Cord-blood banking is a relatively new concept. After birth, the placenta and umbilical cord would usually be discarded with nary a second thought. But in the 1970s, scientists discovered that umbilical cord blood is rich in stem cells, the same cells found in the bone marrow where our blood cells mature. Then in 1988, a French medical team took cord blood from a newborn and gave it to the child’s six-year-old brother who had Fanconi’s anemia, a severe disease that causes skeletal defects. The recipient soon recovered.
Today, thousands of cord blood transplantations, from related and unrelated donors, have been performed with great success. This has led to more and more parents deciding to collect and store their newborn’s cord blood as “health insurance”, to ensure that should the child or a sick relative need an urgent bone marrow transplant, there will be a ready supply of stem cells available.
A closer look at stem cells
Stem cells are the building blocks of the human body. They have the potential to transform into many different types of cells such as red and white blood cells as well as the cells that make up skin tissue and major organs like the heart.
Many life-threatening diseases involve death or grave damage to our healthy cells. For example, heart disease affects cardiac cells and diabetes can damage pancreatic cells. Studies show that stem cell transplantation may help replenish or reengineer replacement cells at the damage site.
Scientists are still researching how stem cells will reshape the future of mankind. However, stem cells are already being used to treat childhood cancers like leukaemia and certain types of immune system disorders. Stem cell transplantation is especially favoured in childhood cancer treatment because chemotherapy and radiation therapy tend to destroy both cancer cells and healthy cells in the bone marrow. When the stem cells are implanted into an ill child, they help to manufacture new and healthy blood cells that can enhance the child’s natural blood-producing and immune defences.
Cord blood collection and storage
If you decide to bank baby’s cord blood, you must do it while you’re still pregnant.
It is a good idea to check with your doctor whether your hospital is able to collect cord blood samples. Then contact a company and ask about their cord blood banking prices and procedures. Cord blood storage is a highly privately-run business and depending where you live, you may not have many service providers to choose from.
You may need to have some blood tests to see if baby’s stem cells are healthy enough for storage. Once you approach your due date, your chosen company will provide you a sterile cord blood collection kit.
After your delivery, once your doctor is satisfied that both you and baby are fine, the umbilical cord will be clamped on both sides and cut. The cord blood will then be collected into the collection kit using a tube. This process may be a little more complicated for a caesarean delivery because your doctor’s main focus will be the surgical details of the delivery. Usually, the amount of cord blood that can be collected after a C-section will be less than the amount collected from a vaginal birth. The amount of cord blood collected is important because the more cord blood available, the more the stem cells available and the higher the chances of a successful transplant when the cells are used.
The collected cord blood will then be sent via courier to the company’s cord blood bank for storage. Here, the stem cells will be separated from the blood and frozen according to strict standards. Studies show that stem cells harvested at birth can be stored for up to 20 years before being thawed for use.
Pros and cons of cord blood banking
It is possible that cord blood banking will become a routine procedure in most hospitals. Till then, however, parents have to consider the pros and cons of cord blood banking very carefully before deciding whether they need this procedure.
Pros:
Banked stem cells can be a lifesaver if your family has a strong history of diseases that require a bone marrow transplant. These diseases include leukemia, lymphoma, aplastic anemia and severe sickle cell anemia.
The collection procedure causes no pain for the mother and child.
The future of stem cell research is very promising and banked cells may be of use for other purposes too.Cons:
Cord blood banking is very expensive, with initial fees costing thousands; without the already steep yearly maintenance fees for banked cells.
The odds that a child without risk factors will use the banked cells are low.
The banked cells will only be available for transplant on a child or adolescent. Experts say that umbilical cord blood stem cells aren’t sufficient to complete an adult transplant.
Other important considerations
There is insufficient evidence to prove that stem cells donated by a relative can offer higher chances of a successful transplant than stem cells from an unrelated donor. Evidence shows that the donor cells do not need to be a perfect match to create a successful transplant.
Some scientists are worried that an ill child risks being prone to the same disease after receiving a transplant of her own cells. Most stem cell transplantations are performed on a relative of the donating child and there is little evidence to show the long-term safety of a child who has received her own stem cells.
There are also some concerns about the risks to the mother and child at the time of collection. Although clamping the umbilical cord too soon may allow more blood to be collected, it can lead to baby having a lower blood volume and possibly, anaemia.
You should also consider the pros and cons before donating your child’s cord blood. It is a noble gesture and may save lives. But if your child or a family member develops a disease that needs stem cell treatment, you won’t be able to use the cells.
The American Academy of Paediatrics (AAP) doesn’t recommend cord blood banking for families who don’t have a high genetic risk of disease. The AAP is also asking parents to be extremely cautious when choosing a cord blood banking company because it fears that some companies may capitalize on new parents’ fears.
Some of the questions you should ask before choosing a cord blood banking company include:
- Is the company financially stable?
- How many samples does the company process? A higher number usually means that good procedures and standards are in place.
- Can I switch to another cord blood bank if I wish to?
- What happens to my baby’s sample if the company goes bust?
- Will yearly and other fees increase or are they fixed?
Is there an alternative?
Stem cell collection is currently a one-time opportunity during delivery. But studies are being conducted on harvesting stem cells from healthy adults too. It is thought that these adult stem cells may still be able to treat the donor when he or she develops a condition like heart disease later in life. However, there are detractors who insist that umbilical cord stem cells are “purer” and thus, more effective because they are taken before the donor could be exposed to harmful environmental factors.
A currently in-use alternative is finding a perfect bone marrow match. This is however, notoriously difficult. Using your own stem cells in contrast, has little or no chance of being rejected by the body.
In a nutshell, if you and your family lead a healthy lifestyle and have no or a negligible risk of inherited diseases, cord blood banking may not be necessary for your child. However, do discuss your options in detail with your doctor so that you are not constantly worried about making the wrong decision.
