This original article was posted on Baby Proofed Parents and written by Kirsten Brunner, MA, LPC.
"Twelve years ago when I had my first baby, cord blood banking was a fairly new concept. My husband and I had heard that it was a beneficial thing to do, but we felt overwhelmed by all of the decisions we had to make. Consequently, we skipped over learning more about options for banking our son’s cord blood. When Americord approached me this year about partnering on a Wednesday Wisdom to help educate and inform expectant parents about the in’s and out’s of cord blood banking, I was genuinely excited. After 12 years of being in the dark on this subject, I figured it was time for me to get educated!
Meet Martin Smithmyer. He is the President of Americord Registry, a pioneer in cord blood and placenta stem cell preservation. Martin has an impressive resume. Among the many roles he has held, he used to be Vice President of Healthcare Investment Banking at BMO Capital Markets and Head of Healthcare Technology Investment Banking. Martin held similar positions at Wells Fargo Securities, American Capital and NewMarket. He received an MBA from American University and graduated from the University of Maryland, Baltimore County with a degree in Biology. It was the birth of his daughter 10 years ago, and the experience of banking her cord blood, that motivated Martin to launch Americord and push for more innovation in the burgeoning industry of stem cell preservation. Martin lives with his wife and three children in the financial district of NYC. I was thrilled to pick his brain and learn about this important topic for expectant couples.
KB: Since many people find the subject of cord blood banking to be intimidating and confusing (including myself!), I would like to start with the basics. Can you share about the potential benefits of cord blood banking and the reasons to do it?
MS: Cord Blood stem cells have been used to successfully treat more than 80 diseases. Some of the best-known examples are treatments for blood cancers like leukemia and lymphoma, which have traditionally been treated with bone marrow. Umbilical cord blood stem cells offer several advantages over bone marrow treatments – they require a less perfect genetic match, lower the risks of infection, and reduce rejection rates.
Expectant parents have a unique opportunity to have cord blood stem cells collected, processed, and stored when their child is born.
Beyond cord blood, there are many medical reasons a family may also choose to bank baby’s cord tissue or mom’s placental tissue. These stem cells are less known by the general public but are equally exciting. They have the ability to develop into a range of tissues including skin, cartilage, bone, and muscle. What makes these stem cells intriguing is that they have the ability to multiply and can repeatedly be used. They are currently being studied by medical researchers working to discover treatments for diseases such as Alzheimer’s, diabetes, and cerebral palsy.
KB: How does cord blood banking work? Please give us the technical (and/or gory!) details of how your company collects the cells.
MS: I’ll try not to get too gory, but once an expectant family signs up with Americord, they are sent a collection kit. The collection kit is taken to the hospital when it’s time for baby to be born and is given to the doctor who will do the collection after birth.
After baby is delivered and the cord is clamped and cut, the blood is collected by inserting a needle into a clean area of the umbilical cord. After the blood is collected, the doctor clamps the cord near the placenta and cuts a segment for tissue processing. Lastly, the placenta is packaged in its entirety.
The whole process takes about 5-10 minutes and is completely safe for mom and baby. When all products are placed back into the kit, it is then sealed, and the family calls our medical courier to pick it up and take it to the lab. After the lab processes the cord blood, it can determine the stem cell count and determine if the cells are viable.
KB: Is the cord blood kept in a real bank? Where is it? How do parents know it will be kept secure and safe for decades to come?
MS: Cord blood banks store stem cells in specially designed laboratories with cryogenic tanks that maintain a temperature of -190 degrees celsius. Because it’s important to process stem cells quickly, our bank is strategically located near transportation hubs.
Parents, as they should, frequently ask about the “what if” scenarios. We address the “what if” scenarios through our contingency plans. All cord blood banks are required by the FDA to have a disaster plan including backup generators, fire suppressants, and evacuation strategies.
KB: Delayed cord clamping and cutting seem to be a growing trend advocated for by many birth professionals. Does cord banking still work with delayed cord clamping?
MS: Yes it does. It is a common misconception that the two are mutually exclusive. The Word Health Organization recommends delaying cord clamping for anywhere between 1.5 – 3 minutes. After that time there is little if any added benefit to the baby. At that point, the doctor can proceed to perform the cord blood collection. There should still be an ample amount of blood left in the umbilical cord to collect.
KB: Stem cells have become a controversial and provocative topic in the media over the last few decades. Can you explain what exactly stem cells are and speak directly to the controversy surrounding them?
MS: There are many types of stem cells including embryonic and newborn stem cells. The embryonic ones are the most controversial because they involve the development, use, and destruction of human embryos. We do not deal with those. Instead, we collect, preserve, and store hematopoietic and mesenchymal stem cells from newborns, which would otherwise be discarded as medical waste.
