The Pros and Cons of Cord Blood Banking (2024)

If you're currently pregnant or thinking about starting a family, chances are, you've heard of cord blood banking. Throughout pregnancy, the umbilical cord acts as the baby's lifeline, connecting them to the placenta that serves as a source of oxygen, antibodies, and nutrition. In the past, this tissue was routinely discarded after delivery, but that's starting to change. More parents are storing (AKA "banking") their baby's cord blood for potential future use, prior to the discarding of the tissue. In fact, donating umbilical cord blood can save lives.

Diseases that can potentially be treated using cord blood include leukemia, immunodeficiencies, some cancers, sickle-cell anemia, and some metabolic disorders—and new therapies continue to be developed that utilize stem cells. However, because cord blood banking is relatively new, it's understandable if you have some questions about the process. Ahead, learn more about your options for banking umbilical cord blood, including the pros and cons of public and private cord blood banks.

How Does Cord Blood Banking Work?

You must decide before giving birth if you want to bank your baby's cord blood. In fact, the American Academy of Pediatrics recommends making these arrangements by the 34th week of pregnancy. You can share your plans for cord blood banking with your health care provider through your birth plan.

If using a private bank, they will send you a collection kit before your due date that your doctor, midwife, or nurse will use to collect the blood. With a public donation, the process is handled directly by the hospital.

Your baby's cord blood will be collected in the hospital almost immediately after they are born—ideally before you deliver the placenta. Once your newborn's umbilical cord is cut and clamped, blood is drawn from it. The entire procedure takes approximately 10 minutes.

Next, a courier sent by the bank typically comes to the hospital to pick up the kit and take it to the bank, where it's processed and stored in a bag or vial that's frozen in liquid nitrogen. There is no risk to the new parent or baby in collecting the cord blood cells, which would otherwise be discarded.

What Is Cord Blood Used For?

When cord blood is banked upon your baby's birth, it can be used down the line to treat and potentially cure some diseases, either in the event your child gets sick, or someone else who is a donor match. "For a whole host of disorders, cord blood is a potential gold mine for treatment and, in some cases, cures," adds Nancy Green, MD, a pediatric hematologist and former medical director of the March of Dimes.

"Cord blood transplants have been in use for [many years], and they're accepted for childhood leukemia and other kinds of disorders," says Dr. Green. Plus, scientists are still studying ways to treat more diseases with cord blood, including heart disease, stroke, diabetes, spinal cord injuries, and more. Some people choose to save their baby's cord blood for potential personal use; others might decide to donate it to a public bank.

Will My Baby Need Their Cord Blood?

Most of the time, cord blood is not used by the family who banks it as it's unlikely that the child in question will develop an illness that can benefit from treatment with stem cells. For example, the rate of new cases of childhood leukemia is 4.9 per 100,000 children per year. With that in mind, banking cord blood is mainly to protect against the hypothetical possibility of your baby needing a treatment that uses stem cells.

Alternatively, you can donate your baby's cord blood so that anyone who's a match in need of stem cells can have access to this precious, lifesaving resource. There are also cases in which a younger sibling's cord blood is able to be used for an older sibling who is sick.

Public vs. Private Cord Blood Banking

When it comes to cord blood banking, you will have to choose between public (donated cord blood) and private banking. Here are the differences between each:

Public cord blood banking

Public cord blood banks are usually nonprofit companies that store donated cord blood for free for use by anyone who needs cord blood stem cells. When donating cord blood to a public cord blood bank rather than keeping it for private use, there's a much greater chance that your baby's cord blood will be used because it can be given to any child or adult in need, says William T. Shearer, MD, PhD, former professor of pediatrics and immunology at Baylor College of Medicine in Houston.

When cord blood is donated, it is put on a national registry and made available for any transplant patient. So, if your child should need the cord blood later in life, there's no guarantee you would be able to get it back. However, it's very likely that another person's donation will be available for their use.

The AAP recommends donating to a public bank, noting that publicly banked cord blood units are 30 times more likely to be used for transplants than privately banked cord blood. Public banks are also looking to diversify the registry by encouraging more people from different ethnic and racial backgrounds to donate. It's completely free to donate blood to a public cord blood bank.

Private cord blood banking

Private cord blood banks are companies that require a registration fee (plus annual storage fees) for your baby's cord blood, but it's saved specifically for your family's use, so you'll have ready access to it if it's ever needed. This could potentially eliminate the need to search for an unrelated donor through the national registry of potential donors.

