Cord Blood Follow Up

I have received several questions regarding my previous post on cord blood.  I hope the following information is helpful in answering your questions.  I would also like to mention that my husband, Alex, contributed greatly to this blog.  Thank you, mi Batata Guapo.

Let me begin by saying I am not a medical professional.  I am just a mom who did extensive -- but not exhaustive -- research.

Nothing is guaranteed in life.  Many times we have to make decisions based on probabilities.  To begin with, the probability your child will need stem cells over their lifetime is low.  Furthermore, the likelihood that their own cord blood will provide matching stem cells for themselves is lower than the probability they will find a match from someone else.  To quote a study cited by the Wikipedia article on cord blood : “The likelihood of an autologous transplant using your own stem cells is 1 in 435, the likelihood of an allogeneic transplant from a matched donor (such as a sibling) is 1 in 400, and the net likelihood of any type of stem cell transplant is 1 in 217.”

By using a public cord blood bank, you are giving your child access to a repository of stem cells that are more likely to be a match than their own cord blood.  Not only do you have a greater chance of saving your child’s life, you also open the door to saving someone else's.

Another aspect to consider is that the promise of stem cell technology is still outpacing the reality.  A panel from the European Union studying the ethics of private cord blood banking concluded: "[t]he legitimacy of commercial cord blood banks for autologous use should be questioned as they sell a service which has presently no real use regarding therapeutic options. Thus they promise more than they can deliver. The activities of such banks raise serious ethical criticisms."

The analogy of insurance is appropriate for a private cord blood bank.  Your child is covered only as long as you pay.  It is also apropos when you consider how profitable of a business model it is.  If you look at the substantial annual fees, it should make sense.  Private cord blood banks cleverly advertise in medical offices and offer rich incentives to doctors and midwives who refer clients to them.  As with other products and services offered in the for-profit world of medicine, you must carefully consider whether your best interests are being served before you sign on the dotted line.

The American Academy of Pediatric policy statement on cord blood banking further states: “Cord blood–banking recruitment practices should be developed with an awareness of the possible emotional vulnerability of pregnant women and their families and friends. Efforts should be made to minimize the effect of this vulnerability on cord blood–banking decisions. Accurate information about the potential benefits and limitations of allogeneic and autologous cord blood banking and transplantation should be provided. Parents should be informed that autologous cord blood would not be used as a stem cell source if the donor developed leukemia later in life. Parents should recognize that there are no scientific data to support the claim that autologous cord blood is a tissue source proven to be of value for regenerative medical purposes."

Under certain circumstances, such as your baby having a sibling who is already in need of cord blood, private cord blood banking may be the better choice.  My husband and I decided that public cord blood banking was the best choice for our baby, for our society and for our wallet.  We encourage everyone to do the research and to make the best decision for themselves.

Questions to ask your medical provider and potential cord blood bank:

1) What is the % chance that my child will need cord blood in their lifetime?
2) What is the % chance that my child's cord blood will be harvested correctly and accepted into the cord blood bank?
3) How long can the cord blood safely be stored?
4) Does the usefulness of cord blood degrade over time?
5) Does the probability that my child will need cord blood decrease over time?
6) Which diseases can currently be treated by cord blood?
7) Which diseases are expected to be treatable by cord blood in the future?
8) How much can I expect to pay over the useful life of the cord blood?
9) Will I receive a refund of all fees if the cord blood is ever damaged or lost?
10) Will the cord blood be used for anything other than transplants, such as research?
11) What rights over my child's cord blood do I retain once it is in the cord blood bank?  Can I choose to have it transferred  to another cord blood bank or to a specific recipient?
12) How will you maintain the privacy of my child's genetic information?

Additional Resource:  http://www.parentsguidecordblood.org/