Years ago, while in a prenatal, paternal panic, I came upon the prospect of banking my infant’s cord blood. At the time this just seemed outlandishly bizarre and the kind of preventative action reserved for only the certifiably paranoid or pessimistic. But in that classic mode of prenatal panic I thought best to consider the option of banking my unborn child’s cord blood.
I did some light preliminary research, made a few calls and soon found myself being contacted, almost on a weekly basis, by a congenial, but pushy, cord blood representative named Robert (I think). Robert’s job was to inform me, with unwavering conviction, that banking my child’s cord blood was about as important of an action as I could take for my child’s, as well as my family’s, future health. I was required to buy into a plan that involved a $2000 down payment and about $100 annual fee for continuing to bank the cord blood. While compelling, I eventually thought better of it and opted not to bank my child’s cord blood.
Since that very singular moment in time, I have been asked the question countless times, by expecting parents, of whether it is a good idea to bank your baby’s cord blood. My answer is always the same, “Yes and No.”
To give a little background, the practice of banking infant cord blood (it sounds much more macabre than it actually is) involves extracting the umbilical cord blood from the fetal end of the umbilical cord after it has been cut (and yes, after birth). This is done within minutes after birth and is a fairly time sensitive process, so the option to bank your cord blood has a finite window. After the cord blood is collected, it is shipped off to either a private or public cord blood bank, processed and then cryopreserved (AKA frozen) for potential later use. So why bother?
Well, the benefits of cord blood banking are potentially huge, as cord blood stem cells extracted from this process can be used in the treatment of several life-threatening diseases, and play an important role in the treatment of blood and immune system related genetic diseases, cancers, and blood disorders. And cord blood stem cells are not just an insurance policy for your child; they may also be used for mothers and a percentage of siblings (depending) for treatment of a whole host of diseases. For instance, studies have shown that cord blood has unique advantages over traditional bone marrow transplantation, particularly in children, and can be life-saving in rare cases where a suitable bone-marrow donor cannot be found.
All of this provides a fairly convincing argument for banking cord blood. So why didn’t I do it. Well in part because it is a racket. Not a scam, but a racket, filled with exaggeration, misinformation and scare tactics. To explain, cord blood banking is a worthwhile undertaking that could potentially save lives, however where you choose to bank your cord blood makes all of the difference. There is public cord blood banking and there is private cord blood banking and the differences between the two are significant.
Admittedly I was ignorant of the option of public cord blood banking when I opted not to bank my infants cord blood. I only knew of the private option, which required a hefty initial fee and subsequent storage fee to maintain that piece of mind. Private banking is costly (a few thousand dollars over time). Private banks store cord blood with a link to the identity of the donor, so that the family may retrieve it later if it is needed. Many of these private enterprises are purely enterprises, subject to fluctuations in the market, and the ability to use the cord blood will ultimately depend on the long-term commercial viability of the enterprise (some private cord blood banks are publicly traded on the stock market). Therefore your cord blood may find itself homeless if the private bank goes belly up.
One key component to the argument for not banking privately is that, unless you have family history of the sort of diseases that would benefit from the use of cord blood stem cells (heart disease and various neurological diseases) the likelihood of ultimately using the cord blood is slim. In addition, much controversy (ethical and otherwise) has surrounded the practice of the private banking of cord blood with several in the medical community taking issue with the standards and practices of many private blood banks in this industry. The American Academy of Pediatrics policy states that “private storage of cord blood as ‘biological insurance’ is unwise” unless there is a family member with a current or potential need to undergo a stem cell transplantation.
This is where the public option comes in (not to be confused with the controversial “public option” tied to the recent health care reform bill). Public cord blood banking is, in theory, the same as the private option with one distinct difference: the cord blood is not permanently linked to the donor. Therefore the donation is largely altruistic and the donation is washed of all identifying information after a short period of initial testing and deposited into a larger collection for the use of anyone in need. The public banking (in most cases) is facilitated by the public cord blood bank (collection, cataloging, etc) and done free of charge.
There is much more to consider in this public vs. private debate, and even more to question in regards to whether to bank cord blood at all: Issues of the viability and availability of blood donations, ethical issues, issues of ownership and use, etc. All things considered, private banking seems to make the most sense if you have a significant family history of disease (specifically diseases that would benefit from use of cord blood stem cells) and the use of such stem cells seems probable. Public banking seems to be the sensible, and painless, option for the rest of us who just want to make a contribution to the betterment (and possible cure) of society and its ills.
What are your thoughts about cord blood banking? Has anyone out there had positive or negative experiences with public or private banks? Did anyone opt out because of the prohibitive high cost? Do you have particular ethical concerns with the practice? Has anyone ever actually retrieved a donation for medical use?