Cord blood is the blood left in the umbilical cord after birth. It contains stem cells. These cells have the amazing ability to grow into many different kinds of cells, like bone marrow cells, blood cells, or brain cells. This can make them valuable for treating some diseases.

Diseases that can be treated with stem cell transplants include leukemia, Hodgkin's disease, and some types of anemia. When healthy stem cells are transplanted into a child who is ill, those cells can grow new bone marrow cells to replace the ones destroyed by the disease or its treatment. Stem cells from the child's own cord blood often cannot be used, because they may have led to the disease in the first place.

Much research is being done to see if stem cells can be used to treat more problems. For now, though, treatment is limited to diseases that affect blood cells.

Cord blood kept in a private bank is usually used to treat disease in a brother or sister. Cord blood stem cells are rarely used to treat adults, who normally need more stem cells than cord blood has.

The umbilical cord is usually thrown away after birth. But the blood inside the cord can be saved, or banked, for possible later use. The blood is drawn from the umbilical cord after the cord has been clamped and cut. Cord blood banks freeze the cord blood for storage.

You may save your baby's cord blood in a private bank or donate it to a public bank. Private banks charge a fee to store cord blood for your family's use. If you donate the cord blood to a public bank, the cord blood can be used by anyone who needs it.

During your pregnancy, you may get ads or brochures from private cord blood banks. Some of them suggest that parents should save the cord blood in case the baby should one day need a stem cell transplant. Be wary of banks that urge cord blood banking for this reason. It is not known how likely a child is to need a transplant of his or her own cells, but experts say the chances are very small.^{footnote 1, footnote 2}

Most transplants of cord blood stem cells use cord blood donated by others to public banks.

One reason why donations to public cord banks are so valuable is that stem cells from cord blood do not need to be as perfectly matched for a transplant as do stem cells from adult bone marrow. Stem cells from cord blood are not as mature, so the transplant patient's body is much less likely to reject them.

It costs money to store your baby's cord blood. Private banks charge about $1,000 to $2,000 to start. Then you must pay yearly storage fees for as long as the blood is stored. The storage fees cost more than $100 a year. Health plans usually do not cover these costs. Only you can decide if the cost makes sense for you and your family.

Some private blood banks will waive their fees for families who need the stem cells right away.

It is very unlikely that anyone in your family will ever need your baby's cord blood.

Doctors worry that the advertising done by private cord blood banks may make some parents feel guilty if they do not want or cannot pay to store their baby's cord blood. Pregnancy and childbirth are emotional times, so learn all you can ahead of time.

If you bank or donate your baby's cord blood, it will be tested for genetic and infectious diseases. What you learn from a genetic test can affect your life and that of your family in many ways.

• Learning that your child is likely to develop a serious disease can be scary or depressing. This information may also affect your relationships with other family members.
• If your child tests positive for a gene that will cause a disease, you may decide to use treatment, if available, to prevent the disease or to make it less severe. Although many treatments work well, others may be unproved or may even be dangerous.

Private banking: If you decide to bank your baby's cord blood, make sure that the blood bank you use follows standardized guidelines for tissue and stem cell collection and storage. Look for a bank that has tested and stored many cord blood samples and whose samples have been used successfully in transplants. Ask for a copy of the bank's policies and procedures.

Public banking: You may decide that you would like to donate your baby's cord blood. Donating makes the stem cells available to others. It does not cost anything. Unfortunately, it is not yet an option in many communities. Call the hospital where you plan to give birth to find out if you can donate cord blood there.

Your doctor might recommend privately banking your baby's umbilical cord blood if:

• You have another child who has a disease that could be treated with a stem cell transplant.