Cord Blood Banking

Dr. Sterling discusses cord blood banking and reasons to consider it.

Transcript

Does everybody know what cord blood banking is basically the umbilical cord and the umbilical blood has stem cells in it. And so some people, and there there’s companies and organizations that, that help you bank your cord blood. So basically you’re, you’re freezing and preserving these stem cells in the event that your child needs. It. The main, the most common reason that these stem cells are actually utilized is for certain blood cancers in which you have to eradicate the blood cancers typically come from the bone marrow where the blood is created.

So the cancer’s actually in the bone marrow. So one of the treatments for some blood cancers is to actually, you know, irradiate or get rid of the bone marrow. And then you have to do a bone marrow transplant and you, in order to do bone marrow transplant, you need a, a match. But if you have your own stem cells,

you can potentially use your own stem cells to repopulate your bone marrow. So you don’t have to worry about finding a match. That’s the most common reason why someone would need to use their cord blood. It’s they’re not very common, right? Childhood cancers are not very common general. And you know, blood cancers are some of the more common types, but that is,

that is it’s, it’s kind of like an insurance policy for a very rare condition. Now, when you talk to cord blood reps andcompanies, they will talk about all of these potential uses cord cord, blood stem cells have been used with autism with developmental problems. You know, of course, people are interested in using it for things like Parkinson’s and other,

other conditions. So there is emerging evidence that maybe these stem cells could be used for a variety of conditions. Maybe an individual could use it, even when they’re older, right. We have cord blood for Celeste. We, you know, we got a deal on it and it was, it was financially feasible. So we thought, why not? We totally forgot for Oliver.

Like literally I was gave birth. And I was like, oh shoot, we didn’t do, we did not do cord blood banking for Oliver. So poor guy does not have any cord blood to fall back on, but Celeste has some. And for us it was, you know, because you know, I’m an OBGYN. They always give OBGYNs and pediatricians,

they give us great deals, but it can be very expensive. And I think if it was full price, I might’ve, maybe I wouldn’t have done it. And honestly, we haven’t even made a decision about this baby, whether we’re going to do it or not. I think it’s a, you know, if it’s going to be a, a financial burden,

I think that, you know, the American academy of pediatrics doesn’t recommend it, you know, routinely, most people because it’s expensive and it’s not just like an ex one time expense you have to pay yearly. Our plan is like, when Celest turns 18 is to be like, Hey girl, do you still want this? Like, you can start paying these bills.

Maybe we’ll give her a little bit more of a Lee of a leeway. But yeah, I think it’s, it’s a personal decision. It’s a financial decision. If you are going to do it, going with some of the bigger companies is really important. So there are many companies in how do cord blood banking. And they all have, like, if you look on their websites,

there’s, you know, they all have their thing, but you want to go with the big companies and the bigger companies are stem site. They get C, B T trying to think. It’s, it’s pretty obvious when you go, when you, when you search, who’s the, who’s the big, you know, the big three, the top companies and the smaller ones,

you just, you know, they’re more likely to say, you know, not last. And then what, what happens to your cord? Blood banking? If they, they file for bankruptcy, hopefully they would arrange for, you know, somebody else to take it on, but you don’t really want to have your cord blood being it’s frozen and preserved.

You don’t really want it to be, to be transferred. So go with a big company. I believe we used stem site for Celeste and that’s, that was the, you know, these reps, this, I was working in a private practice at the time. So that was the rep that came in. It’s not that I’m like endorsing stem site,

but that’s, we used A few follow up questions for you because I had done research on it before my daughter, I think donation is an option, correct. Because for me, I was like, there’s not a shot and how am I about to pay for this monthly? Yeah, I can donate it. And Hey, if more people did that,

you’d be able to access more options. Yeah. But during this research, I read somewhere on Google than, yeah. It’s harder to do, to get stem cells with delayed cord clamping. There is An accuracy to that. Sometimes use One or the other. Sometimes I would not say that they’re, they’re not mutually exclusive for those of you who don’t know delayed cord clamping is,

is a very common practice where we do not clamp the cord immediately. After baby’s born, we wait 30, 30 seconds to 60 seconds, half a minute to a minute. Now, listen, there’s people out there who do, I don’t know if you all have of Lotus, butLotus, you don’t ever clamp the umbilical cord and you just leave baby attached to placenta until it like comes off on its own.

