More than one baby per pregnancy means increasing the risks -- increased risk of prematurity (we have several sets of twins in our NICU currently), increased risk of complications for mom and babies.
Within the last 24 hours, 2 sets of sextuplets were born. One set has a pretty good chance of having a normal life, the other not so much. Neither set is in the NICU where I work. I've seen many babies at both gestational ages, though.
The Masche sextuplets
Jenny Masche gave birth at 30 weeks, 4 days. There are risks involved in having 6 babies, but the survival statistics for preemies born at 30+ weeks are pretty good. 5 of the six need help from ventilators to breathe. The 6th may yet. Sometimes the little ones tire out and need some help. It's also possible that they will all be breathing on their own within a few days.
If they need a lot of help breathing, they'll get surfactant to help keep their lungs expanded. They may get some high calorie IV feedings before they're ready for oral feedings. Those first feedings will be by a tube placed through the mouth or nose via the esophagus to the stomach.
They will be watched very closely for all the possible problems that go with a pre-term delivery.
Apnea of prematurity will probably show up by 2 or 3 days of life (or whenever they are off the ventilator). At just over 30 weeks, the probability is very high that the respiratory center in their brains will be immature and they will take breaks from breathing periodically. Their nurses will watch closely to see if they start breathing again spontaneously. If the heartrate drops precipitously, or their oxygen levels fall significantly -- or if they just wait too long to take that breath, someone will gently stimulate them to get them breathing again. If that doesn't work, the nurse will use a bag-valve-mask resuscitation device (self-inflating, or anesthesia-type bag) to breathe for the baby until he or she recovers.
They may stay on the ventilators for a short time or a longer time. Once they're maturing and breathing more on their own, they'll be placed on a CPAP or SiPAP device to help keep their lungs expanded and decrease the work of breathing. This helps decrease the apnea. They may also be given medication to stimulate the respiratory center.
With all that respiratory support, it will be important to keep a close eye on the oxygen saturation levels -- the percent of the hemoglobin that is actually carrying oxygen. Too low and the baby won't do well, but too high and the risk of Retinopathy of Prematurity (ROP) increases born at less than 32 weeks is a risk factor, but oxygen use increases the risk. About half of babies weighing less than 1700 grams will have some degree of ROP.
The babies will have frequent eye exams to watch for early signs of ROP because it can be treated. Laser surgery and cryosurgery are both effective if used before the ROP is too advanced.
There are other possible risks for the Masche babies, but nothing like the risks faced by the other set of sextuplets.
The Morrison sextuplets
Brianna Morrison's babies were born about 8 weeks earlier than the Masche babies. Just over 22 weeks gestation. As far as I know, only one baby has survived at that gestational age. She was a single baby and should have been larger and better nourished than the Morrison babies as a result.
These babies weigh between 11 ounces and 1 lb 3 ounces. They're about 1/3 of the weight of the Masche babies. Their skin is gelatinous with no subcutaneous fat. It is incredibly fragile and great care will have to be taken to simply avoid tearing it. They will lose so much fluid through their skin by evaporation that it will be a huge challenge to keep them hydrated and keep their electrolytes in balance.
The blood vessels in their brains are even more fragile than the 30+ week Masche babies. There is a significant risk of bleeding into the brain.
Their digestive systems are immature and they may not tolerate oral feedings for many weeks. This means they will have to receive IV feedings for longer - and this can be very hard on those tiny livers.
Their risk of ROP is even higher than for more mature babies. The probability of long-term lung problems is very high.
The challenges faced by these babies are huge and I wish them well, but I do not have much hope for their survival.