Friday, February 26, 2010

Cord Blood Storage (脐带血存储)

Should I store my baby cord blood ?

It is a very common question asked by my patients during the clinic consultation.
As cord blood storage is increasingly popular, partly due to commercial advertisement by the private cord blood banks, the parents must thoroughly understand its advantages before making any decision to subscribe to this service.

What is cord blood ?

Cord blood is the blood circulating in the umbilical cord to provide oxygen and food to the baby. Cord blood contains rich amount of stem cells. The estimated volume of cord blood for a matured baby is around 50 to 80 mls.

How the cord blood is collected, processed and stored ?

The cord blood storage in this country is operated by the 4 private companies. The patients who are interested to store their baby cord blood need to contact the private cord blood bank for the service.
Once the agreement is signed between the parents and private cord blood bank, the doctor in charge will collect the cord blood immediately after the delivery of the baby.

The container to collect and store the cord blood.

The cord blood is squeezed from the umbilical cord for collection
The cord blood will be stored in a plastic container and delivered to the cord blood bank for processing and storage.
During the proccessing stage, the cord blood is checked for any bacterial contamination, blood grouping and the amount of stem cells available.

The cord blood is frozen by liquid nitrogen for life long storage.

What is the different between private cord blood bank and public cord blood bank ?

A private cord blood bank is a profit based service where the patients store their baby cord blood for their own use.
A public cord blood bank is usually operated by the government to encourage cord blood donation to someone who need the compatible cord blood for disease treament. It means you donate your baby cord blood for someone else who needs it.

Unfortunately, the public cord blood bank is not available in Malaysia.

What type of diseases can be cured by cord blood ?

Cord blood is not a magic medicine to treat all the diseases. In fact, the numbers of diseases that can be treated by cord blood is very limited.
Until today, cord blood is only useful to treat blood related diseases, eg: Leukemia (白血病), Thalassemia (地中海贫血) , Aplastic anemia (再生障碍性贫血).
The treatment for other common diseases such as heart disease, diabetes, kidney diseases are not established.
Leukemia is not a common disease to happen. It is etimated that only 1 in 7,000 population may suffer from this disease. In other words, if 7,000 parents store the cord blood for their children future usage, only 1 of them eventually need to use it. The remaining 6,999 parents are going to waste their money.
Furthermore, leukemia and Thalassemia are the family inherited diseases. The chance of having the diseases are extremely low if there is no prior family history.

What type patients should store their baby’ cord blood?

1) Those parents with family history of inherited blood diseases , eg: Leukemia, Thalassemia

2) Those parents who have strong confidence in stemcell technology and they believe in the potential of this technology to treat more new diseases in the future.

What is the cost of storage ?

Different private cord blood bank charge different rate. Generally, the first payment is around RM 2500, followed by yearly subscription fee of RM 250 for 21 years.

What are the disadvantages of cord blood storage from medical point of view ?

1) Upon the delivery of the newborn baby, the newborn needs to expand the lung to breath. During this process, some amount of cord blood need to flow into lung vessel to assist lung expansion.
In cord blood storage, the umbilical cord will be clamped early for collection purpose. Early clamping of umbilical cord will deny the cord blood from flowing into the lung blood vessel.

2) Collection of cord blood may delay the placenta delivery by the doctor. As a result, the mother may suffer from more blood loss after the delivery.

3) Occasionally, the cord blood maybe contaminated by bacteria during the collection process.

As the educated parents, you need to make an intelligent and wise decision before spending your hard-earned money on a new technology which may not be useful in the future.

Wednesday, February 10, 2010

Safe Journey

As the Chinese New Year is coming, many of you will take the opportunity to visit your long distant relatives.

Long distant travel for the pregnant mothers is safe, but special precautions should be taken to avoid unneccessary problems to your pregnancy, especially to those who plan to travel by air flight.

Before you start your journey, make sure you take the important safety precautions as listed below:

1) Inform your obstetrician of your plans.

Because the most common pregnancy-related emergencies happen in the first and third trimesters, the second trimester is generally considered the safest time to travel.

2) Reconsider traveling if there are complications.

If you've experienced second- or third-trimester vaginal bleeding, have gone into premature labor in the past, high blood pressure during pregnancy and twin pregnancy, the doctor may recommend you to stay at home.

3) Air travel is safe for most women up to 34 weeks of pregnancy, provided there are no complications.

Some airlines will only permit women to fly with a fitness certificate from the doctor after 28 weeks (7 months) of pregnancy.

