Running for president is stressful enough. But with seven kids at home, one of whom requires 24/7 nursing?

"There are some challenges out there," admits Republican Rick Santorum, making his second bid for the presidency.

The conservative famously left the trail in 2012 to deal with the constant sickness of daughter Bella.

She was born in 2008 with a rare genetic condition called Trisomy 18, or Edward's Syndrome, and now the family has it under control. Santorum and his wife wrote about it their book Bella's Gift.

Now, he said, "She is doing better than she ever has." His six other kids are in the teen and college years and are eager to join him campaigning.

"It's sort of like the family business in some respects," said Santorum, who is sitting in the middle of the pack of candidates just like in 2012 when he emerged in a shocker to win the Iowa caucus and challenge Mitt Romney.

His experience last time has him encouraged that another campaign won't strain the family. "Last time around, it was a family enterprise. In spite of the travel and other things, it many respects, it brought the family closer together," the former Pennsylvania senator told Secrets during a media breakfast hosted by the Christian Science Monitor.

But don't look for his wife, Karen, to be at his side many days. The reason is that she would have to turn over care for Bella to a full-time nurse, he said, and "that becomes economically challenging ... 24 hours a day gets expensive."

Paul Bedard, the Washington Examiner's "Washington Secrets" columnist, can be contacted at pbedard@washingtonexaminer.com.