The Truth About Cord Blood Banking
The pamphlets are everywhere: at your doctor's office, at the maternity store, in your mailbox, in magazines… all over the place. And a coupon for $500 off — sweet! Who doesn't love saving money?
The message is clear: pay a couple thousand dollars now to preserve your baby's cord blood so that when he is (inevitably) diagnosed with leukemia, you can snap your fingers, inject him with the cord blood that you so meticulously preserved, and voila! Cancer cured. Everyone's happy.
What is cord blood banking?
Cord blood is the blood that's left in the placenta and umbilical cord right after birth. Typically, it's discarded as medical waste. But cord blood contains stem cells, which, in case you haven't heard, can be really valuable for medical research — and sometimes for medical treatment.
Cord blood banking refers to the medical procedure that removes cord blood from the afterbirth, and then preserves and stores it (hence, "banking") for potential use later on.
You love your baby, don't you???
Not surprisingly, the emotional pitch is working. The numbers of families privately banking cord blood has drastically increased since the early 2000's — according to one estimate, parents choose cord blood banking in some 2.6% of births (there are almost 4 million births in the US each year). And since most cord blood banking companies charge $1000-$3000 upfront plus annual storage fees of between $100 and $350 per year, it's BIG business $$$$$. I'll let you do the math.
I'm not trying to talk you OUT of doing it (per se), but I want to share some little known facts I've learned after talking to experts and reading LOTS of research.
I'm lucky enough to live in San Francisco, which is where a lot of this research takes place. I was able to interview people who personally work on these projects and are in the know, but a lot of my quotes came from this article from 2005 published in the SF Chronicle. (Yes, I know it's years old, but none of the salient facts have changed.)
There are a lot of key points the private banking companies DON'T tell you about. Let's call them "marketing omissions," shall we?
1. Bad Blood
The blood from a sick child would probably not be used to treat that child.
Children who develop a disorder often are unable to use their own cord blood because the blood also contains the same genetic defect. In fact, nearly all of the transplants that have occurred to date using privately-banked cord blood have gone to relatives with pre-existing conditions, not to the donors themselves.
Dr. Joanne Kurtzberg, director of the pediatric blood and marrow transplant program at Duke University Medical Center, agrees: "In children with cancer, I would definitely not use a child's own cord blood because it was probably contaminated with the disease at birth."
2. "There ain't enuff."
When they draw the cord blood from a newborn, it's really not a lot of blood — about 3 oz.
The idea that "we don't have many applications for cord blood now, but in 20+ years, we might be able to fix your child's heart, cure his Alzheimer's, etc." is a dubious claim because there's a good chance that there's not enough blood for an adult transfusion anyways.
"Approximately 75% of the units donated to public banks are discarded or used in research because they don't contain enough stem cells for transplants," says Mary Halet, manager of cord-blood operations for the Center for Cord Blood at the National Marrow Donor Program.
Dr. Kurtzberg adds, "Few cord-blood transplants have been given to adults because most units haven't contained enough stem cells to treat anyone weighing more than 90 pounds." It may not even be enough for a child.
The truth is that the majority of all cord blood stored in private banks may be unusable for this reason. In fact, cord blood stored in private cord blood banks is only used for therapy "rarely": i.e., one in several thousand cases.
3. Go Public or Go Home
For a full sibling, there is only about a 25% chance of a perfect match. For a parent or other relative, it's even less likely. This is why public banking is important.
In 2013, there were 1,102 cord-blood transfusions from public banks in the U.S., according to the Department of Health and Human Services. There is no data available for private banks. The AAP (American Academy of Pediatrics) encourages families to donate their newborn's cord blood (which, again, is normally discarded at birth) to public cord blood banks (if accessible in their area) for other individuals in need.
One other thing? Public donation is FREE, y'all.
Find donation locations here (choose your state from the drop-down menu).
Unfortunately, donating cord blood to a public bank isn't necessarily "easy." There weren't even 30 total public cord blood banks in all of North America as of 2017, so there may not be a feasible donation option in your area. If there isn't, don't sweat it.
Technically, these sites have enough cord blood to go around for donations (in terms of the quantity), but they are short on matched samples for ethnic and minority patients. In some sense this plays into an argument for private banking among minority families (see below), but professional organizations like the AAP suggest that this problem could be mitigated with more public donations from these groups.
Okay, so does that mean you shouldn't do it? It's really up to you, but here are the arguments…
The Argument FOR
"The potential for use is very small right now but could be very great in the future," said Dr. Michael Trigg, who chairs Cryo-Cell's medical and scientific advisory board.
