After a baby is born, blood left in the umbilical cord and placenta contains stem cells that can make new blood cells. These cells can be used in transplants to treat some blood cancers, blood disorders and immune diseases. Parents are often offered the chance to store their baby's cord blood, either in a public bank for anyone who needs it, or in a private bank for their own family.
Why cord blood is useful
The American College of Obstetricians and Gynecologists (ACOG) explains that stem cells from cord blood can be given to more people than those from bone marrow, because more matches are possible [3]. Cord blood stem cells are also less likely to cause rejection [3].
Public vs private banking
- Public banks collect donated cord blood, test it and list it on registries so any matching patient can use it. Donation is usually free.
- Private banks store cord blood for the family's own possible use, for a fee and yearly storage charges.
What doctors recommend
ACOG's 2019 opinion states that routine private cord blood banking is not supported by available evidence, and that public banking is the recommended way to obtain cord blood [1]. It stresses the importance of donations from all ethnic and racial groups to public banks [1]. An earlier ACOG opinion said routine storage as "biologic insurance" against future disease is not recommended [2].
Private banking may make sense when a full sibling has a condition that could be treated with a cord blood transplant.
Why private use is rare
- For many genetic diseases, a child's own cord blood carries the same problem, so it cannot be used.
- For many cancers, doctors prefer donor cells.
- The chance that a child will ever need their own cord blood is low.
- Some stored units may be too small for an adult transplant.
Why diversity matters
Patients are most likely to find a match among donors of similar ancestry. People from some ethnic groups have a harder time finding matches on registries. More public donations from diverse families help close this gap [1].
Cord clamping
Delaying the clamping of the cord for a short time after birth benefits the baby, including better iron stores. Parents should ask how cord blood collection fits with delayed cord clamping at their hospital.
Questions for parents
- Does my hospital work with a public cord blood bank?
- Is there a family medical reason to consider private banking?
- What are the full costs, including yearly storage?
- Will collection affect when the cord is clamped?
- What happens to the unit if the bank closes?
Research uses
Researchers are studying cord blood and cord tissue for other uses, such as brain injury and autism. These uses are experimental. Parents should be wary of private banks that market unproven future uses.
Key numbers at a glance
- ACOG 2019: routine private banking is not supported by evidence.
- Public banking is the recommended way to obtain cord blood.
- Cord blood allows more matches than bone marrow.
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How donation works
- Parents agree to donate before or during labour, if their hospital works with a public bank.
- After the baby is born and the cord is clamped and cut, blood is collected from the cord and placenta. This does not hurt the baby or mother.
- The unit is tested, processed and frozen.
- It is listed on a registry so matching patients can find it.
Not every donated unit can be stored. Small units may be used for research or training instead.
Who can be treated
Cord blood transplants are used for some leukaemias and lymphomas, inherited blood disorders such as sickle cell disease and thalassaemia, and some immune and metabolic disorders. Doctors choose between cord blood, bone marrow and other stem cell sources based on the patient's needs and available matches.
Costs of private banking
Private banks charge a collection fee and yearly storage fees, which add up over many years. Parents should ask what happens to their unit if the company closes, how it is stored and tested, and whether it can be donated later.
Cord tissue and other services
Some private banks also offer to store cord tissue or placenta cells. Their medical uses are still being researched and are not standard care. Parents should ask for clear evidence before paying for these extras.
In short
For most families, public donation is the best use of cord blood. It can help a stranger in need today.
What this means
Cord blood saves lives through public banks and transplants. For most families, donating to a public bank does more good than paying for private storage. Private banking is best reserved for families with a known medical need.
Where to read more
All figures in this article come from public sources listed below. For more detail, start with ACOG's committee opinions and patient FAQ on cord blood banking. Each is free to read online. If anything here raises a question about your own health, take this article to your doctor or pharmacist and talk it through together. Buyers, investors and policy makers can also use these sources to check claims in sales materials and compare options on the same public evidence. Where public sources disagree or update their figures, we note the date of each number so readers can see how the picture changes over time. Readers who spot an error or a newer source are welcome to contact our team, and we will review it.
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- Get a free sample report or talk to our team
Sources
- ACOG Committee Opinion No. 771: Umbilical cord blood banking (2019)
- ACOG Committee Opinion No. 648: Umbilical cord blood banking (2015)
- ACOG patient FAQ: Cord blood banking
Banner image: Baby care, Newborn baby girl, Moscow, Russia by Vyacheslav Argenberg, CC BY 4.0, via Wikimedia Commons.
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