Four-year-old Sarah and 15-month-old ErinMarie Russo are as healthy as most kids their age, scampering around the living room of their Manheim Township home when not climbing over the couch to watch "SpongeBob SquarePants."
Their mother, Laura Shanahan, wants things to stay that way.
And she's putting faith in what she calls "insurance" — a procedure known as cord blood banking. It involves the collection of stem cells found in blood from the umbilical cord, which is the lifeline that nourishes an infant in utero and is severed from the baby after birth. The blood is then stored in a public or private facility for potential future use to fight blood-related diseases, such as leukemia.
Some experts have expressed reservations about private banking, saying the process is not a certainty. But Shanahan, 33, is confident.
A full-time mom, Shanahan is a former physical therapist. She had worked with cancer patients and those suffering neurological problems, so she was aware of cord blood's benefits, she said.
Also known as placental blood, cord blood is routinely discarded after a birth, along with the umbilical cord and placenta. In cord blood banking, blood is collected either via syringe or a blood bag collection kit provided by a cord blood bank. The procedure is usually done by a patient's doctor and can only be done right after delivery.
Stem cells are master cells that can change into any cell of the body. These days, many associate the term with controversial
embryonic stem-cell research, which critics say results in the destruction of embryos stored in fertility clinics. Umbilical cord blood banking, however, avoids that; the stem cells are harvested from a source that is normally disposed of. The procedure is endorsed by the Roman Catholic Church, a leading critic of embryonic stem-cell research, because no destruction of embryonic material is involved.
But for parents such as Shanahan, and her husband, Daniel Russo, 36, the paramount issue is peace of mind.
Sarah and ErinMarie, along with their older sister, LeeAnna, 7, are in good health. Yet, while Sarah and ErinMarie have never had to make use of the cord blood stored for them in a private bank in Arizona, their mother has endured several medical conditions that have given her cause for concern and caution.
Shanahan has had follicular adenoma of the thyroid, which, she said, "basically left me with no thyroid" after a thyroidectomy. A complication of that operation also left her with no parathyroid glands; she developed hypoparathyroidism and hypocalcemia, which dramatically lowered her calcium levels. Her hypocalcemia led to tetany, which resulted in tingling in her hands and feet, and muscle twitching. She also worries about potential future kidney damage and osteoporosis.
Though told it was safe to be pregnant, Shanahan worried that her own ailments, which were diagnosed after Sarah's birth, would affect ErinMarie's development when Shanahan became pregnant with her.
Shanahan also has a family history of breast, thyroid, uterine and colon cancer. She worried that the calcium levels in her bloodstream were affected.
The "what if?" remains a central question for supporters of cord blood banking.
"That's what people are thinking of: 'What if my child needs a bone marrow transplant? What if there is no donor?' " said Dr. David Fuchs, a family physician with Oyster Point Family Health Center, Lancaster, who has conducted lectures on medical ethics issues.
Children who might someday develop blood-related diseases, such as leukemia and lymphoma, which involve bone-marrow transplants, can be prime beneficiaries of cord blood banking, Fuchs said.
"It's a great idea, because it's so hard to find matches for bone-marrow transplants," he said.
"This guarantees a match. There's no better match than your own [cells]. Your body would never reject your own stem cells. It's the perfect transplant."
Fuchs did note one drawback; stem cells in cord blood "are not as good as embryonic stem cells [which] regenerate into anything. There are fewer such stem cells in cord blood."
The American Academy of Pediatrics does encourage families to donate cord blood to public banks "for use by other individuals in need," but stated that "storing cord blood at private banks for later personal or family use as a general 'insurance policy' is discouraged."
According to an AAP policy statement, "the chances of a child needing his or her own cord blood stem cells in the future are estimated to range from one in 1,000 to one in 200,000. ... However, the AAP does recommend private cord blood banking for parents who have an older child with a condition that could potentially benefit from transplantation, such as a genetic immunodeficiency."
Private banking is also expensive. Shanahan and Russo chose Cord Blood Registry, a California-based firm that maintains a lab and blood bank in Tucson, Ariz.
"When Sarah came along, I contacted various agencies," Shanahan said; because of her work as a physical therapist, CBR offered her a professional discount. That came to about $1,200, she said. Typically, the cost for private cord blood banking tops $2,000. Shanahan said she also pays about $100 a year, in addition, to store Sarah's cord blood.
When ErinMarie was born, the family was again able to obtain a professional rate for her cord blood storage. They currently pay an additional $125 a year for that service.
Those annual payments will continue for the next 10-15 years. The cord blood will become the legal property of each girl once she reaches the age of 18, Shanahan said. It will then be up to them to decide if they want to keep the blood stored.
With Shanahan's youngest child, however, there were more pressing concerns than financial ones.
ErinMarie was born prematurely "with overactive parathyroids, which resolved itself, thank God," Shanahan said. The condition can cause a potentially serious imbalance of too much calcium in the blood. ErinMarie had not been getting enough calcium in utero; her body thus overcompensated by producing too much.Though ErinMarie is healthy today, "who knows what's waiting down the line?" Shanahan asked rhetorically. "It is a little costly," Shanahan said about cord blood banking, joking that her husband is "Mr. Frugal." But she believes the process is worth it.
She knows she can't predict the future; but, given the tremendous medical advances in the last few years, Shanahan said that's another reason: cord blood might serve as a kind of diagnostic problem-solver.
Her one regret, she said, is not having cord blood banked for LeeAnna, her oldest, but added that the siblings' blood matches could be close should LeeAnna need help. That would not be known, however, unless CBR actually tests the blood.
Still, Shanahan said she feels comfort for the sake of her children, knowing that cord blood can be stored "for the life of the individual," should something happen later.
"They can use it anywhere along the line."
Stephen Kopfinger is a Sunday News staff writer. Contact him at skopfinger@lnpnews.com or at 291-8799. 
