Cord blood is a very special fluid. However, opinions differ when it comes to its use. We at swing2sleep want to provide you with comprehensive information on the subject of cord blood and show you the current state of science.
We want to inform you about all the advantages and disadvantages so that you can make the best decision regarding cord blood for yourself and your baby.
What is cord blood all about?
Today, stem cells from cord blood are already being used successfully for over 80 different diseases, including serious illnesses such as leukemia.
The stem cells contained can either be used for a later autologous transplant or passed on within the family. In medical practice, however, allogeneic transplantation is currently the most common use case.
After the birth of your child, you have several options for how to handle the cord blood. You can donate the cord blood, have it stored in a private cord blood bank, make a directed donation to a specific person, or store the blood while keeping the option open for a later donation.
It is important to know: If you decide to have the cord blood collected, it is no longer possible for the umbilical cord to pulsate fully.
Private storage at a cord blood bank is also associated with high costs. As a rule, these range between approximately 1,500 and 3,000 euros, plus annual storage fees.
Cord blood: Explanation, application, and therapeutic use
During pregnancy, the umbilical cord is the most important supply link between an unborn baby and the mother. It connects your blood circulation with that of your baby and serves to supply your unborn child with oxygen and nutrients.
When your baby is born, part of the cord blood remains in the umbilical cord and in the placenta. This blood contains valuable stem cells that are already being used successfully for the research and treatment of certain diseases. It is becoming clear that cord blood is of great importance not only during pregnancy but also beyond.
After birth, the blood can be collected to obtain the stem cells. They can potentially save lives. For this reason, as an expectant mother, you should ask yourself before birth whether you want to let this blood pulsate out after birth or whether it should be collected to be donated or even stored.
Interestingly, the collection of cord blood is rather the exception. Only about 5% of all expectant parents decide to have cord blood collected each year.
This is often because there was insufficient information provided by the gynecologist during birth preparation or at the maternity clinic. Some parents also feel unsettled by the large number of private cord blood banks and the high costs of storage.
In the following section, you will learn which treatments cord blood stem cells are used for and what the advantages and disadvantages of the various options are.
Cord blood transplants: The beginning has been made
Therapy with stem cells from cord blood is already successful for more than 80 types of diseases, as the German Cord Blood Bank (DKMS) writes on its website.
Great success can be achieved particularly in the treatment of leukemia patients because cord blood stem cells have a particularly blood-forming effect and can therefore be used for restorative treatment after chemotherapy.
Research is still in its infancy, but scientists are confident that many more applications for cord blood will emerge.
Therefore, various research projects are currently underway from which great potential is expected. Researchers assume that cord blood stem cells are additionally capable of replacing or repairing damaged or even diseased body cells.
Young stem cells, such as those from umbilical cord blood, indeed show a rapid multiplication rate. Because they are extremely flexible and undifferentiated, various cell types can mature from them.
Thus, there is the possibility of actual cell repair or even the replacement of damaged body cells. We can look forward to seeing what clinical studies will continue to produce.
Umbilical cord stem cells: What are the possible applications?
Stem cells from umbilical cord blood are very flexible and undifferentiated because they have not yet been exposed to age or environmental influences. They are considered to be particularly well tolerated.
Therefore, they offer a particularly wide range of applications, namely as autologous transplantation, as transplantation within the family, or also as allogeneic transplantation. Nowadays, however, allogeneic transplantation is the standard case.
Autologous transplantation (self-transplantation):
In very young children, autologous stem cell transplantations are generally not yet used. The reason for this is that in such cases, these are mostly hereditary diseases, such as leukemia.
Since the patient's own stem cells carry exactly the genetic material responsible for the disease, treatment with their own stem cells makes correspondingly little sense.
Nevertheless, autologous transplantation is the therapy with the greatest prospects of success for many other diseases. With it, rejection reactions are least likely to occur because the introduced endogenous stem cells are not rejected by the immune system.
Doctors and researchers are very optimistic, and according to the latest research approaches, umbilical cord stem cells are even capable of curing diseases such as Type I Diabetes Mellitus and cerebral palsy (early childhood brain damage).
