Louisiana has state legislation around cord blood education that follows the Institute of Medicine guidelines and mandates/encourages physicians to educate expectant parents about ALL forms of cord blood banking. The Louisiana bill was enacted 12 June 2008 and became effective 15 Aug. 2008.
- Why is it important to ship cord blood with a special courier?
The Parent's Guide to Cord Blood Foundation recommends shipping with a courier that has a division specializing in "Life Sciences" transport. This helps to insure that your critical shipment is not misplaced, arrives promptly, and is maintained within the acceptable temperature range during transport from the hospital to the lab.
The first priority for parents to consider is the cord blood shipping time: Once the cord blood is harvested, the blood cells and stem cells gradually begin to die. Public cord blood banks set a limit of 48 hours on the time between birth and processing the blood for cryogenic storage. It would be a "best practice" if family banks also followed the 48 hour window.
The second priority for parents to consider is the cord blood shipping temperature: The standard procedure for transporting fresh cord blood is to keep it within an ambient temperature range of 15 °C (59 °F) to 25 °C (77 °F). Priority shipping services may guarantee the arrival time, but not the temperature conditions during transit. The cord blood might get too hot or too cold while sitting in the back of a truck, on a loading dock, or in the cargo hold of an airplane. A specialty courier with Life Sciences expertise will carry the cord blood in a controlled environment.
Parents can improve the survival of their child's cells during transit to the cord blood laboratory by selecting a family bank that provides a well insulated shipping container and that provides a specialty courier who maintains the shipment within the desired temperature range. In many countries it is standard practice for the shipping container to have a temperature logger.
In the United States, the post 9/11 security requirements of the Transportation Security Administration (TSA) require that specialty couriers can only offer cord blood shipping through those cord blood banks that are registered with the TSA as a "Known Shipper". Before 9/11, specialty couriers could market their services directly to consumers, and in some countries this is still possible. Parents should check if a Family Bank offers specialty courier services before they sign a contract.
- What is delayed cord clamping?
Some people feel that the blood in the umbilical cord should be allowed to flow into the baby and that the cord should not be clamped while it is still pulsing. Medical studies have shown that, particularly in parts of the world with poor infant health care, delayed cord clamping can help protect the baby from anemia (low blood counts) during the first 6 months of life. However, a prolonged delay will allow the blood in the cord to clot, and the opportunity to collect the blood for stem cells will be lost. Therefore, if clamping is delayed, it should not be more than two minutes.
Hutton, EK & Hassan, ES, JAMA 2007; 297:1241-1252
van Rheenen, P et al., Tropical Med. and Internal Health 2007; 12(5):603-616
Abalos E., 2009; The World Health Organization Reproductive Health Library
- What are the most important considerations in picking a family bank?
1. Nationality - You must follow the national regulations of the country where you will give birth.
2. Travel conditions - It is best to pick a bank that can receive and process the cord blood within 48 hours of birth. It is also best for the cord blood to be shipped in a transport container that will maintain it at close to "room temperature".