Excerpt: 'Eat, Sleep, Poop' by Scott Cohen

What's in the Fridge?— Umbilical Cord Blood Banking
Another decision you'll be confronted with prior to delivery is whether or not to bank your child's umbilical cord blood. You are going to be inundated with mailings and brochures from companies that will offer to store the cord for a "nominal" fee. One father even asked me if he could just keep his baby's umbilical cord in his own refrigerator at home. Obviously, this is not recommended, but we should discuss the reasons why you may want to bank your child's umbilical cord blood.

The idea behind cord blood banking is to keep your newborn's healthy stem cells in case they're needed later for transplantation— that is, to replace bad cells, such as cancer cells. Although this idea may seem cut and dry, there is more to the story. Cord blood bank brochures list hundreds of illnesses for which this procedure can be curative, and yet there is the slimmest of chances that you will be able to use the banked stem cells for your child. Let me explain why.

When a child develops a malignancy such as leukemia, or a rare metabolic or autoimmune disorder, doctors usually look to irradiate the bad cells and replace them with healthy new stem cells. These stem cells can be from bone marrow or cord blood. These stem cells are often acquired from an allogenec donor— that is, from another individual. It is important that the donor's stem cells are as close a match to the recipient's as possible to minimize the potentially fatal risk of the recipient rejecting the donor's cells. Since a perfect match is your best bet for a successful transplant, it makes sense to use your own stem cells. Sounds simple, right? It's not. In fact, if your child came down with an illness such as leukemia, and you had saved her cord blood, the stem cells from that cord blood likely would not be used, because, most often, the condition already existed in the infant's cord blood. So the doctor would need to look for an outside donor for the stem cell transplant.

There is the possibility that with new technological advances there will be more applications for the use of cord blood. For example, using it to generate new organs or tissues. Extensive research is currently looking into the benefits of cord blood used in this way.

At the moment, however, cord blood banking is a double-edged sword. If you bank your child's cord blood and never use it, you have wasted money but possibly gained peace of mind. If you do not bank your child's blood and could have used it, you might regret it. So how should you decide what to do?

My wife is someone who loves insurance policies. We joke that if a salesperson came to our door and offered us insurance in case of the one-in-a-million chance of being struck by lightning, she would buy it. Still, when we were pregnant we were offered cord blood banking for a much-discounted rate and chose not to do so. My wife and I reasoned that, unlike most insurance, we were not likely to be able to use it in the future. We also felt that the cord blood banking companies were preying on our fears at a vulnerable time.

So, while the chances are that your child will not be able to use her own cord blood in the future, there are a few situations in which you might consider utilizing a cord blood bank:

1. If you have a family member with a known genetic or malignant medical condition that could potentially benefit from cord blood transplantation.

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