Hacker News Reader

Comment by jorpal | Hacker News Reader

My wife is 33 weeks pregnant with our first. We plan to donate our baby’s cord blood to research. Cool to think it could help researchers develop treatments like this in some small way!

View on HN

In a perfect world, I think everyone has access to their own stem cells as opposed to sifting thru donor pool.

Donating is definitely awesome, but there's a lot of research surrounding how cord blood transplantation from related donors (or yourself) increases your chance of survival from a stem cell transplant vs. using an unrelated donor. https://www.nejm.org/doi/full/10.1056/nejm199708073370602 - there's a chance of rejection. This woman found a partial match, but she was lucky. I assume she's only 2 races or a common mix i.e. half white, half something else

Finding a match later on can also be much more expensive than keeping your own!

How can you store your own?

with companies like mine haha AnjaHealth.com - we send parents a kit, they can collect, we pick it up and bring it to a lab, and parents can access it later in life

I've done this with my wisdom teeth when they needed to come out. I used this company: ndpl.net. There were a few competitors but it's been years since I looked into it. My stem cells are sitting in a lab, frozen, awaiting my command to send them anywhere in the world for medical treatment.

I still have some wisdom teeth way up and back. They were too far back to conveniently remove. Do they still have fetal stem-cells in them that can be harvested, if need be?

Yes. As long as the pulp of the tooth is healthy.

From what I've read, there's a tradeoff with time prior to removal however. The earlier in your life you take them out and freeze them, the higher their regeneration factor is. The DPSC (Dental Pulp Stem Cells) should always be there as long as the tooth is alive.

We're expecting a baby, and in hospital waiting rooms we've been approached by a few different companies hawking cord-blood storage (in Singapore).

After some brief research I concluded it was probably a waste of money for us as donors, but it's probably valuable to donate for someone else. I haven't yet asked our obstetrician whether that's an option.

In this case, the cord blood had a genetic mutation that conferred HIV immunity, so I think it's only thanks to the donor pool this was possible.

It's better to donate to a public bank. According to the AAP the child itself is almost certainly not going to be able to benefit from their own stem cells because whatever disease you're trying to treat them for is most likely already present in the stem cells. It can be used to treat siblings though. But overall the advice is to donate to a public bank unless you already have a child with a medical condition in your family that could benefit from cord blood from their sibling.

http://pediatrics.aappublications.org/content/pediatrics/119...

It's very healthy for your baby to delay cord clamping as long as possible

Thanks for the tip! At our hospital the standard of care is delayed cord clamping, although it sounds like they wait only a few minutes, not 15+ minutes. It used to be done in ~<1 minute, I guess, so a few minutes is called delayed now. Do you have a good reference recommending to wait “long as possible”?

Wait until all the blood has passed through and the cord is white. Baby will likely be a little jaundiced but if you clamp too early they will have low blood levels. Don't let the hospital staff rush you (they will try). Best to let nature run its course IMO.

Good luck to you and your partner.

Write a birth plan, make the doctor or hospital staff read it and confirm with them they read it. We had told the doctor we wanted delayed cord clamping (not the habit in hk), he acknowledged it despite warning us about jaundice (he was old fashioned). Then during the actual delivery, he completely forgot about it and both of us were too sleep deprived to force the issue.

This is why having a doula is so valuable. She had a clear head and advocated for us. I caught the baby and never would have asked. But the doula knew the correct time to remind the doctor.

Here is more data on delay in cord clamping.

https://www.acog.org/clinical/clinical-guidance/committee-op...

because the placenta continues to perform gas exchange after delivery, sick and preterm infants are likely to benefit most from additional blood volume derived from continued placental transfusion.

there isn't any evidence that delaying cord clamping for longer than 60 seconds gives the baby more benefits than delaying cord clamping for 30-60 seconds

I feel like someone whose business is freezing cord blood should probably cite some sources when discussing guidelines for delayed cord clamping, which reduces the amount of blood left in the umbilical cord. Honestly, I don't know much about it and you could very well be right, but it seems like a conflict of interest.

Check out the question “ How long should you delay cord clamping?” At

https://health.clevelandclinic.org/what-you-should-know-abou...

Thanks for the reference! Glad to see I was just being overly cynical.

Also we don’t dislike delayed cord clamping - our parents delay for max two mins! :)

> It's very healthy for your baby to delay cord clamping as long as possible

Just wanted to echo, this is really, really, important.

So, ignorant question here, but isn't the cord blood supposed to go into the baby?

