Cord Blood Banking: Is It for Me?
Massachusetts Department of Public Health Information for Families

What are cord blood banks?
Cord blood banks freeze and store blood and blood products from the placenta and/or the umbilical cord.  

Why do some families bank their babies’ cord blood? 
Stem cells can be obtained from stored cord blood and used in stem cell transplants to treat some diseases, including certain genetic diseases, cancers and disorders of the blood and immune system.  Researchers are trying to learn how to use stem cells to treat other conditions in the future.  

Some families donate cord blood to support treatment and medical research.  Others save it in case a family member needs a stem cell transplant.  

Do I need to plan for cord blood banking before my baby is born?
Yes, if you want to save the cord blood.  To save it, you must sign a consent form and other agreements with a cord blood bank, usually several weeks before the baby is born.  

How is the cord blood collected?  Does the collection always work?
Cord blood is collected after the baby is born and the umbilical cord is cut.  The delivery room medical staff or a technician collects the blood from the cord and the placenta.  Sometimes, the collection does not produce enough stem cells or the cord blood is otherwise unsuitable for transplant. When this happens, the stem cells are not transplant quality and may not be useful for treatment, but may be used for research.

Does collecting cord blood pose any risks to me or my baby?
There are no physical risks.  The delivery of the baby is the same, whether you save the cord blood or not. 

Many banks require the mother’s blood to be tested for infectious diseases and genetic conditions.  As a result, you may learn about a disease or condition that you did not know about previously.  The bank may be required by law to report your test results to public health officials.  Read the consent form carefully and talk with your physician about any concerns you have.

What kinds of banks collect cord blood from infants born in Massachusetts? 
There are two kinds of banks: private and public.  Public banks, which may be operated by private corporations, accept donations for research and treatment for anyone in need.  Families pay private banks to store the blood for exclusive use by their child or family members.  Several public and private banks store cord blood for Massachusetts families.  Turn this page over to compare costs, benefits, and risks of each kind of bank.

Who can help me learn more about cord blood banking?
•	Talk with your primary care doctor, obstetrician, pediatrician and other medical providers.  You may want to discuss your family’s medical history, risk for diseases, treatment options, and the likelihood of finding a stem cell match from a stranger, if a stem cell transplant were ever needed.
•	Contact banks about their procedures and about the agreements you will sign with them.  Public and private banks advertise on the internet and answer questions by phone.  Ask them who can use the cord blood after collection, where it is stored, how it is stored, and how your privacy is protected.  
•	The National Marrow Donor Program’s Center for Cord Blood has a website (www.marrow.org) with cord blood information for parents.  The National Cord Blood Program also has a web site (www.nationalcordbloodprogram.org). 

Remember: Information is changing quickly.  Only time will tell which additional diseases stem cell transplants will be able to treat and how long cord blood can be stored.  Carefully review materials from many different sources.  Use these materials when you prepare to talk with your doctor about cord blood banking.  

Cord Blood Banks: Public vs Private

	Public Cord Blood Banks	Private Cord Blood Banks	
Costs	The family pays no fee to the public bank.

Massachusetts law says that the family may not be charged for cord blood collection, including by the physician or hospital that delivers the baby, or for storage when  donations are for research. 
	The family pays fees to private banks. Compare the fees: 
o	Are fees fixed or allowed to increase over time?  
o	Is there any refund if the collection is not transplant quality? 
Ask if your doctor or hospital charges fees for collection and who pays those fees.  	
Benefits	Your donation may help others.  Anyone in need who is a good match may use it.  It is not reserved for you or your family.

Your donation will help ensure that people of diverse ethnic and racial backgrounds who need transplants will get them and that research will benefit everyone.

Cells that are not transplant quality can be used instead for research that may help your family and others in the future.

If donors need a transplant, some banks may provide stem cells free of charge if a good match is available.  	Cells you bank are held for you, so if your child or a family member requires a transplant later and your stored cells are transplant quality, you can use them. 
 
If a sibling has a treatable condition, it may be possible to treat the condition with the newborn’s stem cells.  

In the future, if research succeeds in finding ways to treat other conditions, cord blood you stored at the time of birth may be available to your family for the newest types of treatment.	
Risks	If the donor child or other family member needs the donated stem cells, they may not be available.  If a good match is available elsewhere, you may have to pay for those cells. 
 
Your donation is “owned” by the bank.  The bank controls what happens with it, within the limits of your consent.
o	Review the consent forms carefully.  
o	You may want to get information about the bank’s history. 
•	What types of stem cell research or treatment does the bank support?
•	Does the bank sell some of its cord blood to other companies or researchers?  
•	Does the bank use the cord blood to create products for sale?  	You may pay for something you do not use, for at least three reasons:
1.	Very few families will ever have a need for stored cord blood.  Most families that have used cord blood stem cells in the past already had an older child who needed treatment when they chose to save the cord blood.
2.	Some stored blood does not yield transplant quality cells.
•	Compare how the banks ensure the quality of the cord blood.
•	Find out if there is quality testing before the blood is stored.
3.	In some cases, it may be better to use stem cells from someone else. For example, some children with leukemia may have leukemic cells in their own cord blood.

Find out what happens to your stored stem cells if the company goes out of the cord blood business or if you are unable to pay storage fees.	

Massachusetts Department of Public Health 	August 2006