Now that I'm close to the third trimester, my husband and I are faced with a decision about what do with our new baby's cord bloodthe stem cell–rich blood collected from a newborn's placenta and umbilical cord. Specifically, should we pay to privately bank our third child's cord blood, or publicly bank it?
We're debating, trying to decide whether the small chance that the stem cells in her cord blood will be useful to her someday merits the $2,000 expense. And if we go that route, are we selfish for not sharing our baby's cord blood with others who are in need?
Stem cells, like those in my unborn babys cord blood, can be used in autologous stem cell transplants to treat leukemia, lymphoma, or other life-threatening diseases. (Stem cells can also be collected from blood and bone marrow.) Preliminary research suggests that cord blood could also be used to treat neurological damage due to trauma, such as cerebral palsy, although it's still not clear if this is true.
Banking cord blood doesn't guarantee it will be usable, though. Children who develop an immunological disorder or cancer might not be able to use their own cord blood for transplants because the blood also contains the same genetic defect or precancerous cells. And approximately 75 percent of the units donated to public banks are discarded or used in research because they don't contain enough stem cells for transplants in adults.
Is there a right way to store cord blood?
I've heard a lot of conflicting advice about how cord blood should be saved. We could either bank it publicly or choose private (family) banking. In other words, we can give it away like it's a blood donation or we can hoard it for use by our own family.
The hospital where I'm giving birth is directly affiliated with a public cord blood bank, StemCyte. They could, at no cost to me, collect my new baby's cord blood and store it in a public bank, where it may be of use to someone for an allogenic stem cell transplant. Since StemCyte reports that only 1 to 5 percent of their cord blood samples are used, the odds are good that if we should request my daughter's cord blood in the coming years, it would be available.
Next Page: Making a choice for our family [ pagebreak ]Making a choice for our family
If we were in an unusual ethnic group or if our children were of mixed race, this cord blood–banking decision might be easier. Minority communities are currently underrepresented in the donor pool, while white people stand an excellent chance of finding donated cord blood that is a match for potential stem cell treatments.
The American College of Obstetricians and Gynecologists (ACOG) recently released a statement recommending that OBs present their patients with public cord blood–banking options, not just those of private banks in which doctors may have a financial stake. And the American Academy of Pediatrics encourages parents to donate cord blood, not bank it, unless the child has a sibling with a known genetic condition or type of cancer that may benefit from a cord blood transplant.
Charles Lockwood, MD, the chief of obstetrics and gynecology at Yale–New Haven Hospital, supports ACOG's position. "It is very unlikely that these cells will ever be needed," he says. "Private storage is expensive, and [cord blood] should be donated to public banks."
However, Dr. Lockwood adds, "In the far-distant future these cells could prove useful for stem cell therapies for degenerative diseases in aged patients (e.g., for Alzheimers disease), and having banked cord blood could prove very helpful. However, we dont know if they will remain viable for the next 70 years."
Adam Ofer, MD, an OB-GYN based in Fairfield County, Connecticut, disagrees: "Everybody deserves the right to save their own stem cells. Anyone who can afford it should do it."
Having met parents who've used privately banked cord blood to heal their children, Dr. Ofer remains convinced of its value. He advises his patients to re-prioritize their prebaby shopping in order to save money for cord blood storage.
Dr. Ofer also raises an interesting point: Parents could potentially use their children's cord blood. "There is something special about cord blood from relatives that makes it better than any other source of stem cells," he explains. "Even if someone who is ill finds a 'perfect match' to receive a donation, the same match from stem cells collected from a relative have a much greater chance of successful treatment without rejection."
Well now. That's a good way to get my attention. It's possible that my daughter's cord blood could be useful to me. My pregnancy could result in the availability of compatible stem cells for me, my husband, and possibly our parents or our baby's sisters.
We've decided to pay to privately bank this baby's cord blood. It's not cheap, but our cord blood company is offering us a discount. This stem cell "insurance policy" is just too enticing. So, yes, we'll do it for herand maybe for ourselves, as well.