"There's a lot of hype for the first few months and everybody is interested in how you're doing, but the newness wears off after the first year," said Jenny Ferrill, 31, of Danville, Ill. She and her husband, Pete, 35, are raising 2-year-old quintuplets. Four of the five children have lifelong medical problems and the Ferrills are falling behind paying bills.
She and other parents of multiples say they would advise the California mother of 14 that donations that seem plentiful now will taper off after the first year. Somehow free formula and diapers never morph into free shoes or forgiven medical bills. Requests for TV interviews dwindle. Offers to baby-sit, if they ever existed, vanish.
Next can come financial stress, emotional strain and marital struggles - although Suleman is single.
One German study of 54 families of multiples found that most were severely fatigued with worry about money problems, their children's disabilities and chronic diseases. Nearly all the families relied on outsiders for help and financial support. Some felt guilty they had brought a burden on their families through fertility treatment.
A U.S. study of nearly 250 mothers found that for each additional multiple birth child
- from twins to triplets, for example, or triplets to quadruplets - the odds of having trouble meeting basic material needs more than tripled. The odds of lower quality of life and increased social stigma more than doubled with each added child. And the risk of depression in the mothers also rose with each additional child.
"Parents really underestimate the enormity of the burden of providing care for multiple birth children, and this increases with the number of children," said study co-author Dr. Janet E. Hall, a professor of medicine at Harvard Medical School.
In focus groups conducted by the researchers, mothers who'd had fertility treatments described moral judgments from friends, and even strangers, telling them they had interfered with Mother Nature or God's will.
These studies, among only a few on the topic, have led some experts to call for mental health screening or counseling for parents seeking treatment for infertility.
But fertility clinics don't routinely counsel parents about the emotional and financial strains of multiple births, said Barbara Collura, executive director of Resolve, an infertility support group.
Suleman suffered intense depression after a 1999 injury during a riot at a state mental hospital where she worked, according to California documents. The 2001 birth of her first child "helped my spirits," Suleman said in a psychological evaluation detailed in the documents.
In an interview on NBC's "Dateline," she said she always dreamed of having "a huge family" to make up for "certain connections and attachments with another person that I really lacked, I believe, growing up."
Ferrill, the Illinois mother of quintuplets, said she's seen several Suleman TV interviews and is concerned about whether the California woman can get over her admitted desire to have children to make up for the isolation she felt as a child.
"That's a really heavy burden to put on children," Ferrill said. "It's your responsibility to give love to the children, not to have them give that to you, you know what I mean?"
The Ferrills received no counseling after fertility treatment - in their case, a type of artificial insemination and fertility drugs
- resulted in more embryos than they expected.
"We went to a doctor specializing in selective reduction (reducing the number of embryos in a pregnancy), and he was one of the most cold-hearted men I have ever met," Jenny Ferrill said.