KB: Can you share a success story of how cord-banked cells have been used to benefit a family?
MS: In 2015, we were involved with a transplant for a young girl with childhood apraxia syndrome, a motor speech disorder. The family first considered banking her cord blood to treat their older son who had the same disorder. However, when they learned their daughter also had childhood apraxia syndrome, they decided the stem cells should go to her. The transplant took about 10 minutes, and within three weeks her speech improved.
Of course, we can never guarantee a successful outcome in any particular case, but this story shows the real potential benefits of cord blood.
KB: What if a family decides later on that they no longer want to bank their child’s cord blood. Is there a process for withdrawing?
MS: Our service includes 20 years of storage, but if a family wishes to use or relocate their stem cells, we assist with the process.
KB: What are the percentages of new parents who are opting for this service? How have these numbers been growing, and what do you attribute this growth to?
MS: Today, around 4-5% of parents are saving newborn stem cells. In metropolitan areas, such as New York City, we believe the rate to be closer to 10%. The industry has grown substantially in the past 20 years, fueled by FDA clearance for therapeutic applications for disorders like leukemia and sickle cell anemia. Media coverage of medical research using umbilical cord and placental stem cells has also brought attention to the industry.
KB: Can cord blood be collected from a birth center (operated by midwives) or a home birth?
MS: A phlebotomist must be present at birth to collect both umbilical cord and maternal blood. Midwives are trained in these skills and can perform cord blood collections. Our collection kit includes step-by-step instructions on everything from collecting the samples to packaging them for shipping. Midwives should not be confused with doulas, who do not usually have medical training and typically would not perform a cord blood collection.
KB: On a personal note, how and why did you decide to launch this company?
MS: We stored my daughter’s stem cells with another company in 2007. At the time, it was one of the only private cord blood banking companies. Through the process, I realized that the industry was not doing much to advance the technology they had. Being familiar with biotech companies and stem cells, I knew other companies, not private cord blood banking companies, that were conducting really advanced research into stem cells. I thought it was a shame that private cord blood banking companies were not taking advantage of the fact that these readily available stem cells were not being used in more therapeutic applications. I started this company because I, among other things, wanted to help advance the research and development.
We made innovation one of our core values at Americord. Through the years, we have innovated by diversifying our product line. For example, in 2012, we began placental tissue banking. Americord is still one of the only companies that collects, preserves, and stores placental tissue.
KB: I’ve noticed that Americord is more affordable than other services. How have you been able to keep the price down and why should a couple choose Americord over other registries?
MS: We are an efficient and lean operation. In the beginning, we kept costs down by not hiring a nationwide sales force to go out and influence doctors, similar to a pharmaceutical sales force. That was one of the strategies that our largest competitors did. For example, one of our competitors was spending 75% of their revenue on this doctor marketing channel. We thought if we created a great product, parents would tell each other and their doctors, helping us grow organically. We are always conscious of the channels we grow through and leverage technology and innovation as much as possible.
Expectant families should choose Americord because we are committed to collecting stem cells using the very best practices from A to Z. For example, when we launched the company, we had the option to go with several different collection bag systems. Most were far cheaper than the bag we ended up choosing. It was a substantial cost at a time when we did not have a lot of money to invest, but it was the best product for our customers. The system we chose was the Pall Collection Set, which is sterile on both the outside and inside. This seems like a small issue, but if the collection bag is not sterile on the outside, then you do not have the option to use it in the OR during C-sections, which account for roughly ⅓ of births in the United States.
We also have some strict guidelines for expedited shipping. We tried from the beginning to get all these decisions right, from temperature testing to logistics and we’ve continued to improve because the only way to do right by our customers is to do everything in the best possible way. Most importantly, best practices lead to better collection yields, higher volumes, and better outcomes for patients.
KB: What should couples do next if they want to sign up for cord blood banking?
MS: They can visit our website at americordblood.com and sign up to get more information. Our comprehensive Info Guide walks expecting families through the process and helps them decide if cord blood banking is right for them.
Thanks so much to Martin and Americord for partnering with Baby Proofed Parents on this Wednesday Wisdom post. I definitely feel more informed, and excited, about stem cell preservation and the future possibilities! – Kirsten"
About Kirsten Brunner
Kirsten Brunner, MA, LPC lives in Austin, Texas with her husband, two sons, a dog and a hermit crab. She has been actively providing therapy and life coaching for 18 years, first in a corporate setting and now in a private practice. Kirsten is a regular contributor to Huffington Post, Scary Mommy and TODAY Parents. Her writing has also been featured on Mamalode and Real Simple Magazine. She works with clients, in person and over Skype, on a wide variety of issues, but has enjoyed becoming a Reproductive & Perinatal Mental Health Specialist in recent years.