When baby is born there is still blood left in the umbilical cord. This blood is being transferred to the baby from the placenta. So, what to do with the cord blood? You have four choices:
- Dispose of it
- Pay a private cord blood bank to keep it for you to use later, if needed
- Donate it to a public cord blood bank either for research or for use in a sick person
- Allow the umbilical cord to drain the blood fully into your baby – delayed cord clamping.
#1 is pretty self explanatory. #2 is very, very expensive. There is usually an initial fee, in the hundreds of dollars and then an annual fee of $800-$1500 per year, every year that you store it. The likelyhood that your child, or a subsequent child of yours will ever need the stem cells in that cord blood is very low.
#3 Donating the cord blood – this is free. You will need to sign some paperwork, but that’s about it. If there is sufficient blood to donate 60cc’s or more, then if there is a match, those stem cells will be used in treatment. If there are 40-60cc’s of blood, then it will be used for research.
#4 Delayed Cord Clamping – This is what I recommend you do with baby’s cord blood. This isn’t extra blood… it belongs to your baby. Imagine how you feel after you’ve donated a pint of blood to the Red Cross… now imagine giving baby that same feeling by immediately clamping the umbilical cord at birth! Blood carries oxygen to the baby… there is no need for baby to breathe with the lungs upon immediate arrival to the outside world – baby is still getting oxygen through the cord. If you cut or clamp the cord too soon, then you can actually cause the need for resuscitation.
This video, by Penny Simkin, beautifully illustrates the necessity for the transfer of blood from the placenta to the baby after birth: Penny Simkin on Delayed Cord Clamping
Here we have a series of photos, taken over a 15 minute period where baby was outside the womb, the placenta still attached to mom on the inside. You can see how the blood drains into the baby and how the cord withers when it it no longer needed: Photo Series of the Umbilical Cord after birth
It is important for baby to get as much of their own blood as possible. This cord blood isn’t extra, left over, or waste product – it’s your baby’s. That said, delayed cord clamping and donating or banking cord blood are incompatible. There isn’t enough blood left in the cord after it stops pulsing to save.
There are many studies on the benefits of delayed cord clamping. From just one study, “Conclusions: Delaying clamping of the umbilical cord in full-term neonates for a minimum of 2 minutes following birth is beneficial to the newborn, extending into infancy. Although there was an increase in polycythemia among infants in whom cord clamping was delayed, this condition appeared to be benign.”
So, when it comes time to cut the cord, and separate baby from her placenta, do seriously consider delayed cord clamping and allowing the blood to fully flow into her.
Sat Nam.
Another story of two kiddos:
First had immediate clamping. He had many eating problems, was very sleepy, and within 2 weeks was diagnosed failure to thrive. I do not know how related they were, but he could not even wake up to eat for two days. By six months his iron stores were so low that he had to go on supplements.
Second had delayed clamping at my request. She had enormous times of alertness in her first day and was also able to nurse right away. At six months her iron was fine, and by 9 months her iron was still so high that they could not believe she was a breast-fed baby. (full disclosure: I started her on dark meat chicken at 7 months because I did not want to deal with the supplements again. They still said that even that should not have brought her hematocrit up as high as it did).
Both kids were jaundiced. Number 2 was extremely jaundiced very quickly, which is apparently the biggest danger of delayed clamping. But as long as you are prepared for it, that is something that can be remedied (and the lights are much faster to work now than they were 5 years ago).
Lynne ~ Jaundice is linked to delayed cord clamping as something that can be exacerbated by the practice, but isn’t caused by the delayed cord clamping. True, baby will have more red blood cells to process by the liver, but the functioning of the liver isn’t affected either way (by clamping or waiting). So if he liver functions are low at birth, then jaundice will occur. If there are more red blood cells then more jaundice.
There was only ONE study since 1960 which mentions jaundice. Out of 14,000ish babies studied only 17 were jaundiced after delayed cord clamping.
Hi Deena,
I respectfully disagree. Clamping the cord is not harmful for most babies, I don’t know about premature babies, but full term babies thrive just fine.
Also, you mention donating blood would be used for research as if this was a negative thing. Thousands of children have seen their lives saved or drastically improved because of the research done in non-embryonic stem cells. Cerebral palsy, sickle cell anemia, and many other conditions, are curable today because of research performed thanks to the generosity of parents that donated the blood of their babies.
