I was very happy to learn Tuesday that the last of the Suleman octuplets is finally home  to be with his brothers and sisters. Jonah ― the last to be sent home ― was the smallest of the bunch, weighing just 1 pound 8 ounces when they were born nine weeks early.

Click here to see pictures of Jonah and his siblings.

But now, the real challenge begins. Let us not forget that these infants were premature and that this last baby stayed in the hospital for almost 12 weeks. There is a lot of data that has been published and analyzed looking at some of the hurdles that premature babies must overcome in their early years.

To me ― as a person who delivers babies for a living ― I also have three of my own ― I am aware of the significance of paying attention to the way kids grow and develop, and how important that attention is in preventing some of these children from failing to meet their full potential.

For parents of full-term infants, paying close attention to developmental milestones is sometimes an afterthought. But for parents of premature babies, keeping track of movement, visual, social and developmental milestones could make a world of difference in identifying problems and finding solutions to meet their needs.

Most premature babies meet their milestones and catch up by the age of 2. But depending on how early an infant is born, their development may lag anywhere from 6-8 weeks in development usually during the first year of life.

It’s important to use your child’s adjusted age when tracking his or her development. For example, if your baby is 21 weeks old, but was born five weeks early, his or her adjusted age is 16 weeks (or 4 months).

Now let’s take a look at some of the milestones the American Academy of Pediatrics says parents can look out for around 16 weeks…

Motor:
o Brings hands together, or to mouth
o Lifts head and pushes on arms when on tummy
o Reaches for objects
o Turns or makes crawling movement when on tummy

Language:
o Turns head to follow familiar voices
o Laughs and squeals
o Combines sounds more often (for example, “aaah-oooh”, “gaaa-gooo”)

Activities:
o Grasps more and reaches for objects
o Brings objects to mouth
o Increases activity when sees a toy

Social/Emotional:
o Is increasingly interactive and comfortable with parents and caregivers
o Shows interest in mirrors, smiles and is playful
o Is able to comfort himself

For more guidelines and milestones at different ages, click here.

Remember: Always watch for progress and do not be afraid to ask for help from doctors, teachers or other family members.

Again, I am pleased that all eight of the children have made it home safe ― I just hope that Nadya Suleman pays as much attention to their progress as she has to publicizing their births, because it should always be about the kids.

These are interesting times we’re in ― to say the least. Over the past couple of weeks, we have all been concentrating on “Octomom” from California, and with new developments in the story everyday, it’s easy to see why she’s been the topic of conversation. I was following the story too, calling for an ethical investigation of the fertility clinic from day one, but with the state of our economy and the country experiencing what could be one of the most pivotal moments in American history, I want to move past that story.

I think it’s time the media starts concentrating on the changes that the Obama administration will be proposing in the future and some of the ideas that have already been approved.

Now, let’s look at the facts … The American health care system needs help! Why? Well, because it is filled with inefficiencies and overpriced operational costs.

How did it get like that? Well, it’s possible the American health care system has seen a lot of the same issues as our financial sector ― which we all know by now is quite a mess. Our financial experts have given us many explanations for the current economic crisis: Many blame the banks for recklessly handing out loans and credit, some blame the public for borrowing more money than they could ever repay, then there’s all the greedy Wall Street executives making profits off back of funds that don’t even exist, and who can forget those elaborate Ponzi schemes that went unnoticed by federal agencies for years.

Well, believe it or not, we have a lot of the same things happening in health care. We have some patients that demand every test in the book on the basis of what they’ve read or seen on television, hospitals that have been enamored with demands because of technological advances and profit margins, and doctors that have concentrated on sub-specialty service, rather than primary care and prevention.

So now, we are all looking to President Obama’s stimulus bill to see how he will resolve these problems. Some of his proposed ideas are very interesting. Electronic medical records, for instance, provide us with computerized data entry on patients, a way to track symptoms, disease processes, a way to dramatically decrease the overutilization of certain tests, minimize medical mistakes both by physicians and hospitals. And down the road, it might even decrease costs.

But many critics worry about privacy issues. I totally agree that patient confidentiality should always be protected. I remember when the new HIPPA laws came into effect under President Clinton, I could not even discuss a patient’s medical condition or get a second opinion from a colleague without getting a written consent from the patient.

But I think that before we start throwing good money in to solve the problems bad money got us into, the way previous financial stimulus plans have, we need to really understand how our current health care system is working, and address the issues that got us here in the first place.

Click here to share your thoughts on my Facebook page.

The more I hear about Dr. Michael Kamrava, who practices some facsimile of reproductive medicine in California, the more outraged I become.

From what I’ve been reading, I am already convinced that he should probably be considered for malpractice based on the Nadya Suleman case because of a departure from standard medical practice. Consider that the American Society for Reproductive Medicine suggests one or two embryo transfers maximum for a woman of Nadya’s age (33), and she received six embryos. Consider that in vitro fertilization, a billion dollar industry which has doubled in terms of procedures to 135,000 with 50,000 live births over the past decade, has also been policed increasingly by the ASRM and that multiple births (triplets or more) have decreased from 7 percent to 2 percent over this period of time. We don’t have proper laws in the U.S. to police medical criminals like Octodoc, but we do have standards of care.

