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Jan. 3, 2007 -- Paying to have a newborn's umbilical cord blood stored as an insurance policy against future disease is a bad idea, says the nation's top pediatric health group.
But new parents should donate cord blood for public use if they are able, adds the group, the American Academy of Pediatrics (AAP).
In a strongly worded policy statement, the AAP concluded that no scientific evidence exists to support the practice of banking a newborn's umbilical cord blood for his or her own later use.
Companies that bank umbilical cord blood argue that it may one day be possible to use the stem cells in cord blood to treat an individual's diseased heart or liver, repair an injured spinal cord, or for other uses.
But the AAP says the claim that stored cord blood can serve as "biological insurance" against future disease has not borne out.
Private companies that make such claims prey on new parents at an emotionally vulnerable time, William T. Shearer, MD, a pediatrics professor at Baylor College of Medicine, in Houston, tells WebMD.
Parents are led to believe that a child's own cord blood can be useful later if that child develops cancercancer or many other diseases. But this has not been shown to be the case, Shearer says.
In fact, a child's own stored cord blood might not be considered safe for use in the treatment of leukemialeukemia and many other conditions because "most conditions that might be helped by cord blood stem cells already exist in the infant's cord blood," according to the AAP statement.
Private cord blood banking costs $1500 to $2500 at the time of collection, and most banks charge around $100 a year for storage.
"The web sites for these [cord blood banking] companies make you feel like the worst parent in the world if you don't do this," Shearer says. "But the idea that saving a baby's cord blood will protect him or her in the future is just patently false."
Charles Sims, MD, president of the American Association of Family Cord Blood Banks, agrees that some private cord blood banking companies have been less than forthcoming about the immediate benefits of cord blood storage for donor use.
But he argues the AAP policy statement goes too far.
"You only have one chance to collect cord blood," Sims says. "Future research may very well prove a value for this in terms of regenerative medicine, so the decision should be made by individual families. Families should not be told what to do."
Public Banking Encouraged
While the AAP discouraged private cord blood banking in most instances, there was one exception.
The group supports directed cord blood storage in cases where an older sibling has a cancercancer or genetic condition that might be helped by cord blood transplantation.
The pediatrics group also encourages families to donate their newborn's cord blood to public banks if they have an opportunity to do so.
Public banks store cord blood to be made available for use by anyone who needs it.
Only a handful of hospitals across the nation currently allow cord blood donation, but this may soon change, says pediatrician Bertram Lubin, MD
Recently enacted federal legislation is encouraging more hospitals to institute programs to allow cord blood donation for public use.
Cord blood stem cell transplantation from unrelated donors has been proven useful in the treatment of a variety of pediatric diseases, including cancers and genetic illnesses. There is also promising research suggesting cord blood could help treat adult disease.
"Combined cord blood from different donors looks very promising as an alternative treatment for adults," says Lubin, president of Children's Hospital Oakland Research Institute, in California.
Disclose Financial Gains
The new AAP cord blood banking recommendations, which Lubin and Shearer helped write, call on doctors and others who promote private, for-profit cord blood banking to disclose any financial gains they derive from the procedure to patients.
Prospective parents who are encouraged by their doctor or anyone else to pay for directed cord blood banking should ask about financial conflicts of interest, Shearer says.
"It is an unfortunate truth in medicine today that financial considerations play an increasingly important role," he says. "That is why patients have to educate themselves."
Lubin says parents who still want to bank their baby's cord blood for the baby's own future use should be very careful about which company they choose.
"I talk to parents who tell me they understand the AAP's position on blood banking, but they say, 'I can afford it, so I am going to do it,'" Lubin says. "I say, 'Fine, but be sure to find a place that does a good job.'"
SOURCES: AAP Policy Statement: "Cord Blood Banking for Potential Future Transplantation." Pediatrics, January 2007, vol 119: pp 165-170. Bertram Lubin, MD, FAAP, president, Children's Hospital Oakland Research Institute, Oakland, Calif. William T. Shearer, MD, FAAP, professor of pediatrics and immunology, Baylor College of Medicine; chief of allergy and immunology service, Texas Children's Hospital, Houston, Texas.