What Comes After Octuplets

The first question many people asked after Nadya Suleman's babies were born was, “what comes after octuplets?” The eight babies, conceived via IVF, were ushered safely into the world and seem to be doing fairly well medically; however, all eight have been in the neonatal intensive care unit since they were born on January 28, 2009. The challenges of raising high-order multiples (triplets or more) starts even before they are born and continue well into childhood and even the teenage years.

According to the March of Dimes, almost all high-order multiples are born before 37 weeks gestation and the average length of pregnancies goes down with each additional baby. For quadruplets, most pregnancies last only 29 weeks. This means that a set of octuplets will be born extremely early and will be at high risk of having all the problems that go along with prematurity. Babies born before 32 weeks gestations are at high risk of developing bleeding into their brains, which can cause brain damage due to increased pressure on the brain. Babies born early can also experience necrotizing enterocolitis, a potentially fatal intestinal problem.

The low birth weight and extreme frailty of premature babies requires a stay in the neonatal intensive care unit (NICU), probably for several weeks. This stay will probably cost around $100,000 for each baby, totaling $800,000 for all eight children. The babies will probably stay in the NICU until they are able to breathe room air without supplemental oxygen and drink from the breast or a bottle.

Some moms of high-order multiples are able to breastfeed their children, although most are not able to exclusively breastfeed. Breast milk is produced on a supply-and-demand basis; if your babies are removing milk from the breasts, the breasts will continue producing milk. Some moms of multiples are able to breastfeed two babies at a time, and the other babies may be fed pumped breast milk or formula at that feeding. The babies getting the breast would be rotated each feeding, so each baby would get at least one feeding every day at the breast.

Of course, it is logistically easier for a mom of octuplets to simply bottle feed, since breastfeeding eight babies would take most, if not all, of each day. With bottle feeding, it is easy to have several helpers holding a baby and a bottle. If enough help is present, mom or dad could even take a brief break.

Parents of single newborns may remember feeling overwhelmed and exhausted in the first weeks of their baby's life. Imagine that situation multiplied by eight and realize that any parent who has eight newborns simultaneously is going to require some help. Some families with high-order multiples enlist grandparents, relatives, and friends to help care for the babies in the early weeks.

Nadya Suleman has reportedly hired nannies to help care for the babies and her older children 24 hours a day. Since one newborn can go through ten to fifteen diapers every day, octuplets could require up to 180 diaper changes each day. The babies would also need to be bathed, dressed, and fed every two to three hours. In addition to practical needs, infants need to be held, cuddled, and stimulated to develop properly. It would be very difficult for one or even two parents to provide adequate attention to eight newborns. What comes after octuplets? The answer seems to be, “a lot of work.”

After the octuplets become a bit older, mom and the nannies will have to try to get the kids into some type of routine. Structure helps single children to feel safe and secure, and helps parents meet their needs in a consistent way. In a family with multiples, structure and routine are a requirement. Criticisms have been leveled against Nadya Suleman regarding the lack of routine for her older children, but parents often have trouble establishing consistent daily schedules for their children.

For eight children, help will be required into the toddler and childhood years, simply because supervising all of the children would be quite difficult. The National Resource Center for Health, Child Care, and Early Education recommends having only three children under a year old and four children to every caregiver for kids aged 13 months two year in licensed daycare centers. Since children in daycare centers may not receive adequate attention and stimulation to develop fully, even more help would be needed for a set of octuplets.

Every child deserves to have their basic needs for food, clothing, shelter, and education met. Children should also have parents or caregivers who know them, love them, and care about them. For Nadya Suleman, it may be challenging to make sure each of her fourteen children receives the best care possible. The watching population of the U.S. certainly feels that her children deserve a chance for a good life and a happy home, and skeptics and supporters alike are waiting to see how she intends to provide that for them.

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