There’s no doubt that this H1N1 flu, also known as swine flu, has been a real doozy. With more than 1 million people infected in the U.S. alone and approximately 263 deaths, attention must be paid to a potentially worsening condition.

I typically don’t like to scare people into paying attention to health care issues, but I do think that as soon as a vaccine becomes available here in the U.S. for the H1N1 virus, you should get it.

I recently learned of two alarming cases where pregnant women became affected with the H1N1 virus. Any type of flu can be quite devastating for a pregnant patient. The reason for the significant effect in pregnancy is that pregnant women typically have suppressed immune systems and their pulmonary compliance is significantly altered due to the pressure from the pregnant uterus. So when they get the flu, it could very quickly turn into a deadly pneumonia with very high degrees of complication for both the mother and the unborn child.

That was just the case with these two recent reports — one from Australia where a mother fell ill from the swine flu and ultimately the baby died in utero, and in the other case, a woman in Florida had to deliver at 27 weeks of gestation due to the flu, and the infant ultimately died from complications associated with his prematurity.

So the message is loud and clear: This new virus is very contagious. We don’t have natural immunity, and if you have any risk factors — especially if you’re pregnant — get the vaccine as soon as it is available.

Click here to read the full story.

Today I read an incredibly tragic story about a 2-month-old baby in Pennsylvania who died of sudden infant death syndrome (SIDS) because her parents were allegedly too drunk and high on cocaine to notice.

The parents, Jennifer Nicole Gaster and Daniel Keith Martin II, both 30, stood trial Monday on child endangerment charges alleging that after a night spent snorting cocaine and drinking beer and vodka, the couple was too incapacitated to notice their baby was dying.

This is not the first time we have seen a parents with a history of drug and/or alcohol abuse lose a child to SIDS. In February of 2007, a Michigan woman pleaded guilty to charges that claimed high levels of cocaine in her breast milk had killed her 5-month-old daughter. Although the cause of death was originally thought to be SIDS at the time the baby died, further testing proved otherwise, and at the trial, the mother admitted to using cocaine two or three times the day before the baby died.

Traces of cocaine can remain in breast milk for more than 48 hours after a woman uses it — and the transmission from mother to infant has been linked to respiratory failure, seizures, increased cardiovascular risk, central nervous system damage, irritability and addiction — just to name a few.

Babies are at high risk for SIDS if they:

o          Are born to mothers who smoke or use drugs

o          Have low birth weight or premature infants

o          Are exposed to environmental tobacco smoke

o          Sleep in a crib packed with soft objects and loose bedding

o          Are placed to sleep on their stomachs

o          Are between the ages of 1 and 6 months

Please be advised that most drugs are transmitted through breast milk. If you are abusing any kind of drug – especially cocaine – the effects can be deadly.

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.

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.