A malpractice claim is unlikely though, because the patient, Nadya Suleman, doesn’t seem inclined to bring a suit. But even if she signed a consent for the embryo transfer, it also seems likely that she is suffering from a psychiatric disorder and was not correctly informed about the risks. Does Nadya know that the risk of postpartum depression in a normal woman, even without her social and financial difficulties, is close to 25 percent?

I was getting ready to blog about the need for the state of California to go after Octodoc’s license on ethical grounds (each state has a medical ethics committee which governs licensure), when I heard about the second case. A 49-year-old woman was apparently impregnated by seven donor eggs (from a woman in her twenties which increases their chance of being viable substantially). She is now carrying quadruplets.

The ASRM suggests no more than five embryos for a woman in her 40s, and if you add to that the fact that the woman herself reportedly only wanted one child, and at her age is at risk for medical complications including high blood pressure and stroke, the handling of her case appears to be another abomination.

Octodoc’s low success rate at successful births is no excuse for tawdry practices. I’m glad to hear that ASRM is investigating him. The state of California should stop him in his tracks.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.”  Read more at www.doctorsiegel.com

Lost in the media storm surrounding Nadya Suleman, the mother of new octuplets born through in vitro fertilization, is the father of those babies.

Incidentally, the octuplets’ father is also the father of Suleman’s six other children, who were also conceived via in vitro fertilization. 

According to Suleman’s mother, Angela, the octuplets’ father, is one of her daughter’s “admirers.”

Reportedly, the name David Solomon appears on four of the first six kids’ birth certificates. Earlier this week, the Associated Press reported that the octuplets last names would be Solomon. But, no one knows for sure if David Solomon is actually the name of the hopefully-not-so-proud father.

Whomever donated the sperm that resulted in Suleman giving birth to a total of 14 children likely feels he bears no responsibility for the chaos these children will experience in life.  After all, once he provided his sperm to doctors, they were the ones who presumed Suleman to be a competent person and used that sperm to fertilize her eggs.  They acceded to her wishes to implant the resulting embryos in her uterus.  They tended to her during the pregnancy and delivered the children into the world. 

What possible moral failing could be assigned to a man who merely provided the genetic material for a sterile laboratory procedure sanctioned by the law of our land, a procedure that has helped bring millions of beloved children into the arms of good and decent parents?

I believe the octuplets’ father does bear a moral burden for providing the sperm used in this birthing calamity.  The 14 children fathered by Suleman’s sperm donor were born to an unemployed mother with psychological problems and no apparent insight into the consequences of her actions.  But they are also the offspring of someone she apparently knows, and that person apparently has even less concern for the human lives he helped create. 

Imagine having a self-centered mother who is using you and your 13 siblings to feel less lonely (because she’s angry she was an only child herself) and having been fathered by someone who has no particular interest in how or why you were created or what happens to you.  If that sounds like a prescription for low self-esteem, not to mention potential depression or drug addiction or an anxiety disorder, it is.

The Suleman case exposes gnawing ethical questions that are not asked frequently enough about the whole process of sperm and egg donation.

At what ethical cost does a society decide to sever every meaningful connection between millions of human beings and their offspring?  When the medical system is shown to be capable of the kind of reprehensible, misdirected creative impulse evident in the Suleman case, doesn’t it begin to support the notion that donors of sperm and eggs have some responsibility to make sure they aren’t helping to create chaos and suffering?  Must asexual reproduction be, by its very nature, amoral reproduction?

I say no.  I hold the sperm donor in the Suleman case just as responsible as she is for the tears to be shed by her children. He had to participate as an actor in this strange drama for it to go so horribly awry.  It was his sperm.  His.  Part of him.  If that means nothing to us as a culture anymore, then we may indeed be losing ourselves in our science.

Discuss this case on Dr. Manny’s Facebook wall.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com or e-mail him at info@keithablow.com.

Do no harm. That’s one of the oaths doctors have to take and should always practice under – but as more facts come out about this woman in California who just gave birth to octuplets, I’m beginning to wonder whether that oath was forgotten.

I’m still not clear as to how this mother ended up with eight children, but what we do know, is that she had some sort of fertility treatments. This story leaves me with many questions.

First: Did she have a need for fertility treatments? Here’s someone that already had six children under the age of eight. When you advise a woman to undergo fertility treatments, you have to take her previous obstetrical history into consideration, and whether any treatments are going to put her life or the life of the potential newborn(s) in danger.

Second: What kinds of fertility treatments are available? Well, for the most part, you either have in vitro fertilization (IVF) or ovarian stimulation. If it was indeed IVF, I don’t know any physician in his or her right mind that would place eight embryos inside a woman’s womb in 2009 — especially knowing all the potential risk that an octuplet pregnancy can bring on. In many countries around the world, IVF implantation is limited to one or two embryos.

