May 2026: Thirlwall Inquiry report delayed to at least September 2026 · six-baby inquests relisted to 2027 · CCRC review active · Shoo Lee Panel: no medical evidence of deliberate harm.
On certain counts the prosecution proposed that Letby had deliberately over-fed infants via nasogastric tube, causing aspiration (milk drawn into the lungs) and collapse. On Child G in particular, feed volumes were cited as abnormal and deliberate.
Neonatal feed volumes are calculated per kilogram and adjusted per baby per feed based on tolerance. Feed volumes described at trial as 'excessive' fall within the published tolerance ranges for the gestation and weight of the infants concerned. Aspiration is a common and well-documented cause of sudden deterioration in very preterm babies, independent of any wrongdoing — their gag reflex is underdeveloped and their anatomy favours reflux. On Child G, the count where the over-feeding mechanism was most directly alleged, the Shoo Lee Panel found no evidence of over-feeding at all: it attributes the deterioration to infection, possibly enterovirus, and notes that the gaseous distension relied on appears on X-rays that were all taken after bag-and-mask ventilation had been given.
Serious aspiration-driven deteriorations in extremely preterm infants are, regrettably, routine on neonatal units. They are not, in themselves, evidence of deliberate harm — and in Child G's case the Panel found no evidence of over-feeding at all.
The jury heard specific feed-volume figures described as excessive. The context — that neonatal feed tolerance varies widely between babies and even between feeds in the same baby — was given less prominence.
The Panel found no evidence of overfeeding in Child G — the case in which the over-feeding mechanism was principally alleged — and attributed the deterioration to infection, possibly enterovirus. The gaseous distension relied on appears on films taken after bag-and-mask ventilation.