AN “unusual” amount of gas was detected in a baby just hours after his brother was allegedly murdered by nurse Lucy Letby, a court heard.

Letby, 33, is said to have administered fatal doses of air to both infants who died at the Countess of Chester Hospital on successive days in June 2016.

Child O – one of identical triplet boys – was pronounced dead at 5.47pm on June 23 only two days after he and his brothers were all born in good condition.

Following the death, his brother Child P was reviewed on the neo-natal unit by a consultant who ordered an abdominal X-ray.

The subsequent X-ray, timed at 8.09pm, noted “gas filled loops throughout the abdomen”, Manchester Crown Court heard.

Letby was the designated nurse for Child O and P on the day shift of June 23 and continued to care for Child P the following day.

On June 24, Child P collapsed on numerous occasions from 9.35am onwards and required resuscitation after his heart rate and blood oxygen levels plummeted.

Medics, including Letby, were unable to revive the youngster from his final collapse at about 3.15pm and he was pronounced dead at 4pm.

A transport ambulance team had arrived at the Countess of Chester at 3pm in preparation for transferring Child P to a specialist hospital.

When he died, his parents “begged” the team doctor to take their surviving triplet instead, which he agreed to.

Giving evidence on Thursday, March 16, Dr Owen Arthurs, professor of radiology at London’s Great Ormond Street Hospital, said the June 23 X-ray of Child P was “very similar in appearance” to one taken of Child O.

He told the court: “This is gas throughout the gut. This degree of gas is quite unusual in a baby like this.”

He said potential causes were infection or necrotising enterocolitis (NEC), a common bowel disorder in premature-born babies.

An alternative explanation was the administration of air via a nasogastric tube, he said.

Dr Arthurs came to the same conclusions regarding an X-ray of Child O, captured hours before his death.

He said: “This shows a lots of gas in his stomach, small and large bowel. This is more than what would be expected in a normal baby.”

Dr Arthurs agreed with Ben Myers KC, defending, that another possible explanation for Child P’s dilation was an “unidentifiable cause”.

On June 24, Letby was also assigned the day shift care of the surviving triplet, the court heard.

Ahead of the shift a doctor, who cannot be identified for legal reasons, messaged Letby: “Are you OK? It’s rubbish not to sleep well in the middle of 3 long days. Hope your day goes OK.”

Letby replied: “Hmm maybe. I’ll be watching them both (Child P and the surviving triplet) like a hawk.

“I’m OK. Just don’t want to be here really. Hoping I may get the new admissions.”

Letby, originally from Hereford, denies the murders of seven babies and the attempted murders of 10 others between June 2015 and June 2016.

The trial continues on Monday, March 20.