Category Archives: Health

Expectant Parent’s Guide to Cord Blood Banking

Prior to the birth of our first daughter, one of the things my wife and I decided to explore was cord blood banking. When having a child, especially your first, the whole experience can be pretty overwhelming. Most expecting parents are trying to figure out which baby gear to add to their baby registry, which names to add to their shortlist, how to decorate the nursery, and more importantly…how to afford everything. This was certainly the case for us, but after some careful research and multiple discussions between ourselves and with our obstetrician, we decided that it was something that we wanted to do for our family, and we selected Cord Blood Registry. Hopefully, this overview will help other expecting parents decide whether or not cord blood banking is right for you and your family.

What is Cord Blood Banking?

Cord blood banking allows families to store stem cells that are harvested from cord blood extracted from the placental end of a newborn baby’s umbilical cord. The cord blood is usually collected within 10 minutes of giving birth, and then sent to a cord blood storage facility where it is processed and placed into freezers. It is stored there indefinitely in a subzero cryogenic system that preserves the stem cells until a later time when they might be needed to treat medical conditions of the child from whom they originated, or possibly another family member. Hopefully, your child and family will remain healthy, and the stem cells will never be needed. However, many find it comforting to know that they are available should the potential need ever arise.

According to WedMD, cord blood stem cells are considered the building blocks of life. They have the ability to divide and differentiate into diverse specialized cell types, consistent with cells of various tissues such as muscles or nerves. Stem cells have been used for more than 20 years to treat more than 80 life-threatening diseases and disorders, including the treatment of leukemia, lymphoma, and anemia, along with a variety of other hematopoietic, immune system, and genetic disorders, and stem cells are considered a better alternative to bone marrow transplants. Additional treatments and uses are currently being developed all around the world, including the treatment of traumatic brain injury, spinal cord injury, cerebral palsy, Type 1 juvenile diabetes, and autism. While somewhat controversial, and with research and discoveries that are still fairly early-stage, many view this as a sort of insurance policy for their children and family.

Sample Collection Process

Let’s take a step back and talk a little bit about the setup and collection process. For us, the entire process was pretty seamless. After speaking with a company representative on the phone to answer a few questions, we completed the registration process online. They promptly sent us the collection kit in the mail, which provided detailed instructions for our upcoming birth day. We informed our obstetrician that we were collecting the cord blood, and provided the kit to the medical team upon our arrival and admittance to the maternity unit. After the birth of our child and the subsequent cord blood collection, the sealed sample was placed on our newborn daughter’s transport cart and brought with her back to our room. Shortly thereafter, we then called to schedule the sample pickup using a toll-free number provided by the cord blood banking company, and a courier came directly to our room within an hour or two to pickup the sample for preparation and shipment to the main storage facility. After it arrived at the storage facility, the sample went through final preparation steps and was banked in their freezer storage system.

Sample Options

One thing we discovered with our second child is that new technology now allows for additional options on the types of tissue and cells that you can choose to collect and store. For our first daughter, born in March 2010, I believe the only option was cord blood collection and storage. For our second daughter, born in October 2012, the same cord blood banking company now offers the option to also collect and store the cord blood tissue, in addition to or instead of just the cord blood. Of course, there are additional fees for both the upfront cost of collection and the ongoing annual storage cost. We decided to go with the same program as our first daughter, and opted to stick with just the cord blood collection.

Program Costs

Even if parents are interested in cord blood banking, the cost may force many parents to forego this option. To be completely honest, the cost of cord blood banking is rather high. Most cord blood banks have an up front collection and storage preparation fee that ranges from $1,500 to $2,200, and then charge an annual storage fee of $125 to $150. Additional charges apply if you choose to also preserve the cord tissue, in addition to the cord blood.

There is no doubt that this is a steep cost at an expensive time in the lives of young families. So if it comes down to choosing between diapers and formula, or cord blood banking, this decision is an easy choice. In order to help parents manage these upfront costs, most cord blood banks offer payment plans and gift registries that allow family and friends to contribute towards these services. Additionally, a variety of discounts may be available through your obstetrician office, referral programs such as the one offered here for friends of A Modern Dad, and some employers. In our case, my wife is a nurse, and we discovered that we were eligible for a pretty significant discount offered to medical workers by the cord blood bank that we selected. Discounts are also often available for public service providers (military/police/fire/EMT), active students, multiple birth situations, and repeat customers. These discounts greatly helped us to move forward in getting things all set up, so please keep this in mind and be sure to ask.