I don’t know where you are getting your numbers from, but the main companies in US charge about $100-150 as an annual fee for storage. Your numbers are very inflated. When a parent deposits the blood of their children is actually with the hope that they will actually never use it. That is what insurances are for. But in any case, the number of diseases that can be treated is increasing so much that some conditions of aging will be treatable in the near future, according to recent research.
I understand you are into a natural birth experience, like me or many other women, however there is no need to paint in a negative light something that has actually many positive sides.
Costanza ~ I appreciate your well thought out comment. I’ll address your points one at a time.
“Also, you mention donating blood would be used for research as if this was a negative thing” I am sorry if my original blog post did not convey my intention. My intention was to inform parents, fully, of what can happen to the blood they donate. Most parents assume that donate cord blood will always go to a sick individual.
In the literature distributed by our local cord blood bank to parents, The Dan Berger Cord Blood Progam, states “Public donations are free. The cord blood tissue type is recorded and stored in a public bank until needed. If you store your baby’s cord blood privately, there is an ongoing fee for storage, and only your family can use it. You also can donate it to research, which is also free.” However, it does not, anywhere on their website or in their literature tells parents that they need a minimum of 60 cc’s of cord blood to use as treatment for a sick patient. It also doesn’t tell parents anywhere in their literature or on their website they need a minimum of 40 cc’s to be used for research. If insufficient blood is collected, it is discarded – something that is also not conveyed to parents.
So, on this point, my intention was to convey details to parents that the cord blood donation banks do not explain.
The donation bank’s literature also says “Cord blood is the blood left in the umbilical cord and the placenta right after the baby is born. The baby does not need it any more.” This is factually incorrect, since the banks want parents to donate, they have no incentive to explain to parents the risks of relieving the baby of 1/3 of their total blood volume (since that is what’s left in the cord/placenta at the time of birth). Do watch the video by Penny Simkin, linked in the original post.
I am honestly glad to see that many people’s lives are saved from the donated stem cells. I think this research is powerful and can go a long way to save future lives from additional diseases. One thing that research is finding is that the placenta itself is full of stem cells. However, there is no donation program for the placental tissue. Placental tissue donation can be done after the cord blood has drained into the baby and the tissue itself has a much higher stem cell count. At this point, however, no bank takes it.
With regards to your comment “Clamping the cord is not harmful for most babies, I don’t know about premature babies, but full term babies thrive just fine.”
One recent study (4/11) says: “Farrar et al. acknowledge that many short- and long-term effects of delayed clamping are still unclear, and we agree that much research needs to be performed to fully understand the benefits of delayed clamping. Before this is carried out, it will be difficult for current guidelines and practice to change. However, raising awareness of the existing evidence base in the obstetrics department may facilitate change in practice, leading to an increase in delayed clamping and a better overall outcome for the neonate.” That translates to – we need to do more long term research on the subject, but initial evidence points to encouraging delayed cord clamping.
The literature does show harm done to any newborn whose cord is clamped immediately. Namely lethargy, need for resuscitation, delayed breastfeeding, anemia and so on. These are what we call iatrogenic complications – doctor caused. We like to avoid iatrogenic complications.
As for the costs of private banking – they vary from bank to bank; they vary with what coupon or deal they offer to you, etc. Even using your numbers of $150/year… $150 x 18 years = $2700. For many families that is a lot of money. Especially when you consider that less than 14% of the blood banked privately is actually used. So to call it “insurance” is marketing. The vast majority of the blood banked privately goes to waste, hence the preference for donation over private banking.
All of that said – it is always a parent’s choice what to do with the cord blood. It is strongly recommended, with studies going back to 1960 (pre cord blood banking and stem cell research), to practice delayed cord clamping. In my opinion, donating the cord blood to a bank is a good 2nd choice – especially if parents feel strongly about continued stem cell research or about helping those who have illnesses which can be successfully treated with stem cells. Whatever parents choose to do, they need to know the full ramifications of their decisions so they may make the best choices for their families.
Oh, and on the note of me being into natural birth… more like Realistic Birth 😉