Public cord-blood banking is best

We all know the medical world is rapidly changing and that new technologies come and go like the leaves flying by our windows this fall. These medical changes are even happening in the business of pregnancy and birth, despite the fact that the basic mechanics haven’t changed since the beginning of time. For example, let’s look at the new technology, procedure and recommendations relating to umbilical cord blood storage.

Let me start with a brief history. Cord blood storage is not the same as the controversial embryonic stem cell studies, though its potential health benefits aim to treat many of the same illnesses. Cord blood is fetal blood that circulates between the newborn and the placenta at the time of delivery. In addition to having the typical blood components, umbilical cord blood contains a large number of stem cells, which have traditionally been harvested from bone marrow and healthy individuals’ circulating blood.

Stem cells are useful for many known medical treatments, such as those for blood illnesses like anemia (an illness of the red blood cells), leukemia, other cancers and some genetic illnesses. Studies are also examining the potential of stem cell use in the treatment of hearing loss, traumatic brain injury, diabetes and autism. The collection of cord blood is regarded as harmless to the baby and the mother, and can be done in all birth settings under most circumstances.

On the surface, this seems like a no-brainer. It sounds like if everyone just had their newborn’s cord blood collected for storage, viola!, we’d be cured of many rare and life-threatening illnesses in no time. Or at least that is what the private, for-profit (and completely unregulated) cord-blood storage companies would like me to tell you. For the small annual fee of roughly $125 (on top of an initial collection fee of $2,000-$3,000) they offer to store the blood components, calling it a “biological insurance.” What parent would not want that for their newborn?

Here’s the catch: Though autologous (meaning your own cell) transplants have been done with success since the 1980s, recent research has proven that cell matching -- like what we do with blood bank centers -- works just as well and in some cases even better since your individual cord blood may also hold the cause of an illness (meaning it will only harm you more to add it back to your already ailing system).

The advancement toward banking stem cells for public donations is also likely to treat more sick people since it offers treatments and cures for people who did not choose to store their own cells, including those who were born before collection was available. Plus, a public bank gives a constant fresh store, which is crucial since we’re not sure we can store the cells for even a quarter of a typical lifespan. And with the typical lifetime chances that one will even need the cells ranging from one in 400 to one in 200,000, self-storage sounds even less appealing when other options are available and effective.

With all this in mind, what do the experts recommend to you as a parent and consumer who wants all the best for your child, or to me, a clinician hoping to offer evidence-based medicine? Both the American Academy of Pediatrics and the American College of Obstetricians and Gynecologist have statements available to the public related to cord-blood banking. In summary, both state that cord-blood collection should not interrupt routine practice, meaning it should not take priority over delayed or immediate cord clamping if needed for immediate infant medical care, and both prioritize public donations over private storage.

The AAP goes on to make a stronger statement against storage for self-use, stating that cord-blood storage “should be discouraged when cord blood stored in a bank is to be directed for later personal or family use…there are no scientific data at the present time to support autologous [one’s own] cord-blood banking given the difficulty of making an accurate estimate of the need for autologous transplantation and the ready availability of allogeneic [donated material].”

This bit of research has given me new information to share with my clients compared with what I may have said five years ago; if you want to do something good for your child, donate to the national bank and you’ll likely help someone else along the way. Learn if you can donate at The National Marrow Donor Program website, http://marrow.org.

Sarah Bay, who writes The Hard Health Issues column every other month, is a nurse practitioner and certified nurse midwife caring for women of all ages. Her office is located in downtown Peterborough, with care also available at offices in Keene and Milford. For more information, call 801-9485 or visit www.sarahbaymidwife.com.

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