Baby Cord Blood Banking

Stem cell research has developed exponentially over the last few decades, and cord blood banking is one of the new options that expecting parents can choose to get extra assurance for the health of their child.

However, it is crucial for parents to be well informed before making any commitment. Expecting parents face a barrage of marketing promotions and services that tug at the basic emotions of child expectancy. If you are considering cord blood banking for you baby, make sure you sift the truth from the marketing to make the right choice. Here are some cord blood banking facts to ponder over, and some frequent topical queries answered.

What is cord blood?

Post childbirth, the placenta, and the attached umbilical cord contain traces of blood. This is called the cord blood. This blood is collected right after birth.

Is the cord blood the baby’s or the mother’s?

The cord blood contains the baby’s cellular blueprint in the form of stem cells and is used to treat certain disorders. It can thus confidently be said that the cord blood is the baby’s.

What are stem cells?

Stem cells can be called the building blocks of organic cells. They are undifferentiated biological cells which have the capability to grow into a specialised cell. Stem cells can also divide via mitosis (a natural cell division process) to create more stem cells.

There are two types of stem cells- embryonic stem cells and adult stem cells.

• Embryonic stem cells: These are derived from the early embryo, precisely from the blastocyst that forms a few days after fertilisation

• Adult Stem cells: They are found in the umbilical cord and placenta blood during childbirth. These cells can regenerate indefinitely and form complete organs, therefore making them medically precious for the individual they belong to. Stem cells can also be obtained from the bone marrow.

There are many types of adult stem cells, such as hematopoietic, neural, and mesenchymal. As the names suggest, hematopoietic stem cells help in creating more blood cells, neural stem cells have the blueprint for the nervous system, and mesenchymal stem cells can become bone, cartilage, muscle and fat cells.

Uses of Stem Cells

Stem cells can repair damaged cells and help in their self-renewal. This makes them invaluable assets in the treatment of several medical conditions. Here are a few ways in which stem cells are used:

• A stem cell transplant is used to treat ailments like blood cancer, bone marrow diseases, and disorders of the immune system

• Stem cells have the basic property to regenerate and become a new tissue and are thus used to repair damaged tissues

• Cord blood donated to a public bank is also used for research purposes, which helps expand the scope of stem cell treatment (The priority for banks is always storage for transplants, but in case the donation does not meet the volume criteria, it is then used for other purposes.)

Why should stem cells be obtained from umbilical cords?

Stem cells can be obtained in two ways – from the umbilical cord or from the bone marrow.

Also, the process to obtain umbilical cord stem cells is not invasive and is very quick and simple. Cord blood cells are also more compatible with foreign cells and provide a perfect match for the donor. The chances of the cells being rejected by the recipient or are greatly reduced, as also is the likelihood of GvHD (Graft versus Host Disease). GvHD is a dangerous condition where the new cells fight against the patient’s existing cells. As cord blood cells are much more adaptable than other cells, the chances of this dangerous condition are very less.

Stem Cell Preservation

If stored properly, cord blood can be kept indefinitely. State-of-the-art cryogenic methods (freezing in liquid nitrogen) are used to store it. Make sure you have full insight into the technology and market reputation that a cord blood bank has, before choosing it.

Myths about cord blood:

It is important for parents to confront and bust the common myths that surround the practice.

• Myth 1 – Cord Blood Treatment is in the experimental stages

This is a huge myth surrounding the cord blood procedure. Since the first cord blood transplant in 1988, cord blood banking has come to the fore in the treatment of around 80 types of diseases worldwide, and the method is continuously expanding in research and scope.

• Myth 2 – Cord Blood Collection affects the baby

Cord blood collection is a quick and easy procedure for both mother and baby. It does not have any effect on the birthing process. It is done after the baby is born. Collection happens post the cord clamping and the cutting of the cord. The cord blood is usually discarded in a normal birthing situation hence the collection has no direct relation with the baby’s blood supply.

• Myth 3 – Stem Cell Research is a controversial practice

Stem cell research is wrongly accused of being a very controversial discipline. In reality, cord blood banking is one of the most basic and non-intrusive stem cell related procedures and is worlds away from the controversies that frequently get mentioned. The areas of stem cell research that do invite debate are to do with embryonic stem cells and not the adult stem cells that are sourced from umbilical cords and bone marrow. Reproductive cloning is another fringe discipline that is associated with regular stem cell technology. It has no relation to the cord blood banking procedure.

