Storage of Umbilical cord blood stem cells involves collection of the umbilical cord after  birth of a child but before the placenta is delivered. Expectant parents have two options to opt for cord blood banking:

(1) Private cord banks: These companies work on the profit  basis, offer services to expecting parents to store umblical cord blood which they claim, can be used in case of any disease in the donor or related family.  Private banks charge an initial fee for collection and processing and, then, a yearly maintenance fee. Another fee is often charged when a sample is removed for testing or treatment.

(2)  Public cord banks: These are just like organs or blood donation banks, parents can donate their child’s cord blood for use in other individuals. The blood is released on an “as-needed” basis, and a processing fee may be charged to recoup some of the cost of storage.

Unlike private cord blood banking, public cord blood banking has been proven to be scientifically useful and are recommended by the American Academy of Pediatrics, American College of Obstetricians and Gynecologists, the American Medical Association, the American Society of Blood and Marrow Transplantation, and the World Marrow. Private banking for unidentified possible future use is not currently recommended.

3.Direct-donation umbilical cord blood banks- amalgamation of public and private banks. Direct-donation banks collect cord blood without charging fees. In addition, they accept autogenous donations and reserve them only for the family, especially for a family whose infant has a sibling with a disorder that may be treated with umbilical cord blood stem cells.

 There are two major fallback of the private cord banking

– If your child has genetic abnormality, cord cells will be genetically muted too. For example, in malignant cancers such as leukemia which is due to the genetic mutations which would already exist on the DNA of the cord blood. So, using one’s own stem cells would be, in effect, “contaminating” oneself with the same disease process.

– Infant for whom the blood is banked will likely never need the stored blood and the blood is not accessible by the general public for use. The chance that a child would be able to use his or her own cord blood is extremely small: from a 1:400 to a 1:200,000 chance over the child’s lifetime.

Cell dose refers to the amount of useful stem cells in the sample of blood. Use of cord cells in adult transplant recipients remains limited by the total dose of available cells.

A single unit of umbilical cord blood usually contains 50 to 200 ml of blood. If an amount of cord blood is less than this minimum volume (40ml) , the unit is discarded as being unsatisfactory. Collecting an insufficient volume of cord blood occurs in about 50% or more cases of cord blood collection.Only 8–12% of umbilical cord blood units have sufficient cell volume for transplant to a person weighing 80 kg.

4. Standardisation of Umbilical Banking

As per studies, approximately one-fourth of all collected cord blood units meets the established criteria for storage. Unlike public banks utilizing established criteria for storage in cord banks, private banks generally store all collected cord blood units.

5. Is it Possible to Cure Diseases with Umbilical Banking?

The current indications for cord blood transplant are limited to blood cancers, like leukemia and lymphoma , Bone marrow diseases, like Fanconi anemia Certain anemias, like sickle cell  disease, aplastic anemia and thalassemia,  certain immune system problems, like severe combined immune deficiency (also called SCID), Inherited metabolic problems, such as Hurler syndrome and leukodystrophies.

Trials for other diseases cure through cord cells  are in experimental stage like cerebral palsy, brain injuries, Diabetes and Parkinson’s disease etc.

6. Not all pregnancies are fit for cord banking

I suspect that the private cord blood bank only shares information that is in its best interest to gain another customer. Following cases are not fit for cord banking.

–  Mothers  younger than 18 years old

– Mother has been treated for cancer or have received chemotherapy for another illness

– History of malaria in the last three years

– History of infectious diseases, such as hepatitis, human immunodeficiency virus, and syphilis.

– Pre mature baby (there may not be enough blood to collect)

– delivered multiples (but it’s possible to bank your cord blood of multiples privately).

– The American College of Obstetricians and Gynecologists recommends that Umbilical cord blood collection should not compromise obstetric or neonatal care or alter routine practice for the timing of umbilical cord clamping.

7. How long umbilical cord blood will maintain its usefulness while frozen.  According to  research, cord blood stem cells can be maintained up to 15 years, but it is unknown if the cells would be preserved over the entire lifetime of a person. So what if child gets a disease after this period?

The main aim of the article is not to undermine the importance of Umblical cord blood. The umbilical cord blood stem cells offer higher chances of finding a match compared to bone marrow stem cells, and are readily available at the time of need.Graft versus host reaction is lesser  and also for people where there is difficult to get matched bone marrow, Cord cells are a boon. However, most of the expecting parents are uninformed or underinformed about the issue of cord blood banking. Parents should be informed about umbilical cord blood banking should be free from bias.