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To bank blood or not to bank blood?

14:05 / 03.07.07

I considered posting this in the Lab but it's really more of a personal dilemma that intersects with a scientific question, rather than vice versa. My fiance and I are having a little disagreement with his brother and sister in law, who are expecting their 1st baby in Nov. They have told the family that what they really want in the way of baby gifts is cash donations toward cord blood banking (and also bday gifts every year thereafter).

Cord blood banking costs about $1-2k for the first year and $100/yr for the rest of the kid's life. This is pricey for us, but what really bothers us is we think it's a totally unnecessary expense & waste of a lot of money.

For those who don't know, parents freeze dry and pay to store their baby's umbilical cord in case they need to use it as a source of stem cells later. It may work to treat a certain number of diseases, mostly blood and some autoimmune diseases. It is a 100% match for the child of course but only about 25% for future siblings. I read that about 1 out of 2700 babies will ever have a need to use the cord blood, and even in those cases there are often other, sometimes better, treatments available.

I don't know what we should do - try to talk them out of it? Opt out of the gift? Just go along with it? I feel pretty strongly that cb banking is just another part of the parenting-baby industry profiting off the anxieties of new parents... but of course how much of an ass would I be if I talked them out of it and their child ended up in need of it. Does anyone have any info or opinions on this issue?

14:35 / 03.07.07

I never heard of that, how weird. Sounds like a scam to me.

15:01 / 03.07.07

Actually, I have heard of it, although the yearly payment seems a little odd. The system I understood worked more like a blood bank - these are stem cells, after all.

Generally, I have a positive attitude toward that - although it may become unnecessary as stem cell research advances, this is Murika.

Lemme see something...

Ah: this is what I was thinking of, and this is what you're talking about. Strange.

Donations for bone marrow transplants and other transplant research, or preserving exclusively for yourself. Or your kid.

More information here and here.

15:10 / 03.07.07

Thanks for the links, grant. That was a lazy opening post on my part.

Finding objective info about cb banking can be a little difficult, because the marketing by the banks is pretty aggressive - often a parenting mag article will really just be a kind of press release by a corporation. I think this WebMD article does a good job of outlining the arguments for and against. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists both don't recommend (though they don't recommend against) doing this, because the chances of needing & using it are so low and the costs are so high.

I may try to push them to just donate it to the public bank. Donation is free, and again the frequency with which these cells are used is so low that they'd have a very good chance of being able to retrieve theirs from the public bank if they needed it.

It's weird, because the four of us just went to see Sicko together and were all fired up about universal health care... this is a step in the wrong direction I feel, paying a private company a motherlode to hoard your personal private baby cells as a pricey insurance policy that will probably never benefit you.

16:16 / 03.07.07

Before my daughter was born last month, my wife and I attempted to find a way to donate the cord blood, because I'd heard an NPR report on its various uses, and we thought that having our child's first act in the world to be one that could potentially save someone's life would be neat. After calling around to a number of places, we found that the major blood bank in our state no longer accepts cord blood, and that although there is a new university bank accepting cord blood, they will only collect it at one hospital, which was not the one our insurance dictated that we use.

The whole notion of paying a large sum of money to bank the blood away just for the use of one's own child rubs me the wrong way, though. It's yet another example of that self-centered attitude crossed with a dose of paranoia that seems endemic these days.

17:08 / 03.07.07

You have a daughter?

Congratulations!

Yes, I've heard that donating cord blood can be a big challenge - there are few places that can store it properly. I think one is at Duke and one is at UCLA, but I'm not certain.

18:48 / 03.07.07

Congratulations Mirror!

I found this place called Babies For Life that will send out a collection kit for you to bring to the hospital that will allow you to donate the cord blood from anywhere in the country. I'm not sure how many hospitals would actually go along with such a procedure but it might be a good option for people who don't have access to public banks.

21:50 / 04.07.07

Another perspective on this is to consider what might be best for the baby concerned at the time of birth. In order to bank cord blood, you have to clamp and cut the cord pretty much as soon as the baby is born. This deprives the baby of the oxygen-rich reservoir of blood and blood-making cells that helps the baby shift from a circulatory system that is based around the umbilical cord to one that is based around the lungs (as breathing is established). Another benefit of leaving the cord intact for a little longer is more iron, and thus reduced chance of anemia for the baby. You could argue that allowing the cord to stay intact at least until the baby is breathing well if not a bit longer will provide more long-term benefits for the child than the remote possibility that it may need stem cells from cord blood some time in the future.

My partner and I, along with choosing home births, are choosing to have a natural third stage - that is, we won't be having the injection that forces the uterus to clamp down immediately (which also means that the cord has to be clamped immediately), and we won't cut the cord until the placenta comes out naturally. (This is all assuming that we have uncomplicated, physiological labours and there are no medical emergencies.) We're not going quite as far as lotus birth, though, which is where the cord isn't cut at all - the placenta is kept with the baby (usually salted so it doesn't smell too bad) until the cord separates naturally 4-10 days after birth.

There is undoubtedly heaps more info about this available on the internet - one place to start is Sarah Buckley's article Leaving Well Alone - Perspectives on a Natural Third Stage.