We have known for years that at birth this blood is tested to determine the health of the baby. However, more recently, research has discovered the umbilical cord blood to be an invaluable source of stem cells which are unique to the baby and may be used in a variety of medical treatments that can save lives. Saving this cord blood in a process known as “cord blood banking” has raised much attention. It is important that expectant parents understand the difference between cord blood testing and cord blood banking and what each means for their unborn child.
The umbilical cord is the vital link between the fetus and the mother which, during pregnancy, carries nutrients and oxygen to the unborn baby and removes waste products of the unborn baby’s metabolism. Being this vital link, the cord and its blood has the ability to tell much of the baby’s health, wellness and exposure during the baby’s time in utero. Immediately after birth, when the cord is cut, a sample of the cord blood is taken and sent to the lab for testing of the baby’s blood type. In the event of a difficult delivery, cord blood gases are tested to determine the pH and oxygen level of the baby. Furthermore, when babies have been exposed to drugs or when prenatal drug exposure is suspected, a segment of the cord itself is collected and sent to the laboratory for analysis and drug screening. All of this testing is included in the hospital’s policy and procedure guidelines.
Cord blood banking involves a much different process. As stated, recent research has determined that cord blood contains invaluable stem cells. Stem cells are the building blocks of organ tissue, blood and the immune system. Stem cells were first used to regenerate blood and immune cells for patients who had received chemotherapy. In the past, cord blood was usually discarded after the infant was delivered. In the late 1980’s, doctors started using stem cells from cord blood to treat diseases that had previously been treated with bone marrow transplantation. Because of this evolving research, parents now have the choice to collect and store this cord blood and tissue in a cord blood bank for future use. Having your baby’s own genetically unique cord blood offers many advantages if stem cells are ever needed by the baby or even your family for life-saving treatments.
Unlike cord blood testing, cord blood banking is not a standard policy of the hospital. At both DuBois Regional Medical Center and Clearfield Hospital, collection of the cord blood for banking can be completed however; it is the responsibility of the parents to make the arrangements for collection, transfer and storage as well as to pay all fees. There are two types of storage. Public cord blood banks collect and store donated cord blood stem cells for use for those who are in need of a stem cell transplant and are a close match to the cord blood donor. Private or family cord blood banking provides parents with the option to have their baby’s cord blood collected and stored for the baby or another close family member if ever needed. There are also cost and ownership options to be considered in making the decision to store cord blood. Cord blood can be donated to a public bank or it can be saved in a private blood bank. An initial collection and storage fee ranges between $1,000 and $2,000 when the baby is born with an additional yearly storage fee ranging from $100 – $150. Again, these fees are the responsibility of the parent. Parents can contact their health care provider to discuss which options are available. Pennsylvania is one of 27 states requiring persons to receive information about options for umbilical cord banking.
The following editorial from Dr. Frances Verter, Founder and Director of Parent’s Guide to Cord Blood Foundation, a charity devoted to giving parents balanced and accurate education about cord blood, provides an introduction to cord blood banking. It contains two patient stories for human interest, one patient that highlights the importance of donation and the other highlighting the importance of family storage.
Cord Blood banking is a form of health insurance that can protect your baby, your family, and help society. At birth, the blood in the umbilical cord is a rich source of stem cells that can be harvested without risk to mother or baby. Those stem cells can be used for either stem cell transplants or for new therapies where stem cells help the body to repair itself. Unfortunately, more than 90% of cord blood is thrown away as medical waste, making education about this valuable resource critical.
Cord blood has been used in over 20,000 stem cell transplants since 1988. One of them is 10 year old Carol Mulumba. Diagnosed with sickle cell anemia, despite treatment with drugs and transfusions, morphine was not stopping the pain and Carol was on the brink of having strokes. The debilitating nature of the disease was taking its toll on the little girl. Luckily, her brother Mark was born a perfect match, allowing for a bone marrow and cord blood transplant that has left Carol disease free for two years and counting. But 70% of patients who need a transplant do not have a matching donor in their family, requiring them to search the international registries for donors of cord blood or bone marrow. Carol’s family started a foundation to educate expectant parents in their home country of Uganda about the importance of saving or donating cord blood.
Within the past 5 years, about 200 children have received infusions of their own cord blood to help them recover from brain injuries sustained in-utero or shortly after birth. Clinical trials are testing the efficacy of cord blood for the treatment of neurological conditions like cerebral palsy, traumatic brain injury, and hydrocephalus. Amy Hendrix discovered when she was just 18 weeks pregnant that her baby suffered from hydrocephalus – a build-up of fluid inside the brain. Learning of the condition ahead of birth prompted the family to save their baby’s cord blood in a family cord blood bank. Parker Elizabeth was born 8 weeks early, with so much fluid build-up in her brain that her head was the size of a two year old child. A shunt was inserted soon after birth to allow for the fluid to drain from her brain. A few months after that, Parker received the first of two infusions of her own cord blood stem cells. While her doctors offered a grim prognosis for Parker, including the likelihood that her ocular nerve was so damaged that she would be blind, Parker’s recovery has been remarkable. She can see, walk, and talk so well that by 20 months, she was considered “normal” by her Early Intervention therapists.
Stories like Carol’s and Parker’s show that saving cord blood for your family can save your newborn or a sibling, and donating cord blood to society can save a patient in need of a transplant. No matter what choice a family makes when their own baby is born, the hope is that fewer and fewer will simply allow this valuable resource to be discarded as medical waste.
To learn more about cord blood banking, contact the The March of Dimes www.marchofdimes.com, Magee-Women Hospital www.givcord.org, Parent’s Guide to Cord Blood foundation www.ParentsGuideCordBlood.org, or Health Resource and Service Administration http://bloodcell.transplant.hrsa.gov/.
Lori Rancik, RN, BSN, Case Manager
The Women’s Health Center, DuBois Regional Medical Center