According to the small pamphlet I got, there's a small benefit to the baby's immune system if the cord isn't cut immediately and some of the blood in there is allowed to pump into the baby.

Did you consider freezing for future use?

I know some people keep the cord blood in a private bank. In my opinion it only makes sense if you have family history of or current relative with a disease that could be treated with it.

Since the hospital we are using (Stanford LPCH) has a research program that will come collect it with no extra steps on our side, it seemed like a good choice.

Cord blood is a good source of "your own" stem cells. We do not know what is going to be possible with such cells 20 or 30 years from now; possibly unimaginable things. I would save them if I had a child. Just in case.

Do you happen to know what's the maximum storage time? I remember reading that it was about 10 years only?

we did it. It depends on the freezer. at -80C they say it's for a lifetime with a caveat that the technology is only 23 years old so none can prove it's for a lifetime, yet

If few other people save it, then nobody will develop treatments using it, since a treatment is only developed if it makes financial sense, and if <1% of potential patients for a treatment have cord blood banked, then a treatment that requires their personal cord blood will never be developed.

There are many companies doing this now and many (affluent) parents are saving it. I think your analysis misses the mark, even if there's a niche market, if it's comprised of people willing to spend lots of money, it can make sense as a business.

There are state led efforts to bank cord blood as well b/c of it's usefulness in some medical treatments and research.

https://sd25.senate.ca.gov/news/2017-06-26/california-umbili...

Unfortunately, public donations are only an option in some locations.

https://health.ucdavis.edu/cord-blood/locations

I get that it is very tempting. We all want to do anything that could help our kids. However, there are also an endless number of things people are selling to new parents that prey on that reflex. I truly don’t know the right thing to do here, but the position I mentioned earlier basically follows the recommendations from the American Academy of Pediatrics: https://publications.aap.org/pediatrics/article/140/5/e20172...

This was from 2017 and is basically the same as a reference I found from 2007. Has there been any actual changes in the state of the art since it was published?

Realistically speaking I think any breakthroughs that could make use of these stem cells could also create them.

apparently the founder of Anja Health said that she launched it after her sibling almost drowned and needed it, so maybe it make sense even without a predisposition?

If I had a kid and enough disposable income I'd do it without even thinking about it to be honest

hello! founder of Anja Health here :)

Yes, it makes sense without a predisposition. Things like HIV with the woman cited in the article, cerebral palsy due to a near drowning accident, etc. could all be use cases. Our own team has a sales exec who used stem cells for a knee injury he got in track & field in high school. Another has a grandfather who used it for dementia.

BTW, a lot of our clients self identify as having <75k in income. Our pricing is 35-85/mo. for 8 years to cover 20 years of storage. :D so hopefully you don't need to allocate too much disposable income. It's still an investment for sure, but many think it's worth it. Myself included obviously haha

Make sure they don’t forget! In the chaos after birth, sometimes these things slip through. I’m not sure what happened when our first was born, but I do remember the folks who came by a bit later to pick up the cord being annoyed that the delivery team didn’t save it.

The umbilical cord blood storage industry is under-regulated and untrustworthy, much like another freezing-related industry, cryonics. Both are full of examples of amateurs, bad actors, and mundane issues like bankruptcy resulting in things that were promised to be kept frozen for decades or centuries ending up in waste disposal after 5 years. Like this example from Canada:

https://www.cbc.ca/news/canada/toronto/cord-blood-bank-of-ca...

Also, from the same article, does anyone has more information on this:

> there's a very low probability that someone's own stem cells can be used to treat them, according to Health Canada.

There was a YC startup on here attempting to do this... here we go: https://anjahealth.com

I don't expect much in terms of longevity from any startup.

“It’s been said that a person dies twice, once when the body dies & once when their name is last spoken. There’s also a third time, when the company storing your frozen corpse can’t pay the power bill.”

I think freezing for future use is the best way to go. A few reasons: 1) cord blood transplants from related donors have higher survival rates than unrelated donors https://www.nejm.org/doi/full/10.1056/nejm199708073370602 2) this woman was lucky that she was able to find a partial match, but many don't. The combination of using a related blood donor + an unrelated cord blood donor was a lucky strike. I think for many very mixed race folks or especially people of color (specifically Black communities), they may not be so lucky 3) the cost of finding a donor can be extremely steep. Some may be covered by insurance, but not all of it will be. My guess is this woman who was cured from HIV is relatively affluent to some degree. Banking cord blood is considered to be for affluent folks, but the difference in cost of banking vs. finding a donor later on is massive

Reply on news.ycombinator.com