Welcome to Decision Digest, where we summarize important issues that expectant and new parents face. This time, we take a closer look at private cord blood banking and cloth versus disposable diapers. We've also provided an extensive list of resources so that parents can do additional research on each topic, if desired.
Private cord blood banking.
Why Choose It?
- Peace of mind -- a kind of "biological insurance."
- Stem cells have been used to treat certain types of leukemia and other cancers, anemias, and blood and immune disorders.
- With continuing medical research, the list of conditions that may be treatable with cord blood stem cells is growing and may eventually include other cancers, heart disease, brain damage, spinal cord injury, diabetes, multiple sclerosis, stroke, muscular dystrophy, Alzheimer's, Parkinson's and more.
- Banking ensures the immediate availability of a perfectly matched sample. According to the Journal of the American Medical Association, 10,000 to 15,000 Americans each year who need a stem cell transplant are unable to a find suitable donor.
- Cord blood stem cells are easier to match for family members than bone marrow stem cells, which increases the chances the cord blood cells will be used by someone in the family.
- Survival rates double when patients are treated with their own or a family member's cord blood rather than an unrelated donor sample.
- Patients who receive stem cell transplants from cord blood have a smaller chance of rejection than those who receive them from bone marrow.
- If your children have a multiracial or non-Caucasian background, it may be difficult to find any other matching stem cell source.
- The collection process is simple, painless and quick, and doesn't interfere with labor, delivery or bonding.
- Expensive -- roughly $1,000 at delivery and $100 per year thereafter.
- Both the American Academy of Pediatrics and the National Marrow Donor Program recommend private banking only if there is a family member with a current or potential need for a stem cell transplant.
- Although the list of diseases that can be treated with cord blood stem cells is growing, current applications are still very rare, especially in children.
- Amount of stem cells collected may not be enough to treat an older child or adult.
- Stem cells are also available from one's own blood marrow or from a matching donor.
- Additional paperwork, health history and blood tests required for mother.
- Potential for fraud exists since you don't actually see your sample and will likely never request it.
- Time and research involved in selecting which private bank to use for storage.
- Medical staff should be aware that clamping the cord too soon after birth in an attempt to maximize the banked blood volume is not recommended and may pose a risk to baby.
Alternative: philanthropic cord blood donation:
- Both the American Academy of Pediatrics and the National Marrow Donor Program encourage philanthropic cord blood donation.
- Save a life: Donation makes your baby's cord blood available to anyone in need.
- In some cases, directed donations are possible.
- More hospitals and blood banks are accepting cord blood donations, including Swedish Medical Center and Overlake Hospital.
- Same easy collection process.
- No cost to parents.
Why Choose Cloth?
- Easier for caregivers to detect wetness to ensure baby is getting enough milk.
- No exposure to chemicals. Disposable diapers contain sodium polyacrylate, which becomes a gel-like substance when wet and can cause skin irritations and severe allergic reactions including vomiting, staph infections and fever. In addition, a 1999 study found that mice exposed to various brands of clean disposable diapers experienced asthma-like symptoms, as well as eye, nose and throat irritation, while exposure to cloth diapers did not cause the symptoms.
- Some children have sensitivity to certain brands of disposable diapers, which can cause diaper rash and discomfort.
- No potential fertility issues for boys. A 2000 German study concluded that boys who wear disposable diapers maintain a higher scrotal temperature than boys wearing cloth diapers, which may pose fertility issues later in life.
- Earlier potty training -- as much as five months to a year -- because baby can feel wetness.
- No impact on landfill. Disposables are the third largest single consumer item in landfills, making up about 4 percent of all solid waste.
- No public health risks from human sewage ending up in solid waste system.
- No trees consumed for production of fibrous wood pulp filler.
- More affordable than disposables.
- Can be used for more than one child.
- Alternative: Diaper service
- More convenient: no rinsing, soaking or laundering at home.
- Better sanitation processes available than can be provided at home.
- No diapers to buy; rent the exact size and quantity you need per month.
- More efficient, using less water per diaper than laundering at home.
- Supports the local economy since most are locally owned and operated.
Why Choose Disposable?
- Convenience: no extra laundry, can be purchased anywhere, no dirty diapers to carry with you.
- Ease of use: one-piece designs, familiar to all child-care providers, fewer leaks.
- Possible to change baby less frequently due to the super-absorbency, although not recommended.
- Generally, babies have less frequent and less severe diaper rashes with super-absorbent disposables.
- No water pollution from detergents used to launder cloth diapers.
Alternative: "Green" disposable diapers (Brands include Seventh Generation, Nature Boy and Girl, Tender Care)
- Often contain fewer potentially harmful chemicals such as bleach.
- Made from more biodegradable materials, although scientists theorize that they still will not break down in typical landfill conditions.
- "Cord Blood Banking for Potential Future Transplantation: Subject Review," Pediatrics, http://pediatrics.aappublications.org/cgi/content/full/104/1/116
- "Banking Your Baby's Cord Blood - A Serious Option for Pregnant Parents to Consider," Robert Sears, M.D., www.askdrsears.com/html/1/t012700.asp
- "A Parent's Guide to Cord Blood Banks," www.parentsguidecordblood.com
- Puget Sound Blood Center Cord Blood Program, www.psbc.org/cordblood
- "The Diaper Debate: Are Disposables as Green as Cloth?" Amanda Onion, ABC News: http://abcnews.go.com/Technology/story?id=789465&page=1
- "Quiz: Cloth or Disposables?" excerpted from Gentle Baby Care, Elizabeth Pantley, www.naturalfamilyonline.com/5-diap/47-cloth-or-disposables.htm
- "The Virtues of Cloth - Compare for Yourself" - Diapering Decisions Web site: www.diaperingdecisions.com/VirtuesOfCloth.htm
- "Why Use Cloth?" National Association of Diaper Services, www.diapernet.org/whycloth.htm
- Baby Diaper Service, www.seattlediaper.com
Laurie Thompson is a Bellevue-based freelance writer and mother of two.