What is cord blood banking?

Cord blood banking is a way to store the cord blood for possible future requirements. The blood is stored in cryogenic facilities for an indefinite amount of time, always ready to be dispatched when needed.

Types of cord blood banks

The two types of cord blood banks are private and public banks. 

• Private banks: Private banks store the baby’s cord blood in a private facility at the cost of an annual fee where it will be available for the use of the individual and siblings or close relatives
• Public banks: Public banking stores the cord blood for those who may need it for a transplant. One point to note here is that donors may not be able to retrieve their own cord blood from a public bank. However, they have access to a larger pool of donations and the chances of getting a donor are higher.

How is umbilical cord blood collected and processed?

The cord blood is collected after birth, and the process is painless. Post collection, the cells remain active for a few days. In this period, they are taken to a cord blood storage bank where they are frozen to be stored indefinitely. A specialised kit is used for cord blood collection.

Why should one save newborn cord blood?

Stem cell preservation is an important first step to ensuring that a baby will have extra treatment options if he or she needs to combat certain diseases as an adult. Saving a newborn’s cord blood can save a life, and this strong possibility itself is a good reason for cord blood banking (whether public or private).

Cord Blood Banking Pros and Cons

Many debates have raged over the last few decades trying to answer the question – is stem cell banking useful? With continuous research proving that stem cells can be used to treat a growing number of diseases, banking can be considered a safe option for the donor, and for others too.

Pros:

The main advantage of cord blood banking is that since stem cells in the cord blood are more compatible than those from another source, they can be very precious in a future medical scenario. It can be difficult and time-consuming to obtain matched stem cells for transplants from a public cord blood bank. Cells from the umbilical cord (which are not as mature as bone marrow cells) are an ideal choice in case of a transplant, as the recipient’s system is less likely to reject the cord stem cells.

Banking the cord blood is especially useful when there are people in the family suffering from blood-related diseases or other ailments which can be cured by a stem cell transplant. It is also a simple and painless procedure.

Cons

The cons of cord blood banking are associated with the pricing. Cord blood banking is not cheap and includes a continuous payment process, starting from the collection rates to the annual payments. If you are a low-risk family, this may be an extra insurance that will not be needed. Therefore, it is very crucial to study the family history and look for possibilities that the diseases covered by stem cell transplants will occur in an individual’s lifetime.

Certain genetic diseases cannot be cured by using cord blood since the blood stem cells carry the same flaws. There are many theories that propagate the advantage of an outside donor rather than a self-donor.

Diseases that can be treated with cord blood

The stem cells of the cord blood can be used to treat many diseases. Hematopoietic stem cells, which are extracted from the bone marrow or the newborn baby umbilical cord, can create new blood cells via the process of haematopoiesis. These cells produce red and white blood cells as well as platelets. HSCT or Hematopoietic Stem Cell Transplantation is a procedure that is used to treat many diseases. Here are a few ailments which stem cells may help cure:

• Some types of leukaemia: Chemotherapy in high doses is used to kill Leukemia cells. The disadvantage of this process is that it also damages the blood-forming cells which are found in the bone-marrow. HSCT helps replace damaged cells and facilitates the patient’s recovery

• Lymphoma: Much like leukaemia, lymphoma is also treated by a combination of chemotherapy and radiation. HSCT makes it possible to administer high doses of chemotherapy by replacing damaged cells with the healthy ones

• Aplastic anaemia: Aplastic anaemia includes a number of diseases which are caused by marrow failure. HSCT helps treat severe aplastic anaemia

• Severe Combined Immune Deficiency (SCID): A rare genetic disorder, SCID is a severe form of immunodeficiency where a defect in genes makes the patient susceptible to infections due to the disrupted development of the T and B cells. Using the process of HSCT, donor marrow which has been depleted of all mature T cells is transplanted into the patient’s marrow

Other diseases that can be treated with cord blood stem cells include solid tumours, cancers, immune system disorders, metabolic disorders, sickle cell disease and bone marrow diseases. The US Food and Drug Administration (FDA) has currently approved cord blood stem cell treatment for a list of more than 80 ailments. Stem cell treatment is also approved for treatment of osteopetrosis, Langerhans cell histiocytosis and hemophagocytic lymphohistiocytosis.