With hyperstimulation on the other hand, physicians are able to recognize a situation where significant stimulation of follicles has occurred, and most likely, they will decide not proceed with the completion of the cycle due to the potential dangers associated with large multiple births.

In either case, ending up with eight fetuses is not something that is medically indicated, but rather an accident —or better yet — lack of proper medical care.

Now I know the challenges that physicians and their staffs face when dealing with infertility issues in patients that deeply desire to have a child. But choosing the right technique, and psychologically evaluating the person that you’re about to treat, is part of that oath of doing no harm.

Join the discussion on my Facebook page.

Nadya Suleman, who recently gave birth to octuplets in California with the help of fertility treatments, supposedly loves children.  That’s what her own mother, Angela, says, according to the “New York Post.”

The Post also quotes Suleman’s friend, Allison Frickert, as saying, “Her whole life, she couldn’t wait to be a mom.  That was her No. 1 goal.”

Suleman, 33, already had six children, which were conceived with the help of fertility treatment.  So now she has 14 children and reportedly an undergraduate degree in child and adolescent development and is pursuing a master’s degree in counseling. 

Nadya, here’s a look inside the mind of a single woman with six children, living in her parents’ 1,550 square-foot bungalow, who decides to have eight more children.  Since you aren’t going to class anymore, feel free to listen.

This isn’t about loving children.  This is about being completely and utterly lost in your own psychological drama that has absolutely nothing to do with truly nurturing the human beings you are creating.  These children, each of whom I pray overcomes the odds and becomes competent and empathetic human beings, are the expression of your own unresolved psychological troubles.  I wouldn’t presume to make a formal diagnosis, but they may be the product of obsessive-compulsive thinking—an irrational idea that “one more daughter will make me complete” or something as mundane as the idea that “the number six isn’t lucky for me.”  Even more likely, they are a distraction from core, unresolved emotional issues you are hell-bent on not addressing.  With enough children and enough chaos, after all, you won’t have to wonder if you yourself were well-enough-loved or well-enough-nurtured as a child or whether you developed into the person you had hoped to become. 

Using 14 kids to avoid your own thoughts and feelings isn’t much different for you than using alcohol or heroin to bury your emotions.  The big difference is for the fourteen kids who will grow up trying to make sense out of the absurd circumstances into which they were born—not as products of a loving relationship, but as products of you trying to use motherhood as a drug to distance yourself from your own internal suffering.

Now, your suffering has been multiplied.  Your suffering has eight new names to add to the six that already existed.  Your pain now has fourteen faces.  And all this, rather than looking at your own face in the mirror, into your own eyes and your own heart to find out what was missing, what had been injured, what needed real understanding and real repair, not real reproducing.

How could your fertility doctors have missed the barren psychological landscape from which they were extracting new human beings?  How could medical ethics not have caught up with medical technology, to the extent that a single mother can decide to have fourteen children with the help of a small army of health care personnel?  Will the doctors line up to pay for the clothing and childcare and education the children will need?  Will they volunteer their time to play with the kids and give them the quiet time and undivided attention that will allow them to feel secure expressing their thoughts and feelings?  Will they be there at bedtime to read them each their favorite stories?  No. 

This delivery of octuplets isn’t about the octuplets at all.  It isn’t about loving or mothering or doctoring.  It’s about doing what each person in this strange drama wanted to do—for herself or himself.  It’s about not thinking and not feeling, and fertilizing fourteen young lives with the unpaid debt of that emotional blindness.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com or e-mail him at info@keithablow.com.

Congratulations mom, on the birth of your eight beautiful children! Being the resident obstetrician here at FOX News, my staff has been asking me all day today “Oh, Dr. Manny did you hear about the lady who had octuplets in California? Isn’t that amazing?”

And yet, despite the fact that I’m very happy for these parents, and I’m very proud of the physicians and nurses that took care of this patient, I also realize that this was a very high-risk pregnancy that could have easily ended up with significant problems. That’s the topic I want to talk about.

Many times we tend to focus on these medical miracles, and we often do not realize all the potential complications that could arise when facing challenging clinical scenarios.

Take, for instance, the story that we did a couple of years ago about the woman who had twins at the age of 60 — after that story ran, I started getting phone calls from women all over the world, asking how they too could have children after the age of 55.

I assisted in that delivery, and what many people don’t know is that that there were many issues we had to deal with having a patient over the age of 60 delivering twins. The same thing is true for anybody that has a multiple pregnancy because a woman’s womb was generally made to birth only one child at a time. When we artificially enhance that number by 3, 4, 5 or 6, we are playing Russian roulette.

The most common complication for multiple pregnancies is prematurity. A premature infant has a significant risk of developmental delays, visual problems and hearing problems.

There are also a number of maternal complications that can arise from multiple pregnancies like high blood pressure, diabetes and significant post-partum bleeding.

So the take-away is this: Medicine has a beginning and an end. But somehow, many people tend to forget the middle part – and that is the part that must be clearly understood by the patient and physician for the miracle to take place.