Of all the goods and services available to expectant parents, biological insurance—as blood cord banking is often considered—would seem a no-brainer. Yet it’s an incredibly expensive undertaking whose most intriguing benefits are linked to medical breakthroughs that we are still waiting for.
The blood in a placenta and umbilical cord—about 100 milliliters on average, or nearly one third of how much blood an average baby has—is so valuable because it is a rich source of blood-forming stem cells, which are already useful in the treatment of more than 50 diseases, including leukemia, lymphoma, and immune deficiencies. The most exciting stem cell therapies, including treatments for cerebral palsy, autism, and Parkinson’s disease, are still in development. Another promising application is regenerative medicine, which means using stem cells to regenerate organs and tissues that are not working properly (one example: macular degeneration, the leading cause of vision loss). Thus far the regenerative research is in the trial phases and remains unproven in humans, yet experts tend to agree it’s a matter of decades—if not sooner—before people will be able to reap the benefits.
The uncertainty around the procedure—and its average price tag of $2,000 up front and $150 in annual storage fees—is sending many parents-to-be into a state of distress and confusion. “We should have made up our minds a few weeks ago,” says Nobar Elmi, who lives in Brooklyn and is expecting her first baby, a boy, in one week. Rather than make a decision about cord banking, which her ob-gyn brought up a few months ago, she and her husband have focused on selecting a stroller and interviewing nanny candidates for a position that will begin in four months. “I’m leaning against it, but we don’t know what kind of advances there will be down the line,” she says. “What if this could save our child’s life?”
More and more parents, however, are taking the gamble on the process. There are 1.9 million units in private U.S. cord banks, according to market research firm BioInformant. Adding to the confusion is the other—free—option: donating to public banks, which make blood available to anyone in need who is a good match (donors cannot expect their unit to be reserved for their family).
For now, the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists generally recommend the public-bank route with some exceptions. For one, public banks and their banked blood get stricter oversight by the FDA. Furthermore, the chances of stored blood helping its donor in the short term are infinitesimal. “What many people may not realize is that most disease conditions that might be helped by cord blood stem cells are already present in the infant’s cord blood,” says Andromachi Scaradavou, MD, a pediatric hematologist and oncologist at Memorial Sloan Kettering Cancer Center.
There is one group that is advised to sign up with a private bank: Parents with an older child with a medical condition that could potentially benefit from cord blood transplantation. Pablo Rubinstein, MD, program director of the New York Blood Center’s National Cord Blood Program, a public cord blood bank, stresses the differences between firms and the importance of finding a bank that retrieves the blood from the hospital and stores it swiftly—ideally within 36 hours. “It’s a bit like egg freezing,” he says. “The material has to be in excellent shape after thawing. The viability decreases with time.”
In the end, Elmi and her husband decided the benefits of private banking were too hypothetical and have opted to donate their son’s cord blood to a public bank. “We’re sticking with our decision,” she says. “But I still wonder if I’ll be kicking myself if some breakthrough happens.”
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