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Baby Cord Blood Banking: All you need to know about this “biological insurance”

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It was a bright, chilly morning and another day for Ella George (pseudo name) to check on her growing baby bump and pregnancy updates. Scrolling through her daily feed on her favourite pregnancy Application, BabyCentre, a poll asking, “Will you pay to bank your baby’s cord blood?” caught her attention. She wondered what baby cord blood banking meant and why it was needed. 

Is it the same baby cord we dispose of and move on after delivery they are talking about, or something else? This article will answer these questions and many more.  

What is Baby Cord Blood?

Baby cord blood or Umbilical Cord Blood (UCB) is the blood that remains in the placenta and umbilical cord after the birth of a baby. Before now, baby cords were usually thrown away at birth, but according to WebMD, many parents now store the blood for the future health of their child. 

The United Kingdom National Health Service (NHS) explains that cord blood is rich in stem cells, which can treat many cancers, immune deficiencies, and genetic disorders. Stem cells are the building block cells in the body that can develop into many different types of cells.

These stem cells contained in the cord blood were described as “lifesaving cells” by Baby Centre. The centre explains that when a cord blood donation is done, it can be developed into the type of blood cell that a patient’s body needs. This could be red blood cells, white blood cells, or platelets.

A gynaecologist at Garki Hospital Abuja, Sunday Idoko, said he has heard of cord blood but not cord blood banking. He revealed that cord blood can be gotten after delivery or during pregnancy when there is a need to run some tests. 

He explained cord blood: “Cord blood, as the name implies, is getting blood from the umbilical cord. It can be gotten after the baby is born or while the baby is in the womb via a procedure called cordocentesis. This procedure is used to screen and test for many diseases.”

The American Pregnancy Association notes that a baby’s umbilical cord is made of tissue that protects and insulates the veins responsible for carrying blood to and from mom and baby during pregnancy.

Cord blood stem cells are the subject of animal studies. The Food and Drug Administration (FDA) regulated clinical trials exploring their suitability for helping those with autism, brain injury, and many other conditions.

What is Baby Cord Blood Banking?

This is the process of collecting the stem cells in a newborn’s cord blood and tissue and saving it for potential future use is known as cord blood/tissue banking.

A consultant gynaecologist at the National Hospital Abuja explained Cord Blood Bank as a store for a baby’s cord blood for its stem cells. 

“Baby Cord Banking stores the baby’s cord blood for its stem cells. Stem cells can potentially become any other cells in the body. This is used for treating certain medical conditions. I don’t know if you have heard about stem cell transplants for treating sickle cell disease. Banking the cord blood is for future use by the baby or others who need it.”

According to the Parent’s Guide to Cord Blood Foundation, a cord blood bank means parents pay a family bank to store their baby’s cord blood so that they will have access to the stem cells in case of need. The foundation added that many family cord blood banks store additional types of newborn stem cells, such as cord tissue.

Understanding how the umbilical cord tissue is processed and stored is essential, as it varies among cord tissue services. ViaCord, a sponsor of the American Pregnancy Association, extracts the cord tissue cells before freezing and storage so the cells will be ready to use if needed. 

Some banks, however, simply store segments of the cord tissue without extracting the stem cells first, resulting in a final product that is not ready for use.

How does Cord Blood Banking work?

Regardless of the type of delivery you have (a C-section or vaginal delivery), the collection process is non-disruptive to you or your baby, so there is no cause to worry or fear. The stem cells are collected after the umbilical cord has been cut, posing no discomfort or danger to your baby and making the process completely safe. 

After a baby is successfully delivered, the doctor clamps the umbilical cord in two places, about 10 inches apart, and cuts the cord, separating the mother from the child. 

The collection process is targeted at two things: the cord blood and the cord tissue. 

For the cord blood, after your baby is born, the doctor then inserts a needle and collects at least 40 millilitres of blood from the cord. This blood is sealed in a bag and sent to a laboratory or cord blood bank for testing and storage. This process only takes a few minutes. Sometimes, the cord blood bank may also send tubes to take the mother’s blood. The banking kit will have instructions and blood collection tubes in this case.

Once the blood is removed from the umbilical cord, the doctor will cut a segment of the tissue, thoroughly clean it, and place it in a collection cup.

The baby’s cord blood is stored in a public cord bank, a private (commercial) blood bank, or a direct-donation bank. It doesn’t charge anything for storage, and the stored item is available for anyone in need, whereas the private cord bank attracts a fee for processing and an annual storage fee. In this type of bank, the stored blood and tissue are only available for donor and family member’s use. 

The direct-donation bank is an amalgamation of public and private banks, which collect cord blood without charges and accept autogenous donations. They reserve the collected blood only for the donor’s family, especially for a family whose infant has a sibling with a disorder that may be treated with umbilical cord blood stem cells.

Why should one consider baby cord blood banking?