Some of the possible uses of stem cells in disease treatment are at various experimental stages. These include efforts to combat cerebral palsy, various heart diseases, Parkinson’s disease, diabetes, Alzheimer’s disease and injuries to the spinal cord.

Stem cells have also been used to treat burn injuries as a method to replace the damaged skin.

Different uses of cord blood

The main use of cord blood is a cord blood transplant. During a cord blood transplant, healthy stem cells are introduced into the blood stream and help in healing and repairing damaged tissue. A successful transplant results in a new immune system for the beneficiary. The success rate of a stem cell transplant increases with cord blood stem cells compared to those sourced from the bone marrow from an older person.

How much does it cost for umbilical cord blood banking?

There are many cord blood banking providers in India with different rates. The costs of private stem cell banking range from from USD 710 to USD 100 with around two decades of storage offered. It is always prudent to go through reviews of cord blood banks and related providers to ensure you get the best services and rates.

FAQs

1. What amount of blood and stem cells does the average umbilical cord hold?

On an average, you can collect around 60 ml of blood from a cord. This amount of blood would host       more than a million stem cells, provided the baby is healthy and full-term.

2. Delayed Cord Clamping – What is it? Can a cord blood collection happen after delayed clamping?

When a baby is delivered, there is sometimes a waiting period before the umbilical cord is clamped and cut. This varies between 30 seconds to a minute. While the umbilical cord is pulsating, the baby is positioned so it can receive some of the stem cell rich blood.

Cord blood can be collected after a delayed clamping. This is advisable if you choose private banking. As private banking does not involve stringent guidelines for volume, the low volume captured from a delayed cord clamping can be stored. However, there are some disadvantages of cord banking post delayed cord clamping. You will probably not be able to get enough stem cells in case the requirement is for an older sibling.

3. How much time does cord blood have for transportation to a storage facility?

Across the world, cord blood banking companies have adopted 48 hours as an ideal time for the entire process of cord blood processing, starting from birth to the beginning of lab processing.

4. What are the lab procedures for cord blood?

Baby cord care enters a crucial phase in the lab, as this is where the storage will start. Just like a regular collection of blood, the three components of cord blood are separated. The RBC or red blood cells are the heaviest; the lightest is the clear plasma and, in the middle, there is the buffy coat with all the WBCs or white blood cells. It is the buffy coat which goes into storage. Currently, there is no procedure to separate and store the stem cells in an isolated manner.

5. Will blood donations from related donors result in better treatment?

When it comes to cord blood stem cell transplants, related donors offer an advantage. The chances of GvHD or Graft versus Host Disease are less when the donor is a relative, therefore significantly improving post procedure quality of life.

6. Is Cord Blood treatment the only way to treat certain diseases?

No. Even if you don’t opt for cord blood banking, you still have access to other methods for the diseases that cord blood transplant covers. Stem cell transplant can also be facilitated via donated bone marrow from a family member or a bank. Public cord blood banks also ensure that in certain cases and scenarios the patient will have the choice of a transplant from a non-related donor. Just like any other medical procedure, cord blood transplant treatment does not guarantee a cure as there are always risks involved in treatment.

7. How do I make the final decision?

Spending money for cord blood banking can definitely be a robust insurance for your child. However, do not feel coerced by anyone into opting for cord blood banking. Base your decision on a scientific analysis coupled with your financials. Do keep in mind that cord blood banking is real. If your family history dictates occurrences of flagged diseases and you are financially in a position to choose private cord blood banking, it may be a very wise decision.

Cord Blood Banking – An Extra Option

When it comes to caring for a young one, no parent wants to cut corners. Any insurance that might be used to protect a child as he or she grows into an adult is always welcome. Cord blood banking is a new discipline compared to some other established medical disciplines. In a few decades, many large companies have cropped up offering cord banking solutions. The possibilities of having a cord blood transplant are quite low, but in case such a situation occurs, the stored stem cells can be a lifesaver. Family disease history and financials are the main factors for couples considering cord blood banking. Make sure you weigh all the aspects of the process and consider speaking to people who have faced the choice before you take a decision to bank cord blood.