Private banks charge between $1,400 to $2,300 for collecting, testing, and registering, plus around $100 to $175 for an annual storing fee. However, these rates can vary widely.

Private cord blood banking makes the most sense in families with children who have diseases that might be corrected with transplantation, says Joanne Kurtzberg, MD, director of the pediatric bone marrow and stem cell transplant program at Duke University.

"That's a small minority of cases. An example would be another child in the family with leukemia, sickle-cell anemia, or an immune deficiency. In a family where everyone's healthy, there's no evidence that it will be useful," says Dr. Kurtzberg. In fact, research suggests there's only a 25% chance that a sibling will be a genetic match for sharing their cord blood.

Limitations of Private Cord Blood Banking

While some families find security in banking their own family members' cord blood for an emergency, the AAP advises against it. Instead, the organization encourages families to donate to public banks for people in need. The AAP also cautions against viewing a private cord blood registry as a backup plan, stating that there aren't compelling or accurate statistics on the likelihood of children needing their own stored cells one day.

Another limitation of privately banking cord blood is that there might not be enough cells stored for a transplant. Usually, only 50 to 200 milliliters of blood is collected from each umbilical cord. This small amount alone may be enough to treat a sick child, but not an adult, says Dr. Shearer. So, it's likely that in the case your child one day needs stem cell treatment, they'd need to rely on additional stem cells from a public bank anyway.

It's also not clear how long cord blood cells are viable when stored. "The only data we have is for 15 years," says Zbigniew M. Szczepiorkowski, MD, PhD, co-director of the Blood Bank and Transfusion Service and director of the Cellular Therapy Center at Dartmouth-Hitchco*ck Medical Center in Lebanon, New Hampshire.

"But the way we store cord blood now may be better than it was 10 years ago," says Dr. Szczepiorkowski. Indeed, according to the University of Rochester Medical Center, some experts believe cord blood lasts at least 21 years.

Additionally, not all people can donate their baby's cord blood. For example, you generally aren't eligible if you're younger than 18 years old, have a history of cancer or having chemotherapy, or received treatment for a blood disease such as HIV or hepatitis. It might also not be possible to donate cord blood with a premature baby or multiples, as there may not be enough blood to collect.

Whether you use a public or private bank, you'll still need to be tested for various infections (such as hepatitis and HIV). If tests come back positive for disease or infection, you will not be able to store the cord blood.

"People should know that if they can't [privately bank their cord blood] because they can't afford it, or for some other reason, they haven't denied their child a chance at a transplant," says Dr. Kurtzberg. "Public banks have enough units, and in many cases, it's not essential to have a related donor." In other words, parents aren't shortchanging their kids' future health if they don't do private cord blood banking.

Questions to Ask Before Choosing Private Cord Blood Banking

If you decide to do private cord blood banking, do some research to find a bank that suits your needs. The Association for the Advancement of Blood and Biotherapies (formerly called the American Association of Blood Banks), evaluates and accredits many of the nation's private and public cord blood banks. So, checking for accreditation is a good first step.

Dr. Szczepiorkowski also suggests asking the following questions to potential cord blood banks before signing up.

Are you accredited by AABB or some other accrediting body?

Accreditation is not required for cord blood banks to operate, Dr. Szczepiorkowski notes. However, voluntary accreditation shows the company has met some set quality standards.

How do you prepare and store the sample?

The AABB suggests that the white blood cells be isolated first and that the sample be stored in plastic bags, not vials, to lower the risk of contamination (although experts debate this issue).

How much does it cost?

Understandably, says Dr. Szczepiorkowski, the expense may make the decision for you. However, remember that you can always donate to a public bank at no cost. He also notes that higher-priced banks are not necessarily better in quality. In fact, according to the AAP, public banks, which are free, offer the highest standard because they are tightly regulated.

How quickly does the cord blood arrive at the bank?

Find out how long it takes for the cord blood to be transported to the facility once collected. The quicker the better, says Dr. Szczepiorkowski, although the issue of timing is still a gray area. Ideally, the cord blood sample should arrive at the facility within 24 to 48 hours.

The Bottom Line

Research into the benefits of cord blood banking is ongoing. Cord blood banking is an entirely optional, personal decision that parents-to-be can research and choose whether to do. That said, donating your cord blood to a public bank is free, easy, and can save a life. If you find yourself with lingering questions, talk to a health care provider to find out more about whether it's right for your family.