It's all about energy
The top four causes of neonatal death, no matter which specific unit or location in the world, are asphyxia (particularly birth asphyxia and trauma from complications during labour and delivery), infection (particularly sepsis and pneumonia), low Birth Weight/Prematurity and congenital malformations. All the babies in the Letby case series had at least one, and usually more than one of these. 50% of neonatal deaths happen in the first 48 hours. (from womb to tomb). Preterm babies are born in a negative energy state. They use energy quicker than their stores can resupply. A preterm baby has enough glucose to last only a few hours. Therefore, they need a lot of external help to survive. The help need not be overly technical nor difficult to achieve, but it is difficult to sustain day in and day out. Bubble CPAP and a central line will get you 90% success. But you need…