Cord blood banking sounds like a great idea — until you realize what it costs babies

If her social media accounts are any indication, model, cookbook author, television personality, and entrepreneur Chrissy Teigen is a wonderful mother. Many parents regard her as a role model.

That’s why I found it disappointing to learn that Teigen is a spokesperson for the Cord Blood Registry, which advocates for the collection of umbilical cord blood at birth for future use. Unfortunately, early cord clamping, essential for successful cord-blood banking, can do genuine harm to newborn babies in the name of protecting their health.

Yes, stem cells collected from the baby’s blood have remarkable healing and regenerative powers. They can turn into many other types of cells and help treat diseases from anemia to cancer. But research, including my own, shows that these same properties are even more important to the newborn baby in transitioning to life outside the womb. Instead of saving them for a potential future emergency, babies will benefit more from using them immediately.

Interest in cord blood began in 1988, when a 5-year-old boy suffering a rare genetic disease was successfully treated with cord blood from his newborn sister. This extraordinary result gave birth to an industry that is projected to exceed $4.5 billion by 2030.

But what the advocates don’t talk about is the harm that can result from the baby not receiving most of its own stem-cell-rich blood. At the time of birth, the placenta does not contain “extra” blood. The fetus has been circulating its blood through the placenta where all its life functions are performed. This allows its organs to just develop and grow. Immediately after birth, as the baby’s organs begin to function on their own for the first time, they need that blood.

Delaying cord clamping reduces death of preterm infants by 32% as reported by two studies published in the journal Lancet that analyzed individual data from more than 6,000 preterm infants (including some of my studies). They also reported that a two-minute delay in cord clamping was most effective. At age 4, babies who were born at term and whose cord clamping was delayed by three minutes showed notably better social and motor skills. Delayed cord clamping allows infants to receive oxygenated blood while beginning to take in air for those first few critical minutes of life. As the cord continues to pulsate, the baby is placed on the mother’s body — the all-important “skin to skin” contact, providing warmth, comfort, and better adaptation.

Delayed cord clamping works by improving circulation and hemodynamics (the way blood flows through the heart and body). A delay in the cord clamping can give the baby as much as a one-third more blood volume, 50% more red blood cells, and millions more stem cells. The red blood cells have special hemoglobin that provides the infant with additional oxygen-carrying capacity and iron stores. The stem cells provide the foundation for the baby’s immune system, likely reducing their susceptibility to disease both in infancy and later in life. A shortage of these immune cells can lead to asthma, allergies, autoimmune disorders, and cancer. Finally, cord blood contains many other critical components such as hormones, cytokines, and growth factors, which protect the baby’s brain and support transition to life outside mother’s body.

If this blood is harvested, such as for cord blood banking, everything except the stem cells is discarded and unavailable to the baby at the exact time its body is primed to receive them. The contention that the baby does not need this blood is plainly misguided.

For much of the 20th century, the accepted protocol called for clamping the umbilical cord immediately and discarding it along with the placenta. When I became a certified nurse-midwife in 1974, inspired by the work of French obstetrician Frederick Leboyer, I began advocating for a gentle transition for the newborn. I would put the baby on its mother’s abdomen and allow the cord to remain attached until it stopped pulsating and the placenta was ready to deliver.

While viewed as radical protocol by the medical establishment at the time, this was hardly a new idea. Charles Darwin’s grandfather, scientist Erasmus Darwin, wrote more than two centuries ago, “Another thing very injurious to the child is the tying and cutting of the navel string too soon, which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be.” In this, he was echoing wisdom midwives and women had passed down for millennia. My colleagues and I noticed the same thing: Delaying the clamping of the umbilical cord resulted in calmer infants who cried less and had more success at breastfeeding.

It makes sense: The umbilical cord blood is part of the blood that has been circulating through the placenta to provide the baby with oxygen and nutrients while in the womb. It is not “extra blood” but part of the fetal/newborn blood volume. The more of that blood that makes its way into the newborn baby’s body, the better.

After 30 years practicing as a nurse-midwife, I began my studies on delayed cord clamping to understand what I and other midwives witnessed. In 2006, we published the results of a randomized controlled trial comparing a brief delay in cord clamping with immediate clamping. Preterm infants who had delayed cord clamping of only 30-45 seconds and were held gently had less bleeding in their brains and fewer infections. These results sparked interest and stimulated research around the world that has contributed to delayed cord clamping becoming the standard of practice endorsed by most neonatal, obstetric, and midwifery organizations worldwide.

Today companies such as Cord Blood Registry acknowledge in their materials that some parents prefer delayed cord clamping. Their website makes the dubious claim that it’s possible to have the “best of both worlds” by waiting 30 to 60 seconds to clamp the cord before collection (as is recommended by the American College of Obstetricians and Gynecologists). My experience and research suggest otherwise. Waiting longer than 60 seconds to clamp the umbilical cord reduces the stem cells available for collection by a factor of 10. So, where do they go? Into the newborn, of course, where they are needed. But that’s still not enough time — it’s best to wait until the cord is white and all of the blood is in the baby.

In very rare cases, such cells can be used to save a loved one’s life. But in most instances, stem cells belong within the newborn. I encourage interested parents to discuss delayed cord clamping with their obstetrical provider during prenatal visits and to add it to their birth plan.

Immediate cord clamping was the norm in this country for decades, and many babies grew up happy and healthy. I have no reason to doubt the same is true of Chrissy Teigen and John Legend’s adorable son, Wren. But Teigen does her fans a disservice by claiming cord blood banking is a simple decision, a “gift for today and tomorrow,” as she claims on the Cord Blood Registry website.

If there’s a silver lining to Teigen’s advocacy and the aggressive marketing of the cord blood banking industry, it’s that more parents and medical professionals have become aware that the umbilical cord and placenta are not just medical waste, a byproduct of pregnancy. Rather, they contain precious life-giving substances. The question facing expectant parents is whether to allow babies to keep them.

Judith S. Mercer, Ph.D., FACNM, is professor emerita of nursing at the University of Rhode Island; adjunct professor of pediatrics, Alpert School of Medicine, Brown University; consultant, Neonatal Research Institute at Sharp Mary Birch Hospital in San Diego; and most recently was a co-investigator on the “Milking in Non-Vigorous Infants (MINVI)” an international, multicenter, cluster randomized crossover trial which showed that babies who were non-vigorous at birth benefited from milking of the cord.