According to Lucy Letby: What can new parents expect when their newborn requires specialist care?

The facts of the Lucy Letby case are harrowing. A nurse has been convicted of murdering seven of her newborn patients and attempting to murder six others. And there are suggestions that managers in the healthcare system are making ignored the concerns was raised by some of Letby's colleagues, meaning opportunities to halt the killings and injuries may have been missed.

Anyone who has heard the coverage of the case will be shocked and concerned by it, but new parents and those who are about to become parents may be particularly disturbed by what is happening at the Countess of Chester Hospital.

Thankfully, cases like this are extremely rare. Although new parents are very unlikely to encounter anyone who is intentionally trying to harm their child, parents entrusting their baby to the care of a neonatal unit need to know what positive things to expect. In other words, what does good practice look like?

Good exercise

When treating young babies—or those unable to make medical decisions for themselves—healthcare professionals have a legal and ethical duty to act in the best interests of the child.

Although the child is the patient and rightly the focus of professionals' concerns, professionals recognize that parents are usually best placed to assess what is in their child's best interests. For this reason, physicians treating very young children must consult with and update parents on their child's condition and treatment, and obtain parental consent for any decision on how to proceed.

It is also understood that fostering closeness between parents and their children – even in the most unusual circumstances of a neonatal unit – is vital to the well-being of the child wellbeing and development.

A healthy environment for newborn care is therefore one in which parents feel welcome and involved – where they are encouraged to spend as much time as possible with their child and, wherever possible, to hold, feed and care for them to bathe.

Parents should be given every opportunity to bond closely with their child, and staff should respect that bond by recognizing the value of parental intuition, listening when parents express concerns about their child, and taking the time to Provide parents with desired information and explain anything that a parent is concerned or confused about.

If holding or otherwise caring for a baby is not possible due to the type of care the baby is receiving, this should be explained empathetically and alternatives offered where necessary.

For example, if parents are unable to hold a child, “comfort holding”—placing hands on the child's head and feet while the child remains in the cot—may be possible. When an urgent decision needs to be made about the treatment of a child and it is not possible to contact the parents to consult them and obtain their consent, this should be spelled out in detail at the earliest opportunity and the parents should be involved at that time.

whistleblowing

What if the unthinkable happens and someone entrusted with caring for an at-risk young child tries to harm them? Although an alarming feature of the Letby case is the allegation that concerns raised by Letby's colleagues were dismissed or ignored by managers, we should note that such concerns existed in the first place.

When something is seriously wrong in healthcare, professionals notice, and at least some of them are willing to report whistleblowers. Following this harrowing case, we can count on a thorough investigation and the pledge that no NHS station will ever be a hostile environment for whistleblowers.

The circumstances that allowed so many of the NHS's most vulnerable patients to be murdered and injured are likely to be even rarer from now on.

When a child is born requiring specialized newborn care, it is always a scary and vulnerable time for parents and families. In the midst of this agony, parents have a right to be respected, supported, and treated with care themselves.

In the vast majority of cases, staff caring for sick newborns will do their best to provide expert and compassionate care to the children they care for, and they will encourage parents to be as involved as possible the condition of your child allows.