, look up your state in the Parent’s Guide to Cord Blood Foundation’s guide to USA Donation Hospitals.
The public cord blood bank will ask you to complete a consent form and a maternal and family health questionnaire. You’ll also need to provide a small sample of your blood to be screened for infectious diseases, including hepatitis and HIV/AIDS. (No blood is ever taken from your baby.)
Here are some things to keep in mind while weighing financial considerations:
- Some banks offer discounts if you prepay storage for longer periods. On the flip side, make sure that when you compare bank prices, you are calculating the net cost after 20 years, because sometimes banks lure parents in with very low upfront fees, but you end up paying more in the long run.
- Some banks include medical courier shipping in their base price.
- Some banks offer discounts for families that bank more than one child’s cord blood. It’s also common to offer discounts to first responders and military families.
- The real price is almost always lower than the official price, because in any given week many of the banks are running some type of “limited time” discount or special offer. You can find coupons from family cord blood banks here.
Keep in mind, price isn’t a reliable determining factor. A less expensive bank may be cutting corners, such as not providing a well-insulated shipping box and courier transport to safeguard cell survival during transport, for example – or, it may simply be spending less on marketing and passing along the savings to customers.
You may also be able to store your baby’s cord blood for little to no cost if you have a family member who has a qualifying medical condition and may need therapy with the new baby’s stem cells, or your baby is diagnosed before birth with a condition that qualifies for participation in a clinical trial.
More cord blood resources
Watch these videos on cord blood banking
To hear what other parents are saying about cord blood banking decisions, visit the cord blood banking group in the BabyCenter Community.
Visit Parent’s Guide to Cord Blood Foundation for more information.