More and more research is being done for diseases like autism. A recent study run out of Duke aimed to see if a child's own cord blood can help treat autism. The early results looked to be promising, but some say the final data were less compelling. (Translation: the jury is still out.)
Also, you may be a better candidate if one of these applies to you:
1. A known illness: If you have a family member that currently has a disease that can be treated with cord blood, you may want to consider storing your baby's cord blood in a private/family bank. Good news: If you're saving blood for a family member who is currently ill, you may be able to do so at little to no cost, depending on the bank you are using and the services available where you plan to deliver.
For example, the Children's Hospital Oakland Research Institute, in partnership with ViaCord, will bank a baby's cord blood for free if a sibling needs it at the time of the baby's birth. Some private banks, such as Cord Blood Registry, Cryo-Cell, and ViaCord, have similar programs.
2. You are a rare species: It's a known fact that ethnically diverse babies may have a harder time finding a public match than, say, a bunch of whiteys. If you are an Irish/Inuit married to a Polynesian/Brazilian (for example), I'd suspect your babe's blood would be a better candidate for private banking than the average bear.
Cord blood from individuals with any African American heritage is in extra demand. "African-American patients who need bone marrow transplantation have an especially hard time finding an unrelated bone marrow donor."
The Argument AGAINST
In response to the tremendous marketing surge from cord blood companies, the American Academy of Pediatrics came out with a statement discouraging "storing cord blood at private banks for later personal or family use as a general 'insurance policy.'"
The AAP has since issued a revised policy statement (in 2017), which essentially reiterates the same warning, while also acknowledging the importance of continued research and the benefits of public cord blood banking. You can read the overview of the statement here, and the full position here.
ACOG's most recent committee opinion, released in 2019, takes a similar approach.
Other experts agree: "These banks prey on parents' fears of the unknown, and there's no scientific basis for a number of medical claims they make," says Bertram Lubin, MD, a blood specialist and the president and director of medical research for Children's Hospital Oakland Research Institute. Lubin adds, "Most of the people in the hematology community think they're a bunch of snake-oil salesmen in these private companies." Ouch. One mom told me, "I asked about 15 GYN's about it, and could not find one that advised it. In fact, one of them said to take the money and put it in the college fund. Ha!"
It's worth highlighting that the "against" position is not against cord blood banking, but rather against blanket (non-targeted), commercialized, private cord blood banking, for many of the reasons explained here. Beyond the costs, sketchy marketing, and the unrealistic probability of need/use within a family, there is also the fact that public cord blood banks have a therapeutic rate of use at least thirty times greater than the private banks.
If you Choose to Privately Bank Cord Blood
If you're going to go ahead and do it, it's important to find a reputable cord blood bank — one that will continue to store your baby's cord blood even if they go belly up. Look for one that is affiliated with the Cord Blood Association, and accredited by the American Association of Blood Banks (AABB), or the Foundation for the Accreditation of Cellular Therapy (FACT). The FDA also maintains a searchable database of approved private banks here.
For instance, Cord Blood Registry (CBR) is one of the oldest and largest private cord blood banks around, and is accredited by the AARB. This seems like a solid choice and is recommended by our friends at Twiniversity.
One Last Thing to Consider
Recent research in the US, UK, and Canada points to possible benefits of delayed cord clamping (for approximately 30-60 seconds, though some professionals say to delay until the cord stops pulsating) after delivery of healthy, full-term babies. ACOG officially recommends this, for example. For parents who plan to store or donate their baby's cord blood, the delayed clamping may affect the volume and quality of the cells. Discuss this with your provider.
In summary, it's certainly not going to hurt to privately bank your baby's cord blood, but you need to understand what you're actually getting for your money: "A very expensive insurance policy you will likely never use," said one OB/GYN.
Also, make sure you understand the motivations behind the people that are peddling the pamphlets; they're getting paid a lot of money in referral fees (et tu, Pea in the Pod??).
As with most decisions, the right answer is the one that you and your family feel good about.
Meg Collins Editor in Chief
Meg Collins started Lucie's List in 2010 after learning everything about babies the hard way; she is now the Editor in Chief. She's an engineer and former CPST who now lives in the Tampa Bay area with her family of four. She enjoys improv, 80s music, CrossFit, and giving people unwanted nicknames. She's obsessed with anthropology, meteorology, comet/asteroid impacts and autoimmune disease.
Meg CollinsEditor in Chief
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