Pregnancy can be a time of great joy and excitement, but it can also be a period of infinitely increased anxiety. Everywhere you look, you’re inundated by information about how best to set your new baby up for lifelong health and happiness, and the sheer volume of intel can be overwhelming. One consideration that often comes up – especially in social media ads, if the algorithm is wise to your pregnancy – is whether or not to engage in a practice called “cord blood banking.”
Cord blood banking refers to the practice of saving and storing blood from the umbilical cord and placenta after a baby is born. That blood contains stem cells that may be used to help treat certain conditions that your baby could develop down the road. That may seem like a huge perk – but cord blood banking is expensive, and some of the therapeutic uses are still theoretical. So is cord blood banking really worth it?
It’s a question many parents-to-be end up having as their due date looms. So we spoke to experts and put together this primer to help you decide whether or not cord blood banking is right for you and your baby.
What Is Cord Blood?
You’re likely familiar with the umbilical cord, which connects the baby to the placenta in order to provide them with nutrition, antibodies, and oxygen. According to Joanne Kurtzberg, MD, a pediatric hematologist-oncologist at Duke University Medical Center and expert in cord blood therapies, the term “cord blood” refers to leftover blood in the umbilical cord and placenta after a baby is born.
This blood is “special” because it contains hematopoietic stem cells, which have the ability to turn into various types of blood cells, including red blood cells, white blood cells, and platelets. These cells are crucial for the formation of blood and the immune system. “Cord blood contains blood stem cells which can be used as a donor for bone marrow (or hematopoietic cell) transplantation,” Dr. Kurtzberg says. “Cord blood also contains other types of cells which may be used, in research protocols, to manufacture other therapies to treat cancer or other diseases.”
The bone marrow and blood of adults also contain these types of stem cells, but those found in cord blood are more desirable for therapeutic use because they’re considered “immunologically naive,” meaning they haven’t been exposed to infections that may make them more likely to attack a transplant recipient’s body.
What Is Cord Blood Banking?
Banking is the collection, processing, freezing, and storage of cord blood. After a baby is born and the cord has been cut, Dr. Kurtzberg says leftover blood from the umbilical cord and placenta can be collected, processed, and frozen away for later use in blood stem cell transplantation.
There are two types of banks that collect and store cord blood. Public banks are nonprofits that take in cord blood by donation. The donated blood is then put on a national registry and made available for use by anyone in need. (If you later want to use cord blood for your child, you wouldn’t be able to request their own cord blood if it was donated to a public bank.)
More often, expectant parents hear about private banks, which are paid to collect individual cord blood for potential personal future use.
Since cord blood must be collected within 10 to 15 minutes of a child’s birth, banking has to be decided upon prior to giving birth; ideally, you’d begin talking about it with your doctor about three months before your due date, according to the Health Resources & Services Administration (HRSA). You can ask your healthcare provider for bank recommendations, then contact the bank for a cord blood collection kit that will be used by your doctor, nurse, or midwife after delivery.
How Much Does Cord Blood Banking Cost?
Public banking is free. Private banking, on the other hand, can cost between $1,350 and $2,350 for collecting, testing, and registering the blood. Annual storage fees typically range from $100 to $175 dollars.
Private cord blood banking is not typically covered by health insurance; however, if you have a family history of conditions that are treatable with cord blood therapies, you may be eligible for some coverage.
What Conditions Can Cord Blood Treat?
Cord blood transplants are approved for the treatment of a number of conditions. According to Dr. Kurtzberg, these include certain malignant cancers, such as leukemia, lymphoma, multiple myeloma in children, and a condition called neuroblastoma.
Cord blood can also treat certain nonmalignant conditions, including aplastic anemia, a disease where the bone marrow stops working, usually in babies and children born without a functioning immune system; hemoglobinopathies, such as sickle cell anemia or Beta Thalassemia; and certain inherited metabolic diseases in children, such as Hurler syndrome, Krabbe disease, metachromatic leukodystrophy, and adrenoleukodystrophy.
In a cord blood transplant, patients are given high doses of chemotherapy or radiation therapy to wipe out their own bone marrow and immune system. “Then they get a transplant, which is an infusion of cells in donor cord blood, and those transplanted cells replace their bone marrow and their immune system,” Dr. Kurtzberg says.
These therapies have been around for a while – the first cord blood transplant took place in 1988 – so they’re tried and tested, Dr. Kurtzberg says. The diseases these therapies treat, however, are generally considered rare, which means the odds of your child being diagnosed with one of them are relatively low.
What’s more, in many cases, your baby’s own blood won’t be an appropriate donor source even if they are diagnosed with a treatable condition.
“For example, you most likely would not use your child’s own blood to treat a blood cancer like leukemia or certain genetic diseases,” Dr. Kurtzberg says. “This is because their cord blood contains leukemic cells in the first instance and the same genetic disease in the second case as the blood currently in their body, so if used for a transplant, it would not correct the disease the child is being transplanted for.”
In other words, the same problem currently found in your child’s blood was also present in their cord blood, which disqualifies it for therapeutic use. You would instead need to use donor blood.
This may eventually change, as Dr. Kurtzberg says in certain types of gene therapy, the genes in blood stem cells can be corrected to eliminate the issue in question before transplantation. “In those cases, a child’s own cord blood could be the best source of cells, but that’s still experimental,” she says.
And one child’s cord blood could theoretically be used to treat their sibling or other relative “if the sibling and the sick child are full tissue type matches (HLA match) and if the sibling is healthy,” Dr. Kurtzberg says.
