21m ago14:48
Child left brain damaged following 'near death experience' - as Letby made note in her diary
Child M had a "remarkably speedy recovery" from his "near death experience", the court is told as the prosecution opening continues.
One independent medical expert said he "would not have expected such a prompt recovery" had the cause been infection or some other lung problem.
They concluded an injection of air, or an obstruction of his airway, was most likely, the prosecution says.
A neurologist reviewed a later brain scan from Child M and found brain damage "which was, in his opinion, most likely caused by his cardio-respiratory collapse" on 9 April 2016.
The court is then shown an image of Letby's diary from the time, in which she had made a note of the incident.
Letby "denied the notes were a souvenir" and denied deliberately trying to harm Child M. She could think of no reason of how he would have suffered an air embolism, according to police interviews.
The prosecution says the case of twins L and M are similar to that of twins E and F, where one suffered an insulin overdose and another an injection of air.
"What are the chances of that happening innocently?" Mr Johnson asks the jury.
"We suggest that coincidences like that simply do not happen innocently.
"Someone was responsible and we suggest the only credible candidate is Lucy Letby."
13m ago14:56
Letby used Child N's haemophilia as a 'cover to attack' him
The prosecution opening has now moved on to Child N, who was born premature, but his clinical condition was described as "excellent".
The prosecution allege Letby tried to kill him on three occasions.
He was born with haemophilia, a disease which can cause bleeding for no reason, or a trivial reason. Staff at the hospital attributed many of the episodes to this.
However, Nick Johnson KC says: "Subsequent investigation has shown Child N has a mild version of the disease.
"Children with a mild level of haemophilia rarely bleed for no reason."
This, Mr Johnson says, "gave her cover to attack Child N".
He continues: "Because if she caused a bleed she thought it would be put down as haemophilia.
"She was right."
Letby later texted a friend saying she was going to Google haemophilia, saying it was a "complex condition, yeah 50:50 chance antenatally".
Mr Johnson tells the court: "No doubt this is what her Google research had told her.
"It appears therefore that Lucy Letby thought Child N was lucky to be alive."
11m ago14:57
Pre-term baby 'screamed' for 30 minutes after injury 'inflicted by Letby'
The child's designated nurse said he was stable until he went for a break at around 1am.
At 1.05am Child N experienced a "sudden deterioration" which was consistent with some kind of "inflicted injury which caused sever pain, distress and destabilised him", the prosecution says.
Unusually for a pre-term baby, he was described as "crying and screaming".
Independent medical experts said this was "consistent with inflicted injury or having received an injection of air", jurors were told.
His recovery was prompt - which would not be consistent with an infection.
One of the medical experts wrote: "This is life threatening. He was also noted to be... 'screaming' and apparently cried for 30 minutes.
"This is most unusual.
"I have never observed a premature neonate to scream."
Now15:09
Incident one: Child N had swollen throat with 'fresh blood'
Twelve days later, on 15 June 2016, there were two more incidents, the prosecution tells jurors.
At 8am, Child N's oxygen levels had fallen to 48%. A decision was made to intubate him.
The doctor doing so said "he was surprised by his anatomy more than anything else. I couldm't visualise the back of his throat because of swelling".
There was "fresh blood" in Child N's throat - something, the prosecution says, that had been seen before in previous children.
He attempted to intubate Child N on three occasions but was "unable to get the breathing tube down his throat".
Medical notes shown to the jury show that Letby later recorded that Child N had vomited 1ml blood.
The prosecution says that apart from one Facebook message to a doctor, there is "no evidence she brought the bleeding to the attention of any of the medical staff on the ward, which is surprising", given that Child N had collapsed in the first three hours of the shift.
Lucy Letby trial - latest: Nurse 'smiled' to parents of premature baby girl after killing her at fourth attempt, court hears
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