Cord blood banking is a buzz phrase we are hearing more and more surrounding birth. The reason? Blood found in your baby’s umbilical cord is full of stem cells that could possibly be used to cure your baby or family member of disease someday.

However, the vast majority of babies won’t end up ever needing their cord blood, and current technology greatly limits how useful it really is. Choosing to bank your baby’s cord blood may come at an initial cost to baby’s well-being as they adjust to life outside the womb with a significantly lower blood volume than they would have without banking blood.

Often the decision to bank your baby’s cord blood isn’t made with a complete understanding of how it’s done, how useful it really is, and what the cons are to choosing to bank this precious blood instead of letting it all get back into baby’s bloodstream.

Here we’re going to take a complete look at cord blood banking, with extra attention paid to home birth and cord blood banking. In the case of home birth, you are limited to private cord blood banking which is typically not recommended by the American Academy of Pediatrics largely because of a low likelihood of ever using the cord blood.

In this article, we’ll make sure you have a complete understanding of the process and the pros and cons of cord blood banking. You’ll know you’re making a decision from an informed point of view and learn how to make cord blood banking a reality at your home birth if you wish.

What is cord blood banking?

Cord blood is the blood found in the umbilical cord and placenta at birth. This blood is rich in hematopoietic stem cells which can be used to treat some diseases, in transplants or to strengthen the immune system.

The stem cells present in cord blood are unique because:

  • They are rarely rejected during transplants
  • They present more possibilities for matches than bone marrow
  • There are 10 times more stem cells present than in bone marrow
  • They can be frozen for a long period of time before being used

Cord blood banking is the act of collecting this blood from the umbilical cord directly after the cord clamping. The doctor or midwife will insert a needle and collect remaining blood into a bag to be sent to a storage facility.

When it comes to storing cord blood, there are two main options:

Public cord blood banks

Public cord blood banks are free to donate to. Upon receiving the cord blood, the public bank will run tests on the blood and catalog it onto a registry that doctors can access for use in patients in need.

To donate to a public cord blood bank:

  • Your blood will need to be prescreened to be free of genetic disorders and infectious disease
  • You need to give birth at a certified cord blood collection site (which is almost exclusively, a hospital)
  • The blood to be donated also must be at least 40mL which means delayed cord clamping is likely not an option because delayed clamping won’t allow enough blood to stay in the cord (more on this below)

Private family cord blood banks

The other storage option is in a private family bank. In this scenario, your baby’s cord blood will be stored for baby’s use or for direct family donation. Private storage banks charge a fee for collection and a monthly or yearly storage fee after. Private storage banks market their services as “biological insurance for your child and family”. But this claim is rejected by the AAP.

Private cord blood banking is your only option as a home birth momma. Private storage facilities allow for collection at any type of birth, and your midwife can likely aid in the collection process. The private storage company will send a collection kit out a few weeks before you are due. We’ll talk more in detail about this process below.

Private cord blood banking facilities often do not require a minimum amount of blood to be stored which may allow for collection after delayed cord clamping if desired.

What are the benefits of storing cord blood?

To discuss the benefits of storing cord blood, we need to look at it from two perspectives: donating cord blood to a public bank and storing cord blood privately for your family.

Remember, you will only have the option of donating your baby’s cord blood at a hospital birth, home birth families are limited to private storage.

Benefits of donating cord blood to a public bank:

  • Your baby’s cord blood will be cataloged into a registry available to all doctors looking for stem cells to save their patient’s lives
  • The stem cells in your baby’s cord blood might be used to advance medical research or in life-saving clinical trials
  • Donation is completely free
  • For those interested in cord blood banking, this is the method most often recommended by the AAP and ACOG

Benefits of storing cord blood privately:

  • Privately stored cord blood is stored just for your baby and your family’s use
  • The cord blood may be used to treat a sick family member or in the event of a family member needing a stem cell transplant
  • If you have a sick family member that needs or may one day need a stem cell transplant, you may be making a lifesaving choice by storing cord blood privately
  • There is an ever-changing and evolving understanding of how stem cells and cord blood can be used, in the future, it may benefit your baby in a way not currently known
  • Private cord blood storage is only recommended by the ACOG and AAP if you have a family member with a known disease that will benefit. Otherwise, it is not recommended. The idea of “biological insurance” is rejected and seen as a marketing tactic.

What are the cons of collecting and storing cord blood?

While the benefits are certainly there for public donation, and in unique cases for private storage, there are some cons associated with cord blood banking.

Here we will look specifically at the cons associated with cord blood banking in general and the specific cons associated with private storage because this is your only option as a home birth momma.

1. You cannot delay cord clamping

The most significant con is that in order to collect enough cord blood for public storage, or to make private storage worthwhile, you will not be able to practice delayed cord clamping at your baby’s birth.

Delayed cord clamping (DCC) is seen as the gold standard after the birth and is recommended by WHO in all births. During DCC, the cord is clamped 1 to 5 minutes after birth, ideally waiting as long as necessary for the cord to stop visibly pumping. Allowing this extra time before clamping the cord can increase the blood volume in your baby by up to one third!

This extra blood volume provides your baby with iron reserves for their first 6-8 months of life, improves development outcomes in the future, increases hemoglobin and hematocrit level at birth, and increases brain myelination.

