Cord Blood

I was just reading a post on Midwife Thinking's Blog that does a great job of explaining why I don't go in for cord blood banking.  I know the usual reasons I've heard are that those stem cells could someday be used to treat that child's illness later on, or that they are an ethical source of stem cells to develop treatment for others.

The problem with the first reason is that the child may never have an illness where those stem cells could be helpful in treating him.  Even if he does, there's no guarantee those stem cells will create a viable treatment for him.  But it has been shown that allowing the baby to receive the full amount of his blood is beneficial.  It's possible that blood, with those stem cells, could even help prevent any potential illness for which the stem cells would later be used to treat.

That leads me to the problem with the second reason.  Is it truly ethical to deprive a newborn of his own blood in order to bank it either for his or another's future use, without his consent?  Blood that makes Vitamin K deficiency bleeding less likely, raises his iron stores, and make his transition to breathing easier.  I'm not so sure it's really ethical to do that, to be honest.

I will say that I thought about cord blood banking when I was pregnant with K.  However, the more I looked into it, the more convinced I was that delayed cord clamping was the way to go, and that means cord blood banking isn't an option.  Unfortunately they did not follow my wishes about the delayed cord clamping with K, but C received the full amount of her blood, since the cord was not cut until it stopped pulsating.

Breastfeeding and Iron

I thought I'd expand on this topic in particular, since it seems to be the basis for that study I wrote about before saying that exclusively breastfeeding for 6 months may not be a good thing.  The thing is, in their publication, they mention that infant anaemia could be avoided by increasing the mother's iron stores in pregnancy, delayed cord clamping, and supplementing high-risk infants.  From Kellymom, those who are high-risk are babies born prematurely, babies with low birth weight, babies born to mothers with poorly controlled diabetes, babies fed cow's milk during the first year, and perhaps babies whose mothers are anaemic (this last one hasn't been borne out by medical studies, though).  These are things that can be done without needing to introduce solids before the child is truly ready for them.  In fact, the iron in breast milk is more bioavailable for the infant than the iron in other foods.

It seems to me that the proper way to handle this would be to advise pregnant women to get enough iron, to make delayed cord clamping the normal practise, and to screen/supplement those infants who are at a high risk of becoming anaemic, instead of saying that babies should be given solid foods before they are developmentally ready.  Pregnant women are already screened for anaemia, so this is already a discussion women are having with their care providers.  Delayed cord clamping has been shown to increase the baby's iron stores and thus decrease the chances of anaemia.  While this isn't the norm at the moment (or at least it isn't here, as far as I know), you can talk to your care provider about doing this and the benefits of it.  I know with C my midwives had no problem with waiting for the cord to stop pulsing before cutting it (my wishes were not followed with K, unfortunately).

My conclusion: look at the other things that can be done which are beneficial to mother and baby and don't undermine breastfeeding.  Saying that solids should be introduced earlier when the mother can increase her iron intake and delayed cord clamping can be practised is a bit like closing the barn after the horses have gone.  It's not getting to the root of the solution and can, in my opinion, cause other problems, in addition to eroding women's confidence in breastfeeding.  And that is something that we definitely don't need, especially given all the obstacles, false information, and hostility with breastfeeding.