4) Avoid long distant flight to avoid prolonged exposure to X ray in high attitude. Any air travel more than 8 hours is not encouraged.

5) Before traveling, locate the hospital nearest to your destination. Be prepared for an emergency by packing your medications and a copy of your medical records.

6) Avoid swimming in the ocean. Ocean swimming can increase the risk of vaginal or womb infections, which could lead to preterm delivery.

7) Drink plenty of water when traveling or flying. Dehydration can cause the uterus to contract. If in a foreign country, stick to mineral water. This includes staying away from ice cubes, too.

8) Take anti-vomiting pills if needed for travel sickness. Anti-dizziness medications can be taken safely during pregnancy.

9) Move about and walking around while traveling.

To reduce the risk of water retention in your legs and feet, get up and walk around the cabin once every hour. Support stockings can also help. Wear flat, comfortable shoes.

10) Fasten your seat belt. Don't forget to buckle up, with your seat belt below your belly.

Wish all of you have a safe and memorable journey.

Happy Chinese New Year.

Monday, February 8, 2010

Happy Chinese New Year !

To all the readers, Happy Chinese New Year and Gong Xi Fa Cai !

Monday, February 1, 2010

Malaysia Vaccination Programme

Hi Dr. Jason,

I just come across your blog which i find very informative.
I've just delivered a baby boy last month. I'd like to seek for your advice regarding the injections like Pneumococcal, Rotavirus & Influenza, do you think it's a must to get these vaccines? As I know the first two ( Pneumococcal & Rotavirus ) are more common and Pneumococcal is not cheap/dose.

Another question is how come the dose given might different from Dr. to Dr.? For instance, Pneumococcal some only need 2 doses, some even 4 doses and period of time given also different. Can I have your explanation on these?

Any more extra informations you would wanna share? Thanks in advance!

Waiting for your reply. Have a nice day!

From : Yvonne


Hi! YvonneL,

Attached below the tables of the standard Malaysia Vaccination programme:

Malaysia - Mandatory



Immunisation Against


Hep B

Bacille Calmette-Guérin vaccine
Hepatitis B vaccine

2 months

Hep B
DTP / Hib / Polio

Hepatitis B vaccine
Diphtheria and tetanus toxoid, pertussis vaccine Haemophilus influenzae vaccine Oral Polio vaccine

3 months

Hep B
DTP / Hib / Polio

Hepatitis B vaccine
Diphtheria and tetanus toxoid, pertussis vaccine Haemophilus influenzae vaccine Oral Polio vaccine

5 months

Hep B
DTP / Hib / Polio

Hepatitis B vaccine
Diphtheria and tetanus toxoid, pertussis vaccine Haemophilus influenzae vaccine Oral Polio vaccine

1 year


Measles, Mumps and Rubella vaccine

18 months

DTP / Hib / Polio

Diphtheria and tetanus toxoid, pertussis vaccine Haemophilus influenzae vaccine Oral Polio vaccine

Malaysia - Recommended


Immunisation Against

2 months

Pneumococcal C

3 months

Pneumococcal C

5 months

Pneumococcal C

6 months

Influenza (annually)

1 year

Chicken Pox
Pneumococcal C

2 years

Pneumococcal P
Hepatitis A

2.5 years

Hepatitis A

It is compulsory for the baby to undergo mandatory vaccination as stated in the table 1.

The pneumococcal and rotavirus are categorised in the table 2 as the optional and recommended vaccination.

Both pneumococcal and rotavirus are not available in the government health clinic.

The parents need to obtain the injection in the private clinic with the cost range from RM 220- RM 250 per injection for pneumococcal and RM 150 per injection for Rotavirus.

Pneumococcal is associated with lung infection, ear infection and brain infection of the newborn.

Rotavirus infection is associated with severe infant diarrhoea and vomitting.

The number of injection of pneumococcal is depent on how soon the baby starts its injection.

If the baby starts its injection from 2 months, he/she will require 4 injections. If the injection is started after 1 year old, he/she will only need 2 injections.

However, the earlier you start the pneumococcal injection, the earlier baby will receive the protection from the pneumococcal infection.

Dr Jason

Chinese Translation :


Hepatitis B - B型肝炎

DTP -白喉 / 破伤风 /百日咳

HiB -脑膜

Polio - 脊髓灰

MMR -麻疹 / 疹 / 咀嚼

Pneumococcal - 肺炎

Rotavirus -轮状病