What Conditions Might Cord Blood Be Used For in the Future?
Some of the buzzier, cutting-edge applications for cord blood are still in the process of being researched. “These conditions include cerebral palsy, babies with birth asphyxia, children with traumatic brain injuries, adults with stroke, children with hearing loss, children with type 1 diabetes, and children born with hypoplastic left heart syndrome, or basically heart failure at birth,” says Dr. Kurtzberg, who adds that you can find a full list of these studies at clinicaltrials.gov.
While this research is exciting, and Dr. Kurtzberg herself is involved in a Phase III trial for the treatment of cerebral palsy, she offers an important caveat. “Although there are some interesting results from clinical trials, cord blood has not been approved as a treatment in the United States for any of these conditions, and for the most part, additional clinical trials are needed to confirm early results,” she says. It’s also unclear whether an individual’s own cord blood will be able to be used for treatment, or if donor blood will suffice.
Her study on the treatment of cerebral palsy, she says, is actually furthest along in the regulatory approval pathway of any study, and even this treatment is approximately five years away from potential approval by the US Food and Drug Administration (FDA). “The others are all in clinical trials at one level or another but are not proven therapies at this time,” she says.
How Long Is Banked Blood Viable?
At present, Dr. Kurtzberg says experts don’t know whether or not cord blood banked from a baby in 2024 will be viable for use when that baby is 70 years old; however, current data does show that cord blood that is frozen and stored properly under liquid nitrogen is good for at least 30 years. “There’s no reason to think it won’t be good longer, but the data we have now supports 30 years,” she says.
So, Is Cord Blood Banking Worth It?
This is the million-dollar, or at least several-thousand-dollar, question – and it doesn’t have a straightforward answer.
As noted above, your child’s own cord blood will not actually be useful to treat a number of the (already rare) conditions for which cord blood transplants have been approved. “I don’t know what the exact odds of using banked blood are, but my understanding is that they’re kind of negligible,” says Leigh Turner, PhD, executive director of the Bioethics Program at the University of California, Irvine, who studies public health ethics and the ethics of cord blood clinics and banks. “When it comes to privately banked cord blood, the number of units used down the road to subsequently treat children who were the source of the umbilical donations is low.”
Private banking may make sense, however, in families in which one child has a disease that’s treatable with cord blood, such as leukemia or sickle-cell anemia; if the new baby is healthy and a donor match for the sibling, the cord blood could be used in the older child’s treatment. Even in these instances, however, research shows there is only a 25 percent chance siblings will be a donor match.
If you’re interested in the potential cord blood has to be used for conditions it’s currently being researched for, like cerebral palsy, Dr. Turner is careful to reiterate that these applications have not yet been proven. He feels some cord blood bank marketing materials promoting these therapies can be misleading. “I think these businesses may also be creating a false sense of hope,” he says.
Dr. Kurtzberg also points out that there is a significant amount of publicly banked cord blood available to be utilized should it be needed by your child. “There are about a million publicly banked cord blood units that would be available to anyone in need of a donor,” she says.
And for what it’s worth, the American Academy of Pediatrics (AAP) actually recommends donating to a public bank, as units of donated blood are 30 times more likely to be used than privately banked blood. Donating to public banks is also an act of service, as those banks are in need of significant donor diversity in order to serve a greater number of patients.
With that said, Dr. Kurtzberg and Dr. Turner both say that if you understand the limitations of cord blood therapies and you have the financial means, there’s no harm to private banking if it will give you peace of mind.
What to Look For in a Private Bank
If you do decide to move forward with private cord blood banking, begin by checking to see which banks are accredited by the Association for the Advancement of Blood and Biotherapies and/or the Foundation for Accreditation of Cellular Therapies (FACT). The bank you choose should also be licensed by the FDA (or equivalent agency in another country). These steps can help ensure you find a reputable bank.
From there, Dr. Kurtzberg says there are a few things to consider when choosing a specific bank.
The first is how much blood that bank stores. This is important because if there is not enough blood stored, you may not have enough stem cells present in that blood to make it useful for treatment. The American College of Obstetrics and Gynecologists notes that banks should collect at least 40mL of cord blood. The second thing to consider, she says, is the freezers and freezing methods used by the bank. “The cord blood should be frozen using controlled-rate freezing and stored in the vapor or liquid phase of liquid nitrogen,” Dr. Kurtzberg says.
Banks should provide both details up front, but if they don’t, you can ask.
The third thing Dr. Kurtzberg recommends thinking about is the stability of the business of the bank. “You don’t want to bank cord blood and then the bank goes out of business in five years and you don’t know what happened to that blood,” she says. She suggests looking into how long the bank has been in business and whether it merged or was acquired by another bank at some point. “Parents can also ask the bank staff what their procedure would be if the bank had to close or change ownership,” she says.
And, of course, googling the name of a bank and checking out the reviews can go a long way toward making sure you find a bank you trust.
A Final Word to Expectant Parents
Ultimately, Dr. Kurtzberg wants to reassure parents-to-be that if they don’t have the means to pay for private banking, they shouldn’t feel like they’re denying their child of something because, she reiterates, the public supply of cord blood can be accessed by anyone in need. “It’s true you can only get the cord blood around the time of birth, so it is a one-time opportunity,” she says. “But it’s not an essential part of taking care of your child.”
Erin Bunch has more than 15 years of experience as a journalist and professional writer. Her words have appeared in GQ, The Hollywood Reporter, Well+Good, Women’s Health, The Zoe Report, BRIDES, Harper’s Bazaar, Los Angeles Magazine, and other outlets.