Banking Options

A variety of cord blood banking options exist across the United States. I suggest checking out the details of at least two or three companies so you can compare options and pricing, and get an overall feel. There are two types of cord blood banks available to expecting parents. The focus of this article is private cord blood banks, which store cord blood for personal use by your family. In various cities across the U.S., and countries around the world, public cord blood banks may also be available. With public banks, cord blood is donated for research or for use by anyone who may need it. In most cases, there is no charge for that service. Unfortunately, samples submitted to public banks are anonymous, and if a family member later requires a stem cell transplant for treatment, your donation is not retrievable.

Private banking options include Cord Blood Registry (Cbr), Via Cord, Cryo-Cell, and Family Cord. Most private banking options are available throughout the U.S., as long as your obstetrician and delivering hospital are able to provide support.
Public banking options tend to be more location specific, with centers available in many of the major cities across the country. Options include LifeCord, ClinImmune, National Cord Blood Program, ITxM, and Cord for Life. And you can find a complete list on the National Marrow Donor Program site.

Additionally, some public banks offer sibling-directed donation programs for families that have an older child who has cancer, a life-threatening inherited blood or immune system disorder, sickle cell anemia or thalassemia. These programs will collect and store umbilical cord blood for a biological sibling at no charge to eligible families, and then if/when a stored cord blood unit is used for transplant, a fee is charged to the patient’s insurance company. More information can be found on the National Marrow Donor Program website.

More Information

For additional information, here are a few other sites that provide good information on cord blood banks, and the cord blood industry as a whole: American Association of Blood Banks, Parent’s Guide to Cord Blood Foundation, National Marrow Donor Program, WebMD, and Wikipedia.

Image Credit: thesilhouettestudioblog.com

Raising a Child with Food Restrictions – Part 2

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As we discussed in Part 1 of this series, we introduced rice cereal to our baby daughter at six months. Within a week, she started to get sick whenever she ingested it. After initially thinking her illness was caused by some spoiled milk, a dirty bottle, or possibly a virus, we pretty quickly identified the rice cereal as the apparent root cause.

Upon our return to Phoenix from our Santa Fe vacation, we once again consulted with our primary pediatrician. Her feedback was that rice is typically considered the most neutral, hypoallergenic cereal available for babies…especially since it is gluten-free. However, since rice cereal seemed to be the culprit, she advised us to give oat cereal a try instead to see if our daughter would do better with that. We tried that the next day, and again experienced the same excruciating result. Our daughter gobbled up the oat cereal paste, and then about three hours later proceeded to vomit for about three hours. At that point, we knew for sure that something definitely was not right.

We consulted again with our pediatrician. Her latest advice was to just avoid grains all together for a while. Both my wife and I quickly agreed, having already arrived at this obvious conclusion prior to our visit. However, now we were even more perplexed and curious as to what was going on inside our beautiful daughter. Was this “condition” she was experiencing something temporary? Was it being caused by something more serious? Was this something she (we) was going to have to deal with for the rest of her life? These were all questions that were hanging out there, and we needed some answers. Now what?

After some further discussion with our pediatrician, and even though rice cereal is gluten-free, we agreed to do a blood test for celiac disease. According to Mayo Clinic, celiac disease is a digestive condition triggered by consumption of the protein gluten, which is primarily found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye. People with celiac disease who eat foods containing gluten experience an immune reaction in their small intestines, causing damage to the inner surface of the small intestine and an inability to absorb certain nutrients. Unfortunately, there is no cure for celiac disease and people with the disease are forced to manage their lifestyle and dietary consumption throughout their lifetime. Fortunately, celiac disease and other gluten-related digestive conditions have led to the fairly wide availability of a variety of gluten-free lines of food products and ingredients.

After waiting for about a week or so, our pediatrician informed us that the test for celiac disease had come back negative. This did not completely rule that out, due to our daughter’s young age, but it did reduce the likelihood that celiac was the culprit. Okay…now what? Once again, we consulted with our pediatrician to discuss other possible causes or conditions. Food allergies were considered to be the other most likely cause of our daughter’s grain issues. Childhood allergies have received much press in recent years, as studies have shown possible connections between food allergies and a pretty wide range of common childhood illness, from ear infections to general irritability and colic to ADHD. In many cases, children outgrow these allergies by 3 to 5 years of age, and the best way to deal with them is to just avoid the foods causing the problems. Rather than go through a full battery of allergy tests at such a young age (~8 mths old), we decided to just avoid grains for a while and focus on introducing other foods that would satisfy her nutritional needs for the foreseeable future. This would certainly pose some challenges when mealtime rolled around each day…and especially when it came to snacks (no Cheerios, crackers, bread, cookies, cake, etc.)…but it was certainly something we felt we could manage…for now.

