Neonatal care isn’t my specialty but I do work in a related area. I’m trying to think of a good way to say this, but I’m struggling a bit. Think of neonatal medicine as pushing a rock uphill. It’s not an impossibly heavy rock, so it’s doable, but it’s a question of steady progress, and occasionally you might hit a divot so need to push harder, or change your grip on the rock, or you might hit an unexpectedly smooth hit and have some easy steps. Neonatal medicine is largely about keeping going forward, and making small adjustments overall to keep the baby stable - tackling infections, working on feeding etc - so that their own bodies have the time to play catch up. Babies can take a sudden turn for the worse, of course, but on the whole, babies who have shown a long pattern of improvement and are almost ready for discharge don’t just suddenly die.
Neonatal unit care offers a tiered system - usually you’ll have a NICU, where very sick babies who need a lot of support go, and then you’ll have a SCBU, where babies who are unwell but not critical or who have improved enough to step down off NICU go, and then you’ll have a neonatal nursery, or transitional care, or bedding in unit where babies are essentially well but who need a bit of extra support - maybe ongoing medications or tube feeds - and there might be cares that the parents are being taught prior to discharge. A number of the babies that Letby was charged in the deaths of fell very much into this category, and babies like that don’t just die on their own out of the blue.
There were also a number of multiples who died - whilst multiples can and do die, the most common is that the baby who is in the poorest condition at birth usually dies at or fairly soon after birth, whilst the other/others go on to have a longer NICU journey, and again - sometimes babies who have got almost well do die, however the odds of this happening to both/all 3 of a set are extremely tiny.
Furthermore, it is very odd how much she tried to insert herself into the families’ grief and the way she responded to the deaths from an emotional perspective- this simply isn’t the norm, and there were some absolutely huge behavioural red flags.
Almost every neonatologist and neonatal nurse I know, and that’s quite a lot, are convinced of her guilt on the balance of the evidence, and that’s just the publicly available evidence - more would have been available to the jury.
The unit itself sounds very poorly run, but again in the cases of a failing unit, deaths tend to come in clusters with a specific reason, ie you might see a spike in deaths close together from a particular type of infection, or from a lack of timely intervention, or from a specific type of drug error due to poor education practices. The diffuse pattern of the deaths is also in itself a red flag.