What are cord blood testing and cord blood banking?

Cord blood is the blood left in the umbilical cord after a baby is born. The umbilical cord connects a mother to her unborn baby during pregnancy. It contains blood vessels that bring nourishment to the baby and remove waste products.

After a baby is born, the cord is clamped shut and cut. The blood that remains in the cord may be collected and used in two ways:

Cord blood testing. This means doing a variety of tests on cord blood to check the baby's health. Tests may also be done on cord blood if a health care provider is concerned that the baby may have a health condition, such as an infection or an acid-base (pH) imbalance. Some hospitals may routinely collect cord blood samples to do tests to check a baby's general health.

Cord blood banking. This means saving blood from the baby's umbilical cord in a special facility called a cord blood bank. The blood is saved so it can be used to treat certain diseases. Umbilical cord blood is full of special cells called stem cells. Stem cells can develop into many different types of cells found in the body, such as blood, brain, muscle, and organ cells.

Stem cells from cord blood can be used to treat certain blood disorders, including leukemia, Hodgkin disease, and some types of anemia. They can also be used to treat certain inherited metabolic and immune system disorders. Researchers are studying whether stem cell treatment can also help treat other types of diseases.

If you choose to save your baby's cord blood, you have two main options:

• You can donate the blood to a public cord blood bank. Cord blood in public banks may be used by anyone who needs a cord blood transplant. This treatment replaces diseased blood cells with healthy cells from cord blood. In certain cases, donated cord blood may be used for research. If you donate your baby's cord blood, there's no cost to you. But only certain hospitals can collect cord blood for storage in public cord blood banks.
• You can save the blood in a family (private) cord blood bank. This allows you to use the blood for a family member who may benefit from treatment with cord blood. You may be interested in this option if you have a family history of health conditions that can be treated with stem cells from cord blood. You will usually have to pay a fee for the blood collection and storage at a private cord blood bank. But if you or a close family member already has a disease that needs treatment with cord blood, you may qualify for free or low-cost cord blood banking.

What is cord blood testing used for?

Cord blood tests may be done after your baby is born to:

• Measure blood gases. This helps to see if a baby's blood has a healthy level of oxygen and acid-base (pH) balance.
• Measure bilirubin levels. Bilirubin is a waste product made by the liver. High bilirubin levels can cause jaundice, a condition that causes the skin and eyes to turn yellow. Jaundice is common in healthy newborns, and it usually clears up in a few weeks. But it can sometimes be a sign of liver disease, a blood disorder, or another type of condition.
• Do a blood culture test. This test may be done if a provider thinks a baby may have an infection.
• Do a complete blood count (CBC). This test measures many different parts of the blood. It may be done to check for an infection.
• Check blood glucose (sugar) levels. Blood glucose may be high if the mother has diabetes.
• Check to see if a baby was exposed to illegal drugs or certain prescription drugs that the mother may have misused during pregnancy. Umbilical cord blood testing can find many drugs, including sedatives, cocaine, and opioids such as heroin and fentanyl. If harmful drugs are found in cord blood, a provider can treat the baby to help reduce the chance of problems, such as developmental delays.

What is cord blood banking used for?

Cord blood banking is used to save cord blood so that the stem cells can be used to treat certain blood disorders and cancers.

You may want to consider donating cord blood if you want to help others. A public blood cord bank provides lifesaving stem cells to people who need treatment now.

You may want to consider family cord blood banking if:

• You have a family history of a genetic disorder or cancer that can be treated with stem cells.
• You or a family member currently has a disorder that may be treated with stem cells.

If neither of these situations applies to you, providers don't recommend saving your baby's cord blood in a family cord blood bank. There are two main reasons:

• The conditions that are currently treated with stem cells from cord blood aren't common. That means your child and other family members are unlikely to ever need the cord blood. Most cord blood that's saved in case of a future illness is never used. But as research continues, it is possible that stem cell treatment may be developed for more common diseases.
• If your child should someday need stem cell treatment for a genetic disorder or cancer, they won't be able to use their own stem cells for treatment. That's because their stem cells will have the same genes or pre-cancerous cells that caused the disease in the first place.

How is cord blood collected?

Collecting cord blood does not change anything about your birth experience. After your baby is born, the umbilical cord will be pinched closed with a clamp and cut. Then the provider will either use a needle to remove blood from the cord or let the blood drip out of the cord. The blood is collected in a special bag and sent to a lab for testing or to a cord blood bank for long-term storage.

Sometimes, the cord doesn't contain enough blood to use for cord blood banking.

Is there any preparation needed for cord blood testing or banking?

For cord blood testing, you don't need to prepare anything.

For cord blood banking, you need to plan in advance. If you're considering donating cord blood or privately banking it, talk with your provider at least three months before your baby is due. This will give you time to:

• Decide whether to donate the blood to a public bank or save it in a family cord blood bank.
• Get information about your options for collecting the blood. Not all hospitals can collect blood for public cord blood banks. If you choose to use a family cord blood bank, you'll need to select which bank to use.
• Finish paperwork about your medical history and your family health history.
• Receive a cord blood collection kit if you are using a family cord blood bank. Your provider will use this kit to collect and send the blood to the bank.

Are there any risks to cord blood testing or banking?

Cord blood testing has no risks.

With cord blood banking, the mother will need to have a blood test to check for infections to help make sure the cord blood is safe to use. There is very little risk to having a blood test. You may have slight pain or bruising where the needle was put in, but any discomfort or bruises usually go away quickly.

Some cord blood banks may require testing of the mother's blood for genetic disorders, too. If you find out you have a gene that could cause a serious disease, you or your family members may feel upset.

If you choose family cord blood banking, the costs can be very high.

What do cord blood test results mean?

Cord blood test results will depend on what was measured. If the results were not normal, ask your baby's provider to explain what they mean for your baby's health.

Learn more about laboratory tests, reference ranges, and understanding results.

For more information on cord blood testing and banking, talk with your provider.