While it is possible to practice delayed cord clamping and store your blood privately, the act of DCC means the amount of blood collected will be very limited negating the potential benefits and high cost associated with private storage.

You can read our in-depth look at delayed cord clamping here.

2. Private cord blood storage is costly

To store cord blood privately, there is an initial processing fee averaging around $2000 and an annual storage fee for every year after of $100-$300. Some private storage facilities do offer payment plans to help defray the upfront cost.

It should also be noted that in the event of a proven need for your baby’s stem cells in a direct family member, free storage at a private facility may be available on a case by case basis.

3. Private cord blood storage is not recommended by the AAP unless medically necessary

For a variety of reasons, the American Academy of Pediatrics does not routinely recommend private cord blood storage.

The main reasons being that:

  • Private cord blood banks are expensive
  • Private cord blood banks are “not subject to regulatory oversight or quality control”
  • Privately stored cord blood is underutilized
  • Privately stored cord blood cannot be used to treat your child in the event of leukemia later in life
  • Private cord blood storage is only useful in the event of known serious disease in the family

These claims are supported by the ACOG as well.

4. Cord blood can currently only be stored for ~20 years

Currently, cord blood can only be stored for 20 years. If you are choosing to store your baby’s cord blood for “biological insurance” it will only last until their 20th birthday.

Additionally, you need to be careful about choosing a private storage facility because if the facility goes out of business, your cord blood may not be safe either. For help with this, find a private cord blood bank that is affiliated with the Cord Blood Association.

Do people actually use their privately stored cord blood?

According to the Cord Blood Association, the chances of your baby ever needing their own cord blood is very low. WebMD cites a study that says the likelihood is between 1 in 400 and 1 in 200,000. One reason for this is that in the event of blood cancer (like leukemia) a baby’s own cord blood cells cannot be used to fight the disease.

Moreover, the likelihood of a family member using your child’s stored cord blood is also very low. This is because the amount of stem cells in a single cord blood collection is not enough to support a transplant in most adult patients.

Two scenarios most often discussed as warranting private cord blood storage and eventual use of the cord blood are:

  • A child in your family who has a known blood cancer (like leukemia) or another inherited blood disease
  • When a mother is at risk of conceiving a child with certain genetic disorders like sickle cell disease which could be treated with cord blood

(source)

Can I donate cord blood after a home birth?

To recap, if you are planning a home birth, cord blood donation is not an option. This is because cord blood collection for public banks can only take place at accredited facilities.

Can I store cord blood after a home birth?

If you are interested in privately storing cord blood for your baby or family’s personal use, this can absolutely be a reality at your home birth.

You will need to choose a private blood bank during your third trimester and contact them at least 4 weeks before your birth in order to receive your cord blood collection kit.

What is the process of collecting and storing cord blood at my home birth?

  1. Discuss the decision to collect cord blood with your home birth midwife to ensure she is able and willing to assist you in the process
  2. Research and choose a trusted private cord blood processing and storage company
  3. Contact the company during your third trimester, or at least 4 weeks prior to your due date to enroll and have your collection kit sent out
  4. The kit will include all of the equipment necessary for collecting the blood, storing it, and packing it for delivery
  5. Your midwife should follow the included directions to collect the blood and is likely familiar with the process
  6. After the cord blood is collected it should not be refrigerated! Keep the cord blood at room temperature and send back the completed kit ASAP, but within 72 hours at the most.
  7. A sample of the birthing mother’s blood is also required to be sent back with the collected cord blood
  8. Some private cord blood banks offer “courier collection service”, meaning a representative will come to pick it up.
  9. Once your collection is received, you will generally receive stats on how much blood was collected and a lab report within 8-10 weeks

(source)

How to choose a private cord blood bank?

When it comes to choosing where to store your baby’s cord blood at your home birth, you need to do your research. Some of the cons associated with private cord blood storage have to do with the lack of oversight, and storage and handling regulations. But there are certainly reputable private storage facilities out there.

The 3 oldest and largest private cord blood banks in the US are:

  • Cryo-Cell
  • Viacord
  • Cord Blood Registry

Because of the length of time they’ve been operating in the industry, their accreditations, and experience with collecting, handling and releasing cord blood for use, these are the most popular choices among many parents.

For more information on these top three companies, head here for a complete comparison.

Is cord blood banking right for your home birth?

With this complete overview of cord blood banking after your home birth, you will be able to make a decision from an educated and informed standpoint, which is always our goal here at Natural Home Momma.

In short, at a home birth, your only option for cord blood banking is private cord blood storage. In general, private cord blood storage is not recommended by the AAP or ACOG largely because of the unlikelihood of ever using the cord blood. The major exception to this stance is if there is a family member with a known use for stem cells.

However, if you are interested in cord blood banking at your home birth, be sure to choose an accredited private blood bank and contact them at least 4 weeks before birth. This is also a decision that needs to be discussed with your home birth midwife.

Whew. This article is full of a lot of info on an important decision related to your baby’s birth. Don’t forget to PIN IT so others can benefit from the information and you can access it again later.

Additional Sources

https://www.acog.org/Patients/FAQs/Cord-Blood-Banking?IsMobileSet=false

https://www.webmd.com/parenting/baby/should-you-bank-your-babys-cord-blood#2

https://www.whattoexpect.com/pregnancy/cord-blood/public-vs-private-cord-blood-banking/

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