Exactly two years ago, when I was pregnant with Teddy, I was approached by a Cord Blood Banking Company and asked to become a “friend of the brand”. I was offered the cord blood collection kit (valued at $2,900) for free, as contra for social media posting of “why you decided to save your baby’s cord blood”. If I shared a code ‘meg’ I would also receive the first year’s storage ($225 value) for free.
I hadn’t thought of our Cord Blood Banking decision since, but this week, that discussion and our ultimate decision was raised again by one of my followers, and I re-shared an instagram post I made in May 2019. I have since been asked many questions about my decision, and so have decided to share our journey in full, in the hope it can help you decide for yourself. I have also chosen to state my reasons here rather than talk to the media about our decision.
This offer prompted an agonizing discussion, and my husband and I spent almost an entire month deciding whether or not to do (and agree to promote to my followers) cord blood banking for our first born. We discussed it with our midwife, I reached out to other midwives for their thoughts and advice, we read independent studies and guides for parents, considered the World Health Organisation (WHO) recommendation on delayed cord clamping, and asked many questions of a nurse who called us from the cord banking company – but ultimately we had to decide for ourselves whether cord blood banking was worth it for us.
As we were being offered the service for free, there was no financial consideration, but rather, this decision came down to whether it was genuinely the best choice for our baby, and whether we felt it was a good product/service to promote to my audience.
While we chose not to accept the offer, and did not go ahead with cord blood banking, this decision was a very difficult one, and I have only support for any parents who choose to do so for whatever reason. My hope is that every parent can make this decision with only the most accurate information, and feel comfortable knowing they are doing the right thing for their baby
Delayed Cord Clamping vs Cord Blood Banking
Can you have delayed cord clamping and still collect (and bank) cord blood? This became the crux of our discussion and decision.
Rather than attempt to summarise the importance of delayed cord clamping, I refer briefly to WHO guidelines, but insist that you take the time to read them in full, as well as talk to your midwife or obstetrician about the benefits.
In short, delayed cord clamping (DCC) means the umbilical cord is left to continue to bring blood from the placenta to the newborn baby – DCC results in a 30% increase in the infant’s blood volume, and a 50% increase in iron-rich red cell volume. The WHO recommends at least a 1–3 minute delay in clamping the cord, its guidelines stating (since 2012) “the cord should not be clamped earlier than 1 min after birth” and “Early umbilical cord clamping (less than 1 min after birth) is not recommended unless the neonate is asphyxiated and needs to be moved immediately for resuscitation”. In New Zealand, DCC is recommended (and standard practice) – it is performed for both vaginal or C section delivery.
Immediate Cord Clamping: the cord is clamped within 60 seconds of birth, usually immediately after birth.
Delayed Cord Clamping: the cord is clamped more than 60 seconds after the birth.CDHB
The first thing I asked the cord blood bank company was “Does this enable delayed cord clamping/post delivery of placenta” to which they replied “You absolutely can have both”, sent me a video of someone from the company explaining the process and asked me to discuss with a cord blood advisor over the phone.
Both the video, the advisor over the phone, and the company’s written advice to me was that delayed cord clamping and cord blood banking were not mutually exclusive, and could be achieved together. I was told that cord blood banking had to be done within the first minute (that the cord could be left for at least 30 seconds, but no more than 60), and that was consistent with DCC guidelines. This is consistent with information given to RNZ in 2018 “cord delayed cord clamping and stem cell collection were not mutually exclusive and that enough blood could still be harvested if the delay was between 30 to 60 seconds”.
When compared to WHO guidelines and information and advice from our midwife and another midwife (Carmen Lett) I reached out to, it was clear to me that I would not be able to have delayed cord clamping of at least one minute. This was a main reason for our decision, as I wanted our baby to get all the benefits of DCC.
Benefits and Costs of Cord Blood Banking / Pros and Cons
Cord blood banking is advertised as an “insurance” policy for your child. You hope that you will never need it, and that if you do, it will be of great value.
We read many resources about the potential benefits of cord blood banking, also known as “stem-cell harvesting”, and rather than attempt to summarise those either, suggest you read some of the online resources available and talk to your midwife/obstetrician.
We thought What are the odds that we will need our cord blood? from Parent’s Guide to Cord Blood Foundation was useful.
Family cord blood banks tell parents that there are 80 diseases for which stem cell transplants are a standard treatment. That is a true statement, but it can be misleading. Most of those 80 diseases are rare among children. In the United States, the net probability that a child will need any type of stem cell transplant by age 20 is 3 in 5,000 or .06%. So the odds of use for transplant of a child are only 3 in 5000 for all of the 80 diseases combined!Parent’s Guide to Cord Blood Foundation
The cost at the time of the offer was $2,900, with $225 in yearly storage fees. The financial burden of this on other families also came into our decision. As a young family, we felt that it would not be an investment/insurance policy we would purchase – we considered that the benefits of allowing the baby to receive its cord blood outweighed the small odds of the baby using its cord blood.
Given that other families would not be able to afford to do so, and the benefits did not seem great enough to outweigh the benefit of delayed cord clamping (for free), I also felt uncomfortable promoting it as a beneficial service.
The original post is here, and summarises the above decision. If you have any queries about your own decision, please talk to your own medical professionals.