A Warning: Fetal Cord Blood Banking

by Sarah TheHealthyHomeEconomist May 26, 2010

Banking of a newborn baby’s stem cells after birth is an increasingly popular option for parents as a sort of additional health insurance policy for their baby and other family members.     The procedure involves obtaining 3-5 oz of fetal cord blood usually from a clamped umbilical cord.   The blood is then shipped to a cord blood bank where the stem cells are processed and preserved at sub zero temperature for a fee.

To date, cord blood has been used to successfully treat over 70 diseases including leukemia, sickle cell anemia, non-Hodgkins lymphoma, and Hodgkins disease among others.     Cord blood has a 25% chance of being a genetic match for full siblings and a 50% chance for parents.    Of course, cord blood is a perfect match for the baby it came from.

Cord blood is preferred to bone marrow as it is less likely to cause life threatening rejection complications.   As a result, using cord blood for a less than perfect match is more likely to work than a similar procedure using bone marrow.   Cord blood is desirable, then, for extended family members as well and has a better chance than bone marrow of not being rejected.   Cord blood is also a more pristine source for stem cells and is much less likely to be contaminated with viruses such as Epstein-Barr which can cause serious infections in transplant patients.

Cord Clamping Procedure


Many prospective parents do not realize that when they opt to bank their newborn baby’s cord blood that the birth attendants are more likely to cut the umbilical cord early (within 30 seconds of birth) in order to ensure an adequate amount of cord blood is collected for the cord blood bank.  This is not desirable, as the umbilical cord should never be cut until it has completely stopped pulsing.  A recent study at the University of South Florida confirms that giving the baby all the cord blood improves outcome, even for healthy, full term infants.    Allowing all the cord blood to flow into the baby may take in excess of 3 full minutes.   Cutting it prior to this point can deprive the baby of much needed oxygen in those crucial minutes as the baby transitions to breathing on its own.

Some scientists have expressed concern that early clamping of the umbilical cord can lead to iron deficiency anemia, brain impairment, and even autism.    David Hutchon, a consultant obstetrician at Darlington Memorial Hospital went so far as to call premature clamping of the umbilical cord “criminal” for at risk and vulnerable babies.    This concern was borne out by a large scale study in 2007 of 1900 newborns where delay of cutting the umbilicus for 2 minutes reduced anemia by half and low iron levels by one third.  

In babies where cord clamping is delayed, the chance of polycythemia are heightened (an increased level of circulating red blood cells), but has proven to be of no concern.   In addition, the risk of excessive bleeding in the Mother does not appear to be significantly increased when there is a delay in cutting the umbilical cord. In fact, delay in cutting the cord appears to be of primary benefit to the baby and of little concern for the health of the mother.   It may well prove inconvenient for hospital birthing staff, however, which is why discussion of your desire to delay the cord cutting needs to be discussed well in advance of the birth even if you don’t plan to bank your baby’s cord blood!



How to Get Cord Blood AND Delay Cutting the Umbilical Cord


Once you’ve established with your OB or midwife that you desire for the umbilical cord to be cut only once it stops pulsing with blood flow into the baby, the next question is how to get cord blood for the cord blood bank?    The answer is from the placenta!    Once the placenta is delivered, the birthing staff can obtain plenty of cord blood to meet this need.    It will likelly take a bit more time and effort to retrieve the cord blood from the placenta versus the umbilical cord.   The extra effort is well worth it given the much improved chances for health in the newborn by doing so!

Sarah, The Healthy Home Economist


 

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  7. I think it is great that you are writing about this. It is also possible to let the cord pulse for even ten minutes and still pull cord blood from the cord/placenta, according to a home birth midwife I know who has spoken with me about this recently. I am considering banking cord blood for my brother, who has leukemia at age 18 and may end up needing it to save his life. Despite all the issues with delayed cord cutting, I would gladly cut the cord early to save my brother’s life if I thought that were the only way. My baby will recover from less blood at birth, but my brother’s life may be saved by my baby’s unchosen gift. I’m a labor doula and childbirth educator planning a home birth, so I really do know how valuable the blood is to the newborn. I was much relieved when I learned A) I can do cord blood banking at a home birth and B) I can wait to collect the blood so the baby can get much of the blood herself. It’s definitely good to know.

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  8. Oh, and for the 2nd birth where we let the cord pulse out completely and the placenta deliver before clamping, we dried and encapsulated the placenta for me to take post-partum — more info at http://placentabenefits.info/medicinal.asp. I suppose one could probably drain the cord blood, then still do this procedure.

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  9. Thank you for posting this article! In the hospital, although my birth plan asked for delayed cutting until the cord stopped pulsing, my 1st child's cord was cut immediately after she was born *because* she wasn't breathing right away. It makes no sense because this cut off her oxygen supply! Following this, my placenta didn't deliver, and it had to be manually removed. After my second birth, this time at home, my midwife let the cord pulse out completely and the placenta delivered before we cut the cord. Because of my placenta/cord issues and the research regarding anemia and blood volume to the baby, I've always felt the cord blood banking had some flaws — this article explained some of them. Thank you!

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  10. Sarah, the Healthy Home Economist May 27, 2010 at 11:35 pm

    This would be a question for your midwife or OB. This procedure was done for my son's birth and the midwife told me that it takes extra work to do it this way, but that it can be done.

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  11. Thank you for letting me know that there is an option to bank cord blood and still let the baby have all of their blood from the cord. My son was denied this blood because the doctor who performed our unplanned c-section didn't think it was important and ignored our wishes. Although we still aren't sure if we wish to bank cord blood it is good to know we have the option.

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  12. So glad to see this issue being addressed. Early cord clamping is a terrible injustice to the integrity of baby's immune system and overall constitution. Just another interventional assault causing compromises from day one on this side of the womb. Thanks so much for addressing the hard issues Sarah!

    Teresa<><

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