Transplantation within the family:
Due to the good compatibility between relatives, this transplantation is also very promising. Particularly in the case of sick siblings, impressive healing successes can be achieved through treatment with umbilical cord stem cells, e.g., in cases of congenital anemia or immune deficiencies.
For this, it is important that you opt for a directed donation. The public cord blood bank then reserves the umbilical cord blood specifically for the sick family member. Should you prefer storage at a private cord blood bank, make sure that you are allowed to access it for family members in an emergency.
You will need a release permit for relatives for this. This way, you are definitely on the safe side and can rely on the stem cells actually being available to you in an emergency.
Allogeneic transplantation (donor transplantation):
This procedure is the standard case today because the young stem cells from umbilical cord blood are very well tolerated and the donor's immune system usually shows little to no defense reactions.
The stem cells are not immunologically fully matured. This means there is a good chance that the recipient's immune system will not attack the donor's cells. In addition, thanks to the placental barrier, the stem cells show little to no viruses or bacteria and thus do not lead to infection.
Allogeneic transplantation is currently used with great success for leukemia, blood formation disorders, and genetic diseases.
The possibilities: donate, store, or delayed cord clamping
If you decide to have umbilical cord blood collected, you should be aware that delayed cord clamping is then no longer possible because there is simply not enough blood left in the umbilical cord.
If you nevertheless decide to have umbilical cord blood collected, you basically have two options: You can donate the umbilical cord blood to a public cord blood bank (for example, DKMS) and thus save a stranger's life, or you can have it stored at a private cord blood bank.
Should a disease occur within the family at some point, you can use the donation for autologous transplantation for your child or, if applicable, for a family member. It is important that you explicitly check this option on the form.
In the following, the respective advantages and disadvantages of the different options are presented in more detail.
The first option – Donation
With this option, the collected umbilical cord blood is donated to a public cord blood bank. It is processed anonymously in the laboratory and then recorded in the stem cell register. It is now available worldwide to all patients who require a stem cell transplant and thus saves lives.
Public cord blood banks:
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DKMS, Cord Blood Bank, Dkms.de
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José Carreras Stem Cell Bank, Düsseldorf Uniklinik-duesseldorf.de
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German Cord Blood Bank NKR-Giving Life, Hanover Nkr-hannover.de
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Mannheim Cord Blood Bank Umm.uni-heidelberg.de
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Freiburg Cord Blood Bank Uniklinik-freiburg.de
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Munich Cord Blood Bank Akb.de
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Erlangen University Hospital Transfusionsmedizin.uk-erlangen.de
Advantages of a donation:
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Anyone who donates cord blood saves lives. Because it gives a very seriously ill person with matching tissue characteristics the chance to get healthy again.
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There are no costs for you for transport, examination, processing, and preservation of the cord blood. All costs incurred are borne by the public cord blood bank.
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There is a possibility that you can fall back on your own stem cells if needed, provided they have not been donated in the meantime.
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In the case of a directed donation, the umbilical cord stem cells can be used within the family.
Disadvantages of a donation:
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Allowing the cord blood to pulsate out is no longer possible. Naturally, this influences the cord-cutting process, as this procedure requires early clamping of the cord.
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Should you donate the cord blood, you no longer have a claim to your own cord blood. Of course, you can inquire in the event of a medical necessity, but there is no guarantee that the donation is still in stock.
The second possibility – Storage
Alternatively, you can have the cord blood stored at a private cord blood bank. This means the blood is reserved for your own use if needed. Processing and preservation take place here just as they do at a public cord blood bank.
However, you must cover the costs incurred. Furthermore, this donation is not recorded in the stem cell register. There is one exception: storage with the option of a donation.
Private cord blood banks:
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Vita 34 AG, Leipzig Vita34.de
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Eticur GmbH, Munich Eticur.de
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German Stem Cell Bank DSB Deutsche-stammzellenbank.de
Advantages of private storage:
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With this option, you remain the sole owner of the stored preparation. In an emergency, you can access the umbilical cord stem cells at any time.
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If you explicitly ensure before signing the contract that there is also a release permit for siblings in case of need, the donation can also be used for family members.
