LL Part 21: Reflections on Baby G

Why are there so many unanswered questions?

PLEASE NOTE: If you are involved in the Appeal of Conviction or retrial of Lucy Letby on the charges related to Baby K, please stop reading and close your browser.

Following on from our last post on the Lucy Letby Trial here.

This will be a short post, but in reading around baby G I was left with the suggestion of a couple of ‘coincidences’… and I don’t like coincidences.

One of the first issues used to suggest Letby harmed Baby G was when Baby G projectile vomited over 100mls after a 45ml feed - a feed that had been administered not by Letby, but by the unnamed nurse.

Dewi Evans when giving testimony said that Baby G had been overfed with ‘potentially catastrophic consequences’. Also, in a trial where statistics were not allowed, and in a way that almost sounded like she was both chastising and belittling the jury, Dr Bohin said in a schoolmarm way that it was ‘basic arithmetic’ - two large milky vomits plus 30mls of aspirate meant Baby G had been fed much more than she should have been. Evans went on in a later TV interview to exaggeratedly describe the 100ml vomit that got on the hood of and chair beside the cot as ‘vomiting all over the ward’. However, Dr Ventress, who was there at the time, testified that the 100ml ‘could have been air’ - although she admitted she could not be sure. Dr Brearey, who was also working in the unit with Dr Ventress on the day, failed to even record the 100ml event at all!

The issue here is that while Evans et al are happy to ascribe the 100mls that Dr Ventress was not certain hadn’t been air, to forced feeding of Baby G by Lucy Letby - not one of them discusses the other potential causes for Baby G being unwell. Nor did any of them tell the jury that projectile vomiting in babies is a completely common occurence, or that in severe cases it can be caused by a blockage or thickening of the muscle at the outlet of the stomach. This condition is known as pyloric stenosis and was not expressly checked for in Baby G’s case.

First, during the days before the crash Baby G was being given doses of medicine that Dr Brearey described as being administered to help Baby G open her bowels. While he testified that she had no blockage, and the x-rays while non-specific were, to some degree, in agreement. However, there still seems to have been concern that Baby G was not having bowel movements suggesting that there was an issue with her bowels - either they were not functioning (constipated), were not patent (blocked), were afflicted due to infection (sepsis and NEC can fill the bowels with gas and in protracted cases can cause inflammation of the bowel tissues, potentially damaging and killing off parts of the tissue that can require surgical removal), or there was some other as-yet unknown reason why Baby G was not defaecating and therefore required what was, presumably, laxatives. Often glycerol suppositories are used in neonates as stimulant laxatives, but osmotic laxatives (stool softeners) may also be used. If medication to help Baby G open her bowels was being administered, this confirms the nurses notes that she had not had her bowels open during the shifts prior. All those feeds that were being administered to Baby G had to go somewhere - and it is not uncommon for the constipated person to eventually, after a few days of limited or no bowel movements and in response to the pressure in their digestive system, to start to bring up first the most recent feeds from the stomach and duodenum, and later, the even more malodorous contents of the bowels.

Therefore, it is possible that the 100mls may have been the current feed (45mls) and portions of the previous feed and stomach juices that had accumulated in the stomach and duodenum that, under pressure due to constipation or gasses from a rising NEC infection, were simply expelled when the pressure got too great.

Second, and also during the 24-48 hours prior to the vomit and crash, Dr Brearey testified that he had administered a vaccine to help Baby G with her chronic lung condition. The clinical notes read for Baby G and Dr Breary’s testimony do not elucidate as to what this magical vaccine was, but it is not uncommon for doctors to prescribe a fluvax and a pneumococcal vaccine, to neonates with chronic lung conditions. The evidence for their administration for this reason is specious at best, with the supposed intent being to prevent pneumonia in the neonate. Also, doctors have been known to administer them to inpatient neonates even against parents instructions. In the case of Prevenar 13, the pneumococcal vaccine approved for use in babies under 2, the manufacturer safety leaflet describes nausea and vomiting as common side effects after administration (here). Further, the manufacturer safety leaflet also says that Prevenar 13 should be delayed (i.e. not given) if the infant has an infection, high fever or weakened immune system. Given her prematurity and other significant medical conditions, and the fact that the doctors who testified admitted they were already querying whether Baby G had sepsis or NEC infections, administration of Prevenar 13 would have clearly been contraindicated. Yet it seems that not only did Dr Brearey vaccinate Baby G anyway, both he and his medical colleagues failed to consider that nausea and vomiting as was seen in Baby G the next day, were common side effects of that administration.

Is it possible that either, or, given the evidence, both of these in combination, caused the projectile vomiting?

Is it possible that the projectile vomiting was just yet another symptom of the infection escalating inside the poorly neonate?

And, are these possibilities more likely than the idea that Lucy Letby, who did not administer the 45ml feed (nor the most recent feeds before it), somehow, from where she was caring for a different neonate in the room next door, forcefully overfed Baby G?

Remember that she was only called in AFTER Baby G had suffered these events.

E&OE

ADDENDUM:

A side note that I should have considered in the above article is this: It is also common for doctors to vaccinate these inpatient neonates twice - at 6 and 14 weeks - with the Rotovirus vaccine. While the vaccine manufacturers and doctors would like you to believe it is unicorn rare, the rotovirus vaccine has caused enough neonates and babies to develop intussusception that some lecturers actually warn midwives and SCN/Neonatal nurses about it during their training. Intussusception causes the intestine to literally fold over on itself - wherein one part of the intestine slides or 'telescopes' into an adjacent part of the intestine. This action blocks the passage of food or fluid, causes abdominal pain, projectile vomiting, bloating and, on occassion, watery bloody stools. The NHS says it is so rare that it affects 1/100,000 babies (0.001%). The CDC say it is 500% more likely - at 1/20,000 (0.005%). A 2020 study found 5/346 (1.45%) after the first dose, and when dose 2 cases were also tallied, their study had a total of 38/346 cases (11%) - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146001/). When real-world studies report rates of post-vaccination intussusception as high as 11% - that is HARDLY rare.

Part 22 of my series on the trials of Lucy Letby can be found Here