An article by Harvard Health Publishing highlighted that the blood left over in the umbilical cord and placenta after a baby is born contains special cells that can treat and even cure some severe diseases. The article advised that parents should collect and store this blood in case a child (or someone else in the family) develops one of these diseases.

The American Pregnancy Association describes it as a solution that allows families to secure an additional source of stem cells that work differently than cord blood stem cells. The association also agrees that immediate biological family members may benefit from this cord blood bank because of the compatibility issue. 

Although cord tissue stem cells have no proven uses yet, their unique qualities, like their ability to respond to inflammation, help the immune system, and aid in tissue repair, excite scientists and researchers about their potential use. 

It is important to note that a significant amount of research is underway to understand better how the Mesenchymal Stem Cells (MSCs) from cord tissue could play a role in future therapies that could benefit from their properties, like Parkinson’s disease, Alzheimer’s, Autism, Type 1 diabetes, Lung cancer, Rheumatoid arthritis, Sports injuries (cartilage), Lupus.

Scientists and researchers are also interested in MSCs from cord tissue to help heal the damage done by COVID-19. Clinical Research Studies are also underway using stem cells from cord tissue to treat COVID-19.

Baby cord blood banking in Nigeria 

A 2021 study on the awareness and practice of cord blood donation by pregnant Women in Lagos, Nigeria, revealed that although the understanding of the clinical uses of Umbilical Cord Blood (UCB) is very limited in Nigeria, the intent to participate in UCB donation is high. The study identified factors such as religion, education, and prior information about UCB donations by healthcare providers as influential factors in the decision to donate to the UCB.

Mr Agim and Mr Sunday agree that cord blood banking is still a new concept in Nigeria and that they would like to know of any centre where it is currently practised in Nigeria. 

“Cord blood banking is like a new concept in our environment. I don’t know of any centre where that is done in Nigeria. We are still trying to do banking on eggs and sperm and are yet to be fully established,” Mr Agim noted. 

The Pros and Cons of Baby Cord Blood Banking

Although several benefits have been identified with baby cord blood banking, with some private blood banks referring to it as biological insurance, this study highlights its advantages and disadvantages. 

The first highlighted advantage is that umbilical cord blood is relatively easy to collect and process and less likely to be rejected in transplants when compared to bone marrow stem cell transplants. Infant cord blood banking decreases the risk of infectious disease transmission. This process also allows for data collection on the history of infection during the mother’s pregnancy.

One disadvantage of cord blood banking highlighted by this study is the need for engraftment for stem cell transplants to be successful. Engraftment indicates that the stem cell transplant is “working.” The two measurable signs of engraftment are the recovery of both neutrophil (a type of white blood cell) and platelet (a clotting factor) production. This is a disadvantage because these two clinical signs of recovery take longer in umbilical cord blood stem cell transplants than in bone marrow stem cell transplants.

Another disadvantage is the limited use of an infant’s umbilical cord blood stem cells (autologous transplant) later in life. It is unknown how long umbilical cord blood will maintain its usefulness while frozen. Available research indicates that cord blood stem cells can be maintained for up to 15 years, but it is unknown if they would be preserved over a person’s entire lifetime. 

There is also the Financial cost implication of cord blood banking and the significant lack of regulation for umbilical cord blood banking. The study believes this lack of quality control affects the quality of the specimen available for transplant.

The American College of Obstetricians and Gynecologists (ACOG) in 2008, regardless of these pros and cons, recommended that pregnant women be given information about umbilical cord blood banking free from bias. ACOG recommends the collection and banking of cord blood only when an immediate family member has a known diagnosis for which stem cells are currently being used for treatment because the chance of a child or family member needing a stem cell transplant is about 1 in 2,700.

The American Academy of Pediatrics (AAP) in 2007  that using banked umbilical cord blood as “a biological insurance” is unwarranted because many of the claims by private cord blood banks are unfounded. 

The AAP recommends cord blood collection and banking for all families, but this should be banked in public banks for use by the general population.

While the ACOG neither recommends nor advises against cord blood banking, it cautions parents about private cord blood banking because collection and storage costs at private cord blood banks are high, and other effective treatments that are less expensive may be available.

Another reason the college advises against privately banked cord blood is the low chance of it being used by the child and the fact that it cannot be used for genetic disorders such as sickle cell disease and thalassemia. It is also important to note that other diseases that can be treated with a stem cell transplant, such as leukemia, may also already be present in a baby’s cord blood.

Diseases that can be treated with a stem cell transplant are uncommon, as there have been more than 400 autologous cord blood transplants in the United States in the last two decades, while more than 60,000 unrelated donor cord blood transplants have been performed worldwide.

The only situation where private cord blood banking is said to be reasonable is in the case where parents don’t know the medical background of their children either because of adoption or conception via a sperm or egg donor.

Conclusion 

Although baby cord blood banking is still a new concept in Nigeria and already has its pros and cons, it is an exciting concept that parents need to be aware of, as saving baby cord blood increases family options in case of future needs. 

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