Fast forward eight months. Our daughter is now almost 16 months old and we have learned to manage her dietary restrictions quite well by closely monitoring product ingredients and watching carefully for crumbs on our floors. A few weeks ago, we decided to investigate some more to try to find other possible causes of the grain intolerance/allergy/reaction with which we are dealing. After going in a few different directions with our research, we stumbled onto something called FPIES. FPIES is short for Food Protein-Induced Enterocolitis Syndrome. FPIES is a severe, cell-mediated gastrointestinal food hypersensitivity typically provoked by cow’s milk, soy, grains, poultry, and/or some vegetables. It is commonly characterized by profuse vomiting and diarrhea. As I read through descriptions of the condition and read through details of how FPIES has affected other young children and babies, I started to get goosebumps as I realized that we had finally found some of the answers we were looking for. We visited an allergy clinic this week and confirmed our FPIES suspicions with the doctor, who was familiar with the condition and was in agreement with our discovery.

Check back soon for more details on FPIES, and also for more information on the foods and snacks that have helped us to manage our daughter’s dietary restrictions and keep her healthy.

If you have any questions about how we are dealing with FPIES, please let us know…and please join in the conversation on our website, on Twitter, and on Facebook to share your stories of dealing with childhood food restrictions.

Raising a Child with Food Restrictions – Part 1

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No grains?? None? Uhhh…I think we have a problem.

This is Part 1 of a series describing our experiences with identifying and managing food restrictions for our baby daughter and how our journey eventually led us to the likely cause…FPIES (Food Protein-Induced Enterocolitis Syndrome).

From very early on, our daughter has been a good eater and a good sleeper. After being exclusively breastfed for her first six months (and all the way through to 12 mths), we started to introduce solid foods into her diet. Per the common recommendations, we started out with watered down rice cereal (using breast milk). Over the course of the first week or so, we gradually thickened it up to make it a little more manageable. She did okay initially, but after about ten days or so…while my wife was out of town for business (of course!)…our daughter got sick (vomitted) for pretty much the first time since her birth.

I had given her a little bit of rice cereal with her dinnertime feeding that night and put her down to bed around 6pm. Shortly before I was about to give her the last evening feeding at 9p, she proceeded to vomit all over herself and her crib. Awesome. After I got her and her crib all cleaned up, she perked up and took a full bottle, before passing out for the night. Not really sure what to make of it, the next morning at about 6:30a, I gave her another serving of rice cereal with her morning bottle and all seemed fine. Once again, shortly before her mid-morning bottle (~9a), she vomited all over herself and her crib. Now this started to worry me a bit, and after talking it over with my wife on the phone, I decided to take her to the pediatrician for a visit that afternoon.

At the pediatrician, I explained the situation and gave her as much info as I could remember regarding our daughter’s feeding schedule and the timing of the vomiting. Her response was probably one of the most common that parents will hear in this situation…that it was probably just a stomach bug. In her defense, this is probably the correct guess 98% of the time. She recommended that we avoid the rice cereal for a few days, and then reintroduce. Okay…no problem. That makes sense.

As it turns out, a few days later meant we were now on vacation in Santa Fe, New Mexico with my wife’s family. After making the eight hour roadtrip to Santa Fe and getting all settled in, we decided to try again. We offered rice cereal with a lunchtime bottle and our daughter gobbled it up. All seemed fine, so we packed up the family and headed to the historic downtown Santa Fe for lunch and a little shopping. Shortly after arriving, she began vomiting. After the third round of vomitting in less than 20 minutes, we headed back to our vacation home to get her cleaned up. She proceeded to vomit all the way home…and pretty much every 10-15 minutes…for almost three hours.

About two hours in, she was getting lethargic and was absolutely exhausted. We called our pediatrician’s answering service (of course, it was a Sunday), and explained the situation. We were told our main concern was dehydration. Since we were at a much higher altitude (7,000ft) than our home in Phoenix (1,000ft), this was even more of a concern. Ultimately, we decided to take her to a very good local hospital that had a pediatrics unit (thank you Santa Fe Christus St. Vincent!). Fortunately, while waiting nearly an hour for a doctor, she began to perk up and show signs of recovery. By the time the doctor showed up, she was starting to smile and get her color back. The doctor was a bit perplexed, but once again, we were told it was probably a stomach bug and to take a few more days off from the cereal. Since her primary nourishment was still coming from breast milk, and since we were really just getting started with “solid” food, going a few days without cereal didn’t really concern us. Again, we felt that made sense…but we were now definitely sensing that there was something more to all of this.

So, where do we go from here?

To be continued…

Be sure to also check out Part 2 of this series, and if you have any questions about how we are dealing with food restrictions, please let us know. Also, please join in the conversation on our website, on Twitter, and on Facebook to share your own stories of dealing with childhood dietary issues.

Rethinking Infant Immunization Schedules