I honestly cannot imagine anything worse than having to like, breastfe, placenta’s just the umbilical cord stump is like enough for me to be like, this is, but yeah. So anyway, delayed cord cramping, you know, what we’re really talking aboutis just 30 seconds to 60 seconds. It’s not very long. Some people like the cord to stop pulsing.

Sure. No problem. There’s no data that, that, that that’s important. Delayed cord clamping is much more important for premature babies than it is for term babies. There may be some marginal benefit in term babies to delayed cord clamping. It’s not a huge benefit. There are some studies that actually show an increased risk of, oh my gosh. Why am I jaundice with delayed cord clamping?

But again, there, but there’s also studies that show that that it’s be it’s beneficial and that’s not increased risk. So, but we’re not talking about huge benefits here. Term babies, no medical problems. Sure. Give them a little extra boost. Do they need the little extra boost? Maybe. Maybe not. Okay. So if somebody’s doing cord blood banking,

what I typically did as a provider is I’m like watching that cord. Okay. I’m gonna try to get 30 seconds cuz we know that there’s benefit to 30 seconds of delayed cord. But if it looks like that cord is drying out really quickly because the, the cord will go from big and juicy and, and, and filled with, with blood to,

you know, if you leave it on for long enough, it gets very flat and there’s nothing in there. So I’m watching as the provider trying to get as much time to get to the 30 to 60 seconds, but also knowing like, Hey, I want to collect cord blood for them. So it’s not that. And it’s not that hard to do,

you know, hopefully your provider, isn’t like totally swamped and hasn’t been up for 36 hours, but it’s pretty simple to just watch the cord and make a, make a decision like, okay, this is when we’re gonna clamp. And so I can collect the cord blood. So I would say that that’s the ideal situation is, you know, doing it that way now for premature babies there,

you know, some people make the argument, well, cord blood is more important for premature babies because if they end up with cerebral palsy or autism or whatever, maybe we’ll want to use the cord blood for those indications. Okay. But also like we know that their outcomes are going to be better if we either their studies that compare milking the cord or doing delayed cord clamping,

whatever it is, it’s actually really important for them. And so that, you know, you, you can talk to the, the NICU team is also helping you make that decision in those circumstances. So when we deliver premature babies, there’s oftentimes the NICU team is there and we’re saying, okay, they tell us when to clamp the cord. So sometimes it’s really tough cuz like really premature babies will have like a little,

like a little bag. It’s like a little bag that we put them in because they’re, you need to keep them warm. And then we, as the OB GNS are like standing there with this extremely premature baby and the NICU team is saying, okay, wait, like don’t clamp yet. Don’t clamp yet. And we’re like seeing this like little baby struggle to breathe.

And it makes OB GNS super nervous cuz we’re like, oh my God, this is, this is a tiny baby. This is not our area of expertise here. So it’s oftentimes a coordination. But I think that, you know, as long as you have a conversation with, if you’re doing cord blood banking, the person to talk to is your labor and delivery nurse because you,

your OB provider is may or may not. Especially if you told them in the office, it’s very unlikely that they’re gonna remember when you’re in labor that you’re doing this. So you talk to the, the labor and delivery nurse, they deal with it all the time. They tell you what to do. And you can also say, Hey, I still wanna do cord blood banking,

but I’m, I’m hoping that, you know, we can, you know, get, try to get 30 seconds of that, that delayed cord clamping so that we can collect some of this and your O you know, OB providers are collecting cord blood all the time. It’s, you know, so they, they know how to handle it.