Disadvantages of private storage:
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With private storage, costs for transport, laboratory tests, processing, and preservation are incurred, which you must bear yourself.
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The German Medical Association points out that there is currently no known medical indication for storing cord blood for self-retention. This treatment with stem cells from cord blood in childhood is primarily used for diseases such as leukemia or genetic diseases. However, this is only possible with foreign stem cells, as the patient's own cord blood contains exactly the stem cells with the causative genetic defect or the corresponding mutation.
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Research and treatment of and with umbilical cord stem cells has only existed for about 15 years. Today, it is not yet known how the donations behave after decades of storage or whether they are still usable at all.
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If the contract period with a private umbilical cord bank ends, the umbilical cord preparation is destroyed. A great pity, as this donation could have saved lives.
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Allowing the umbilical cord blood to pulsate out is no longer possible. Naturally, this influences the cord-cutting process, as this procedure requires early clamping.
Important to know: Storage with the option to donate
Private umbilical cord blood banks often also offer storage with an option to donate. In this case, the rights to the stored stem cell preparation remain with the parents of the newborn child. At the same time, however, the data is passed on to a public umbilical cord blood bank and recorded in the stem cell register.
Should the stem cells be required as a third-party donation, the parents receive a request. If they release the stem cells, they are reimbursed the money for the storage. Of course, the release can also be refused. In this case, the stem cells remain stored for their own child or family.
The third option – delayed cord clamping
If you decide on this option, collection of the umbilical cord blood is no longer possible. Afterwards, there is simply too little blood left in the umbilical cord to choose both options.
Advantages of delayed cord clamping
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By allowing the umbilical cord blood to pulsate out, the blood volume of your unborn child increases by up to 30%. Additionally, it has a positive effect on iron levels. Therefore, doctors advise cutting the umbilical cord as late as possible in premature and multiple births, because these children are particularly prone to anemia.
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The umbilical cord supplies your baby with everything it needs. In addition to nutrients, this also includes oxygen. The baby can therefore begin breathing independently in a very relaxed manner.
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According to experts, late cord cutting promotes mother-child bonding.
Disadvantages of delayed cord clamping
- There is no longer any possibility to donate the umbilical cord blood or have it stored for private use.
The collection of umbilical cord blood
Umbilical cord blood collection is basically a completely normal blood draw from a vein. On the one hand, it is completely painless and harmless; on the other hand, it takes up very little time.
How does an umbilical cord blood collection take place?
After the birth of your child, the attending doctor or midwife will perform the cord cutting immediately. They then collect the blood from the part of the umbilical cord that is still connected to the placenta.
As a result, you and your baby feel absolutely nothing from the blood collection. The collected blood is caught in a small sterile bag. Afterwards, blood is also taken from you as a new mother once more to rule out possible infections.
The umbilical cord blood and the blood taken from the mother are then transported to the umbilical cord blood bank at 22 degrees and examined in a separate laboratory.
This naturally influences the cord-cutting process, but the placental stage remains the same. There is also nothing standing in the way of the desired cutting of the umbilical cord by the new dad.
Storage at a private umbilical cord bank
The transport and storage of umbilical cord stem cells take place according to established guidelines of the German Medical Association. This ensures a high quality of the umbilical cord blood.
Guideline of the German Medical Association:
The collected preparations must arrive at the umbilical cord blood bank within 24 hours. The laboratory immediately examines the samples for possible infectious diseases and the quality of the stem cells.
In order for the umbilical cord blood bank to store the samples, all quality criteria specified by the German Medical Association must be met. If this is the case, the umbilical cord stem cells are compressed and frozen in small tubes at minus 196 degrees using liquid nitrogen. This entire process must not take longer than 48 hours.
Private umbilical cord blood bank – costs incurred
Storing umbilical cord blood at a private umbilical cord blood bank is not exactly cheap. The costs currently amount to approx. 1500 to 3000 euros, whereby payment is not made annually, but a specific contract term is concluded. In addition, parents often face storage costs per year.
Donation to a public umbilical cord blood bank, on the other hand, is completely free of charge.
